Does Milk Constipate Kids? (Pedcast)

 

I had an interesting discussion with a family the other day about their five-year-old son who has been chronically constipated. They were concerned about having to give him laxatives almost daily for his chronic constipation.  I agreed with them,  they should have been concerned. The laxative they were giving him has never been tested in children and was intended for short-term use in adults only. After talking about his diet, I discovered that their son loves milk and drinks about 30 ounces a day. I was pretty sure that his large milk intake was causing his constipation and that eliminating much of his dairy would solve his need for laxatives. They couldn’t see the association of lots of dairy intake and constipation so I thought since  this conversation was useful for these parents, maybe my audience would like to hear about the connection between milk and constipation.

I started our “constipation conversation” by posing this question– how do cheese makers make cheese? Well you can imagine I got a rather blank look from these parents because of that question but I knew, understanding this process, would give them a good understanding of why their child was so constipated. Here is the process. First you start with warmed milk (about body temperature) and  blend in some bacteria. Lots of bacteria and some molds. You mix it well, and put that mixture in a warm dark place and you give it some time to grow. Next you add some enzymes that are found in the intestines of cows interestingly enough and cheese starts to form. The longer the fermentation process goes on, the harder the cheese that is  going to be the final product.

Well I think you can see where I was going with this conversation.  The conditions in their sons intestines are exactly the same conditions that are needed to ferment milk into cheese a substance that is thick and hard and very difficult to push through a child’s intestines. For many kids, lots of milk means constipation. This family was having to give their son a daily laxative that chemically bound to water to make his poop wetter and softer, just to allow him to push his poop through his intestines. That’s horrible. Lots of kids have problems with chronic constipation and I think a lot of them simply can’t digest and eliminate cows milk. Milk is not the perfect nutrient for a lot of children, pure and simple.

Additionally since he was not drinking water, his stool was becoming very hard and his intestines were absorbing what little water was left in his poop. His poop therefore became dry and hard. Add a diet high in fat and low in fiber, a sedentary lifestyle, and a lack of access to a bathroom for long periods of time, and you can see why so many children have trouble with chronic constipation.

So here’s what I suggested they do;

  1. Stop most of his milk intake and give him soy milk or almond milk instead.
  2. Increase his water intake and as much as what they could get in them.
  3. Make sure the bathroom is available and easy for him to use even at school.
  4. And finally try and increase his level of physical activity that’s possible.

I haven’t spoken with him since our conversation but I’m pretty sure based on my previous experience with other families that he will not be taking laxatives the next time I see him. Understanding how milk turns into cheese in a child’s intestines and how that can cause constipation is fundamental to understanding a lot of the digestive problems that kids have.
Well I hope that talk was helpful. Thanks for joining me as always. My blog is growing and becoming very popular. For that, I’m very appreciative to you, my audience. Please take a few minutes to subscribe at my website to get and email blast about my the latest content. For you podcasters, subscribe on itunes for new content. As always, I love to hear from you so keep your comments coming. And if you are a big DocSmo junky, get ready for my book that should be available for purchase In March 1st, 2015. I think you are going to love it. This is Doc Smo, hoping you now have the scoop, if your child has trouble with poop. Until next time.

 

 

 

Smo Notes:

 

Intolerance of Cow’s Milk and Chronic Constipation in Children

http://www.nejm.org/doi/full/10.1056/NEJM199810153391602

3 Comments

  1. Christina says:

    I’m so glad you posted this. Our pediatric doc had no problem recommending miralax… But I’d much rather not. I wish we’d made water more of a habit early on with our 4 year old, but it’s never too late to start!

    • DocSmo says:

      Allison, Great question. Soy products, be they soy milk or any other have been controversial in pediatrics as long as I have been a pediatrician. I think there is some very mild estrogen effect of soy products but I don’t think it is biologically relevant. I believe that the Asian world consumes far more soy than we do in America and has no history of health problems from them to my knowledge. For me, that’s a real world test that tells me not to worry about soy. As you might know, the Academy of Pediatrics now does not recommend soy based formula for infants but for reasons other than any estrogen effects. I hope that helps. Doc Smo

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