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  • By Steve Hodges, M.D.,

Does Dairy Cause Constipation in Children?

Parents in my clinic are often stunned when they see, right there on an X-ray just how clogged their child’s rectum is. The X-ray answers one of their big questions: What is causing my child’s bedwetting? The enlarged rectum is pressing against their child’s bladder — it’s easy to grasp.

But X-rays can’t answer the other big question parents ask: How in the heck did my kid get so constipated?

As I explain in The M.O.P. Book and It’s No Accident, the constipation epidemic has three main causes: 1.) the highly processed Western diet, 2.) toilet training too early, and 3.) restrictive school bathroom policies. Most cases of chronic constipation can be traced back to one or more of these factors. But lately I’ve been getting a lot of questions about another possible contributing factor: dairy.

Parents ask: Could dairy be constipating my child? Could eliminating cow’s milk stop the bedwetting?

Based on published research and reports from parents in my clinic and in our Facebook support group, I think that yes, in some children dairy is a significant contributor to constipation. Is it the sole cause? In some kids, maybe. In other kids, no.

As for the second question — Could cutting out dairy resolve the accidents? — the answer is usually no (though there are exceptions). Even for children highly sensitive to this food group, eliminating cow’s milk products does not appear to be a substitute for the Modified O’Regan Protocol.

However, for children who are already on M.O.P. and who are sensitive or allergic to dairy (possibly to the proteins in cow's milk), an elimination diet may prove helpful, both in speeding up results and in preventing a relapse. If you do go this route, check with your pediatrician so the nutrients your child gets from dairy, such as calcium, are supplemented elsewhere in your child’s diet.

The parents in our support group report a wade range of responses to eliminating dairy. Some say it has made no difference at all. Some say their child feels less bloated but accidents persist. Other say it’s been a huge help in reducing accidents.

One mom posted, “Cutting out dairy had a clear impact within 3 days. I thought we were sorted out, so I stopped the constipation meds, only for the accidents to start again about a week later. We now are full on with M.O.P. and also limit dairy. Too much dairy and she will have a relapse.”

Another mom posted: “Cutting out dairy has helped immensely, but we still do M.O.P. When my daughter cut out dairy, she stopped leaking poop almost immediately. When the doctor said to reintroduce it after 9 months, she started soiling again three days later.”

You can read the full dairy discussion in our ebook Answers to 52 Questions About M.O.P. It’s question #16.

Once a child is constipated to the point of having accidents, simply removing dairy from a child’s diet does not usually solve the problem. That’s because the holding habit is deeply ingrained in children. If a child has been withholding stool for years because dairy made pooping painful, the child may continue to withhold — out of habit or fear of pain — even when pooping no longer actually hurts.

Does Research Show Dairy Causes Constipation in Children?

There’s not a huge body of literature exploring a possible dairy-constipation link in children. However, a number of published studies do support a link in some children.

For example, researchers in Spain studied of 69 children who’d been referred to a GI clinic for chronic constipation. In 39% percent of the kids, constipation resolved within a week when they cut out cow’s milk and came back when cow’s milk was re-introduced into their diet. During the period of improvement, these kids went from pooping 2.9 times a week, on average, to pooping 7.7 times. An additional 11% of the kids improved when dairy was eliminated and did not become constipated again when dairy was re-introduced.

Meanwhile, 49% of the children saw no improvement when they cut out dairy.

The researchers did not report on how many of these constipated children also had enuresis (wetting) or encopresis (poop accidents) or whether, among the “responders,” cutting out dairy had enough of an impact to resolve toileting problems.

In another study, conducted in Iran, researchers tracked 140 children whose constipation had not resolved on PEG 3350 (Miralax), lactulose or other oral laxatives.

The study found that 80% of the children showed improvement in constipation symptoms after excluding cow's milk products. The researchers concluded: “Chronic constipation can be a manifestation of cow's milk allergy in children. At present, although many questions exist that have no answer, a therapeutic trial with elimination diet is advisable in all children with constipation unresponsive to correct laxative treatment.”

In other words, cutting out dairy is worth a try.

I agree with that but, again, would not count on dietary changes to reverse bedwetting or accidents. No matter what dietary changes you experiment with, make sure your child mostly eats whole foods with plenty of fiber and drinks lots of water.

You can download Answers to 52 Questions About M.O.P. here and The M.O.P. Book here.

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Must-read books for kids by Steve Hodges, M.D.

• Bedwetting and Accidents Aren't Your Fault

• Jane and the Giant Poop

CONTACT​ US

Feel free to contact Dr. Hodges or Suzanne directly:
shodges@wakehealth.edu
suzanne@bedwettingandaccidents.com

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