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Childhood Constipation

Constipation is often considered as the most common gastrointestinal disorder in children and is usually associated with low-fibre intake.  Most constipated children (90–95%) suffer from functional constipation3,6, characterized by decreased bowel movements and/or hard stools, which cause significant distress for children and their caregivers. “Functional” implies the absence of organic causes with a focus on behavioural aspects1.

During infancy, the transition from breastfeeding to formula feeding or the introduction of solid foods is sometimes a trigger for the onset of functional constipation10. Symptoms of functional constipation include infrequent depositions, possibly painful, and large and hard stools with or without faecal incontinence. Regarding therapeutic options, some evidence exists about prebiotic dietary fibre and their benefits on intestinal functions3.

Prebiotics may help babies with constipation

Breast-fed infants have an intestinal microbiota dominated by Bifidobacterium and Lactobacillus and this is quite different from those fed with a standard infant formula5.  Breastmilk is gifted with both prebiotic and probiotic properties which standard infant formula doesn’t. Today’s infant formulas are often fortified with prebiotics to better mimic properties of human milk with respect to its effect on gastrointestinal microbiota composition and function2.

The effectiveness of prebiotics is due to their ability to resist digestion and to reach the large intestine, where they are completely fermented by the gut microbiota and are leading to a selective increase of beneficial bacteria8. Infants on these supplemented formula with prebiotics inulin and oligofructose have a lower stool pH, a better stool consistency and frequency and a higher concentration of bifidobacteria in their intestine compared to infants on a non-supplemented standard formula4,7,9.

Conclusion

Supplementing the baby’s diet with prebiotic inulin-type fructans seems to be promising for treating functional constipation in infants and young children3. At DPO International, we are honoured to be in partnership with Beneo Orafti to bring you a wide range of ingredient choices that will elevate the nutritional quality of your baby food products.

References

1Avelar Rodriguez, D., Popov, J., Ratcliffe, E., & Toro Monjaraz, E. (2021). Functional Constipation and the Gut Microbiome in Children: Preclinical and Clinical Evidence. Frontiers In Pediatrics, 8. https://doi.org/10.3389/fped.2020.595531

2Borewicz, K., Suarez-Diez, M., Hechler, C., Beijers, R., de Weerth, C., & Arts, I. et al. (2019). The effect of prebiotic fortified infant formulas on microbiota composition and dynamics in early life. Scientific Reports, 9(1). https://doi.org/10.1038/s41598-018-38268-x

3Closa-Monasterolo, R., Ferré, N., Castillejo-DeVillasante, G., Luque, V., Gispert-Llaurado, M., & Zaragoza-Jordana, M. et al. (2016). The use of inulin-type fructans improves stool consistency in constipated children. A randomised clinical trial: pilot study. International Journal Of Food Sciences And Nutrition, 68(5), 587-594. https://doi.org/10.1080/09637486.2016.1263605

4Closa-Monasterolo, R., Gispert-Llaurado, M., Luque, V., Ferre, N., Rubio-Torrents, C., Zaragoza-Jordana, M., & Escribano, J. (2013). Safety and efficacy of inulin and oligofructose supplementation in infant formula: Results from a randomized clinical trial. Clinical Nutrition, 32(6), 918-927. https://doi.org/10.1016/j.clnu.2013.02.009

5Hojsak, I., & Pavic, A. M. (2014). Supplementation of prebiotics in infant formula. Nutrition And Dietary Supplements, 69. https://doi.org/10.2147/nds.s39308

6Kranz, S., Brauchla, M., Slavin, J., & Miller, K. (2012). What Do We Know about Dietary Fiber Intake in Children and Health? The Effects of Fiber Intake on Constipation, Obesity, and Diabetes in Children. Advances In Nutrition, 3(1), 47-53. https://doi.org/10.3945/an.111.001362

7Oswari, H., Widodo, A., Handayani, F., Juffrie, M., Sundjaya, T., Bindels, J., & Hegar, B. (2019). Dosage-Related Prebiotic Effects of Inulin in Formula-Fed Infants. Pediatric Gastroenterology, Hepatology &Amp; Nutrition, 22(1), 63. https://doi.org/10.5223/pghn.2019.22.1.63

8Roberfroid, M., Gibson, G., Hoyles, L., McCartney, A., Rastall, R., & Rowland, I. et al. (2010). Prebiotic effects: metabolic and health benefits. British Journal Of Nutrition, 104(S2), S1-S63. https://doi.org/10.1017/s0007114510003363

9Vandenplas, Y., Greef, E., & Veereman, G. (2014). Prebiotics in infant formula. Gut Microbes, 5(6), 681-687. https://doi.org/10.4161/19490976.2014.972237

10Walter, A., Hovenkamp, A., Devanarayana, N., Solanga, R., Rajindrajith, S., & Benninga, M. (2019). Functional constipation in infancy and early childhood: epidemiology, risk factors, and healthcare consultation. BMC Pediatrics, 19(1). https://doi.org/10.1186/s12887-019-1652-y