Fluid and Fiber

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Fiber is normally ingested in the diet, and part of fiber cannot be broken down. A diet rich in fiber produces soft and more frequent stool and can help with constipation. There are two types of fiber, both of which are important in your child’s diet:

1. Soluble

  • Creates larger, softer stool
  • Good sources: beans, fruit, oat products

2. Insoluble

  • Increases stool bulk
  • Good sources: whole-grain products and vegetables

Daily fiber recommendations

Use this formula to figure out how much fiber your child needs daily:

Minimum: Child’s age + 5 = grams of fiber needed per day
Maximum: Child’s age + 10 = grams of fiber needed per day
Example: Eric is 10 years old. The amount of fiber he needs daily is: 10 (his age) + 5 = 15 grams per day, minimum 10 (his age) + 10 = 20 grams per day, maximum Eric needs 15–20 grams of fiber per day.

Tips to encourage and increase fiber intake

  • Include a variety of food sources at meal times that contain fiber, such as fruits, vegetables, whole grains, and nuts.
  • Slowly increase the amount of fiber your child eats over the course of a few weeks to meet his/her fiber goal. Rapid increase may make the constipation worse or cause gas, cramping, bloating, or diarrhea.
  • Drink plenty of fluids. Fiber works best with adequate fluids, which will help soften the stool and make it easier to pass.
  • On certain occasions, your physician may recommend over-the-counter fiber supplements (Benefiber, Metamucil, etc.) if dietary fiber is insufficient.

Ways to incorporate fiber at meal and snack times

Breakfast

  • Original rolled oats instead of instant oats
  • Whole grain cereals or bran
  • Add sliced apples, peaches, or berries to cereal or oatmeal; keep the skin on for extra fiber
  • Whole wheat flour when making muffins, pancakes, and waffles

Lunch and dinner

  • Brown or wild rice instead of white rice
  • Whole wheat breads for sandwiches
  • Whole wheat pasta instead of white pasta
  • Add vegetables to pizza, tacos, and pasta
  • Add beans to soups

Snacks

  • Popcorn, whole grain pretzels, whole grain fruit and granola bars, and whole grain crackers
  • Dried fruit (prunes, raisins, and cranberries)
  • Add fruits and vegetables to smoothies
  • Puree black beans or chickpeas to make dips

Choose high-fiber fruits and vegetables at all meal times

• Eat raw fruits and vegetables with the skin on.

• Choose fresh fruits and vegetables instead of juices.

• Fruits, including green kiwis, dates, figs, pears, apples with skin, prunes, and raisins are helpful for constipation management.

Reading food labels

When grocery shopping, read the labels to see how much fiber a product contains. It will list the amount of fiber per serving. The first ingredient listed should be whole grain or whole wheat.

Choosing foods with at least 3 grams of fiber per serving will help your child meet his/her daily fiber goal.

Fiber-containing foods

Breads/muffins:
1 slice whole wheat, rye, or pumpernickel bread: 1- 2 grams
1 small corn tortilla: 1- 2 grams
1 small bran muffin: 3- 4 grams

Cereals:
1 cup Corn Flakes or Fruit Loops: 1- 2 grams
1 whole-grain Pop-Tart: 3 grams
1 cup Cheerios: 3 - 4 grams
½ cup Quaker old fashioned oats: 3 - 4 grams
1 cup Kashi: 9 grams

Fruits:
10 grapes or 1 cup cantaloupe or pineapple: 1 - 2 grams
1 medium-size banana, kiwi, peach, or plum: 1 - 2 grams
1 cup blueberries or strawberries: 3 grams
6–8 prunes or 1 medium pear: 4 - 5 grams
1 cup raspberries: 8 grams

Vegetables:
1 cup raw spinach or ½ cup broccoli, green beans, corn, or raw carrots: 1–2 grams
½ cup green peas, brussels sprouts: 3 - 4 grams
1 medium sweet potato with skin: 3 - 4 grams
½ cup lima beans: 8 grams

Pasta/rice:
½ cup whole wheat pasta: 3 - 4 grams
1 cup brown rice: 3 - 4 grams

Dried beans/nuts/peas:
1 ounce nuts or ½ cup seeds: 3 - 4 grams
½ cup kidney beans, pinto beans, or chickpeas: 5 - 6 grams

Snack foods:
1 serving whole-grain goldfish: 1 - 2 grams
6 Triscuit crackers: 3 - 4 grams
3 cups popcorn: 3 - 4 grams
Kashi granola bar: 4 grams

Fluids

Fluid helps soften stool and make it easier to pass. Adequate fluid is important when increasing fiber in the diet. Water is the best source, but fluid can also come from healthy beverages and even some foods. Clear or pale urine is a good sign that your child is hydrated.

Daily fluid recommendations Note: 1 cup = 8 ounces
Age: 1-3 years Ounces/day = 45 - 50 ounces Cups/day  = 5.5  - 6 cups
Age: 4-8 years Ounces/day = 55 - 60 ounces Cups/day  = 7  - 7.5 cups
Age: 9-13 years Ounces/day: Males = 80 - 85 ounces, 10 - 10.5 cups Females = 70 - 75 ounces, 8.5 - 9 cups
Age: 18-18 years Ounces/day: Males = 100 - 110 ounces, 12.5 - 14 cups Females = 75 - 80 ounces, 9.5 - 10 cups

Types of fluid

1. Water

  • This is the recommended source of fluids.

2. Juice

  • Choose 100% fruit juice – apple, pear, and prune juices can help with constipation.
  • Substitute half of juice with water to increase overall fluid intake.
  • Limit to the following: 1 - 3 years old: up to 4 ounces daily; 4 - 6 years old: up to 4 - 6 ounces daily; 7 - 18 years old: up to 8 ounces daily.

3. Milk

  • 1–2 years old: 2 cups daily; offer whole milk; reduced fat (2%) milk is recommended if obesity is of concern or if there is family history of obesity, dyslipidemia, or cardiovascular disease.
  • 2–8 years old: 2 cups daily - Offer low-fat (1%) or fat-free (skim) milk.
  • 9+ years old: 3 cups daily -  Offer low-fat (1%) or fat-free (skim) milk.

4. Sports drinks

  • Use only with prolonged, vigorous physical activity (>90 minutes).

5. Soda/energy drinks

  • Not recommended for children or adolescents.

Ways to increase fluid intake

  • Flavor water with cut-up fruit, vegetables, or herbs.
  • Offer fruits and vegetables that are high in fluids, such as grapes, watermelon, cucumbers, oranges, celery, strawberries, blueberries, and kiwis.
  • Include low-sodium broths and soups at meal times.
  • Snack on fruit popsicles, Jell-O, or Italian ice.
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition
The Association of Pediatric Gastroenterology and Nutrition Nurses
North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Foundation
The NASPGHAN Council For Pediatric Nutrition Professionals
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