That’s right, we are talking about all things poop in this week’s episode. This includes constipation, poop patterns while weaning, and everything else that comes into play when weaning your child off their feeding tube. This is an important topic to discuss because it can be a large factor during a wean if a child is feeling off. Heidi and Jennifer dive right into the poop talk and discuss what to consider so that your child is feeling good throughout their weaning journey and can continue to move forward. While participating in a tube wean in any program, it is likely that when reducing tube delivered nutrition and hydration, your child may be at risk for constipation. This episode will break down how to have that conversation with your doctor prior to starting your wean. Throughout the Thrive Tube Weaning Program, we always work with your child’s physician during our evaluation, intensive treatment, and follow up.  Your hosts will talk about why it is so important to work with your medical team, how to start this conversation, and tips for being prepared prior to starting your wean. 

You can download this episode from Itunes, Stitcher, Spotify, Google Play, or listen to it below:

Talk to your doctor! 

At Thrive, we start the conversation with your doctor during the preparation phase of treatment. This involves discussing a prevention plan for keeping children from getting constipated. Once doctors have agreed that weaning is the right path for the child, the discussion then turns to parameters. Our general parameters were discussed in a previous episode, but we felt it was important to highlight the conversation about constipation. 

Kids eat less when constipated 

Kids do not eat very well when they are feeling constipated, and therefore it’s important to have the conversation about prevention prior to getting started. This is not something that most families of children with feeding tubes have to confront while their child is tube-fed. Typically a child on a liquid diet or a predictable tube schedule has regular bowel movements, although not all the time.

Let’s prevent it rather than “fix” it 

Constipation is much easier to prevent than it is to fix, why is why it would help to have this conversation prior to getting started on a wean. Instead of asking what to do WHEN it happens, we want to talk with your medical team about what we can do preventatively. What can we do? 

• Every child is different, and every physician may have different recommendations so it is important to consult with your doctor 
• At Thrive, we often work to keep children more hydrated and replace any decreased calories with some hydration.  

• Prune juice or pear juice is something that parents have mentioned before that we have found helpful when working to prevent constipation from occurring, especially when transitioning diets. 
• Have a conversation with your therapy team about what they have done in the past, if they have ever done anything, and what their medical team recommended for the future 
• Ask specifics: Some doctors may just give a prescription for a stool softener, but ask specifically: WHEN to give the medicine, HOW to mix it, etc. 
• Discuss possible combinations of medicine with your medical team to help prevent the constipation from starting or worsening. 

Our preference at Thrive is that there is always a preventative measure in place. We have seen in our practice that if a child is already constipated, it may take them a longer period of team to wean because as all kids, they tend to not eat well for a few days (which is normal!). Throughout the weaning process, there is so much that we can’t control as caregivers and therapists, but this is one factor that we can try to prevent and take control over. Having a plan in place with your therapy and medical team is crucial. 

We continue to work with physicians throughout follow up as well because some children may need it for a longer period as they transition to different foods or to a completely different diet. Their little bodies are already working SO hard to learn to eat, if we can help take some of that pressure off the GI system, it may help them! We know that the entire point of tube weaning is to help children establish a positive association with how their body feels and relates to food. IF they are constipated while learning this or associate it with pain, then that does not help to build that association. 

We hope this is helpful to families as we have found these tips and strategies very helpful in our practice and when working with medical teams!