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Tubies, Constipation & Growing Up Prebiotics

Published October 05, 2022

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Our Favorite Tubie and Constipation Relief Tips

Constipation is one of the many evils that parents battle in an effort to keep their children healthy and happy. As the parent of a child that receives tube feedings, AKA a Tubie, you likely know all too well how constipation can disrupt everyday life. Here I’m going to cover tips for your Tubie and constipation.


Typical Fixes Don’t Work

Constipation in a Tubie is generally not caused by poor diet habits. Children that require tube feeds can also suffer from hypotonia, gastroparesis, formula intolerance, delayed transit, and other medical issues that result in constipation. Typical fixes that may benefit a child may not be achievable. For example, increasing physical activity and intake of fruits and vegetables and increased fluid are not gunna happen.


Check Formulas and Try to Make Blends at Home

Commercial tube feeding “enteral” formulas have evolved tremendously in the past five years. There are now options for real foods blended into formulas that are thin enough to be administered through a pump or syringe and plant-based formulas that have natural fiber sources that can more closely mimic the dietary recommendations and meet fiber goals. Another option for parents is to make their own foods and home blend for their tubie!


Even with these options available, managing constipation may require the use of medications, adding to an already long list of daily medications you may find yourself managing.

Summary -Parents with a Tubie have limited options to manage constipation. Options include real food blends, plant-based formulas, and making home blends.

Have You Heard of HMOs?

Most of us know what fiber is, but what are HMOs? Do you constantly worry about your Tubie’s immune system? HMOs are Human Milk Oligosaccharides, the 3rd most abundant component of breast milk. They are unique to breast milk but are now being added to infant formulas. Research shows HMOs work to feed our good gut bacteria and promote the development of the immune system by preventing harmful bacteria and viruses from attaching to the lining of the intestinal tract! 1% of the HMOs consumed are even absorbed and reach the systemic circulation, having a direct impact on immune function.

How HMOs Help Tubies and Constipation 

Researchers studied the effects of oligosaccharides on constipation in animals. Oligosaccharides were given to healthy mice once a day for 17 days. Oligosaccharides were shown to treat constipation. They increased the water content in the stool, reduced the time of intestinal transit, changed the composition of the intestinal microflora and increased the concentration of short-chain fatty acids in the stool of mice with constipation. After oligosaccharide treatment, Lactobacillus and Bifidobacterium dominated in the intestinal microbiome.


A recent HMO supplementation study was conducted in 75 children consuming 2′-O-fucosyllactose (2′FL) at various daily doses and mixtures for 8 weeks. It was shown that 2′FL supplementation in daily doses up to 4.5 g is safe and well-tolerated in children. Results showed supplementation modified the microbiome of the intestines, decreased the relative abundance of harmful or pathogenic bacteria and promoted the growth of beneficial Bifidobacteria. HMO diet supplementation may be a valuable tool in shaping the human gut microbiome, improving gut regularity and the immune system.


Try Begin!

Begin Health Prebiotics are a dissolvable, tasteless powdered prebiotic supplement that provides 3 grams of fiber from plant-based chicory root and 500 mg of Human Milk Oligosaccharides. Begin Health has set out to promote gut health by offering a supplement for kids age 1 and up that softens stools and promotes regularity. I understand the fear of powdered medication flushes, hello clogged G-tube! Begin Growing up Prebiotics completely dissolve in liquids or purees and can easily be flushed through a G-tube. Our Prebiotics are an ideal product to add to your Tubie’s daily routine to promote regularity without having to rely on unapproved medications that may or may not negatively impact health. Talk to your pediatrician to learn more.

Summary -Another option to take on constipation in a Tubie is to try is a HMO. Begin Growin up Prebiotic makes it easy.
Kate Gerweck, MS RD LD

Kate Gerweck, MS RD LD

Kate Gerweck is a Registered Dietitian based out of Charleston, South Carolina. Kate Gerweck specializes in pediatric nutrition and kids’ constipation.