Chronic constipation in toddler - could it be caused by cow's milk? What else?

[BedHanger]

DS1 (2.5) has been regularly constipated for about six months (with one four week period of diarrhea, stool sample clear for common viruses).

He's currently on half a sachet of movicol a day, which seems to make his stools softer, but very sticky and he's still distressed when he goes. Better than when he doesn't take it though, when he regularly takes all day to have a poo and gets very upset. Poos streaked with blood, lots of complaining about having a sore bottom and trying to get his hand in his nappy to scratch. I've also noticed that he has fairly frequent pale, chalky poos.

The start of his constipation coincided with my milk supply all but drying up in pregnancy, and him dramatically increasing his cow's milk intake to compensate. GP thinks it's most likely that he's not drinking enough, but I'm wondering if it might be the milk?

If not, are there any other factors to consider? Is it just one of those things? We can't even consider potty training just yet as he's so upset by pooing that he refuses point blank to use the potty, and has no routine for going.

[Levantine]

I would ask your gp to refer you - I think there are often specialist children's constipation clinics. You need some specialist advice I think

[BedHanger]

Ok, we're due to go back in a month if things haven't improved so I will ask then, thanks.

[nightcat]

OP, yes, it can be caused by cows dairy and also by wheat overload.
When my ds was little, he had the same problem. A locum dr who is also a pprivate nutritionist immediately pinpointed the problem and I realised that he was having wheat and dairy at literally every meal.
For dairy, try reducing cows and use goats instead. I would also limit wheat to maybe 1 meal a day.
With both the above, it's the build up that causes the problem, so it's not usually obvious from the outset.

[TeWiSavesTheDay]

Too much dairy could be a problem, if it men's he's filling up on it and not having enough other fibre (fruit/veg) and water how is his diet in general?

Lactose intolerance does not cause constipation but as I understand it an intolerance to cow's milk protein potentially could.

If you are concerned diet may be the cause you could ask for a referral to a dietician/nutritionist. I would try the constipation clinic first though, personally.