This may sound strange, but try getting her to squat instead of sitting. It apparently lines the bowel up (or something) and helps it all..happen. It certainly works for alot of people I know. Good luck, poor luv.
DS1 had this problem for ages but has just decided to abandon the loo seat 'insert' and just sit on the normal seat. Because his bottom sort of hangs down more(!) it seems to help with the pushing. He's doing a poo every night for the first time in 4 years!! Mind you, he couldn't have done it before now because he didn't have the muscular control to hold himself up on the full sized seat and this might be the same for your DD. Good luck!
thankfully the pessary worked. she has to sit on the loo seat(special seat) as she can't sit on the toilet] it is a toilet chair really(hope that makes sense.
& she can't squat
thanks for advice though
My DD (4) also suffers from periods of constipation, due to her low muscle tone. It is so distressing to watch her sometimes, straining so hard but not managing to produce anything. Sometimes she can be constipated for over 24 hours and the distress she goes through strains my heart strings. She has lactulose and sometimes (prune juice - which my son calls prawn juice because it tastes so horrible). She is only just out of daytime nappies and have not had an episode of constipation yet - dreading it as and when (if) it happens.
Bumblelion stock up on pessary just in case. she is ok now I have upped her lactose dose as well. I think it was all linked to the high temp she had Monday. But apart from being a bit off her food she's ok( she also has senna)
Love prawn juice lol
my dd has always suffered from constipation. We recently started her on movicol and it really has helped. i was very reluctant initially and wanted to control it through diet (yep - lots of prune juice in our house!)but she goes through so much less discomfort now that I am glad we tried it.
I've been there with the pessary thing too - always feels horribly invasive.