OK, blatantly ignored Dr re constipation and dairy for DS 12m...what now?

[suwoo]

DS is just one. He had reflux when a baby (FF) but this stopped with cow & gate comfort, I didn't use the Gaviscon he was prescribed. When I switched to SMA progress her got terribly constipated, he is BLW and eats a healthy mostly vegetarian diet. The constipation lasted 2 months or so until we switched back. I started him on cows milk at 10 months and he has been chronically constipated since. We have increased fibre/ decreased fibre, increased carrots/ decreased carrots, cut out yogurts, filled him up on beans, weetabix and digestive biscuits and lots more stuff all to no avail. He had 2 weeks of suppositories- no difference and I have just stopped the lactulose after a month and no improvement. He has been prescribed movicol today, but I have had enough of meds that don't work so I have decided to cut out dairy and try soy instead. I have bought Infasoy, but should I just be using soya milk? Any thoughts from anyone in similar positions please? Sorry if I've rambled. Thanks.

We use a combination of rice milk and prescription toddler milk for my son who can't have dairy. It works pretty well. I wasn't happy with soy milk or soy formula because there's some doubt about the safety of large amounts of soy in a diet and because over 1/3 of children with dairy intolerances also develop an intolerance for soy too.

Ask for a referral to a pediatric dietician if you can (not a regular dietician - they're not so helpful). We see one every six months at the children's hospital and it's very helpful.

soy is a common allergen and the use of soy milk is linked to nut allergy. Why not try goats milk? It's more readily digested. If you can also get a dairy free probiotic (good for most gut problems) even better. Have you tried prune juice?

If that doesn't help Pepti Junior before soy. You don't want to have to live with soy allergy, it's a real pain.

Don't just use soya 'milk' - it is not really a milk substitute as it doesn't contain the same fats, proteins, vitamins etc.

Goats milk may work - Nanny Goat formula maybe?

Feel bad as I'm doing this without Doctors 'permission'. I am trying the Infasoy, is that OK for all the vitamins/minerals/nutrients etc? Yes we have tried prune juice and those gorgeous tesco wholefood prunes which he loves. Tatt, can you be more specific about the dairy free probiotic please? Do you mean like yakult type thing? Thanks everyone.

Infasoy is fine for nutrients as it is formulated to be a substitute for babies and small children.

I meant normal soya milk in cartons.

We also stopped dairy with ds1 (with the osteopath's input) for the same reason at eighteen months. Originally she advised us to do it for six months. We did a year of no dairy and eighteen months of no cow's milk. (He'd get constipated again before then.) He still can't stomach cheese though and will throw it up. It worked for us and fairly quickly too.

I would avoid soy, we had this prob with DD and DS2. DS2 was still constipated on soy. We used a prescription milk thats name escapes me (sorry but it is widely used with allergic kids so your DR should know). It is very distressing while it lasts but this type of allergy is generally to do with gut maturity and both my kids were able to go back to dairy at 2 / 2.5.

Can I add that Movicol has been highly effective in sorting our DD's long term constipation. Like your DS she had reflux as a baby and at about 12 months her constipation started.

She is 6 and half now and has been on it for nearly 2 years. It is not absorbed into the body at all, just makes the bowel absorb more water and the stools therefore softer. You will find that they drink loads more liquids though.

Although our case is different in that DD was older by the time we were referred to peadeatrician I was told to only give her 1 glass of milk per day and no apple juice at all.

DD2 is 2.2 and still gets very constipated. Movicol is really excellent, i use it from time to time. Lactulose didn't work for her though i have heard recently that unless they drink a lot of water with it it can actually make the poo sticky and therefore harder to pass.

prune juice is good. i mix it with apple juice and water.
innocent smoothies are good.

i use a probiotic called GG Culturelle - they come in powder capsules which i open and sprinkle into those fruit puree pots or similar.
Caricol is also good which are a papaya puree in a sachet though i struggle to get her to eat it.

i tried goats milk and it turned her poo to putty, a total disaster. i keep her largely on formula still - babynat (cow) is the only one she seems able to tolerate.

if you know someone going to or in spain/italy you can get tiny pumps which squirt small amounts of liquid into their bum and they poo quite effortlessly from that. Way easier than trying to put in a suppository, especially if they are constipated.

Thanks for all the tips so far, I will go through them properly and take notes. This is the second day without dairy and he has still strained all day and as yet, produced nothing, so we'll see

Suwoo, I am astounded that your GP hasn't referred you to an allergy specialist or paed dietician. A lot of medics don't realise constipation can present in milk allergy. GP can prescribe Nutramigen which is milk and soya free, personally I would avoid soya formula for a boy, some doubts over future fertility issues.

Don't give goats milk as the proteins are the same size as cows milk/soya. Rice milk very inadequate nutrition wise.

My DD very constipated until we went onto Nutramigen, although at 1 you may have problems getting him to take it at first as its pretty foul, but worth persevering with as it has all the iron/calcium etc needed. It made my DD very happy. I would also avoid meat for a while and stick to veg, fruit.

There is a good site called MILKFREE which I use, hope things get better. Good luck.

hello I hope i am not hijacking but I have just read through this and I am having a total revelation.
My ds is now 4 and has been constipated as long I can remember, probably since he stated solid food. He had egg allergy when he was small but seems to have grown out of it for well cooked egg (cake quiche etc) I've not been brave enough to try lightly cooked egg. He's on 10-15ml lactulose a day and this week he went 5 days before having a poo. He eats lost of fruit and veg and fibre, drinks lots of juice.
I spoke to my Dr about constipation and allergy but she said allergy usually had the opposite effect.
I don't know hat to do I'm just completely gob smacked that this may be an allergy. Would it do a 4v year old too much harm to remove dairy for a few days to see what happened?

We had dd in hospital for constipation pria to christmas, its been bad also for a long time. Has numerous allergies. Movicol made her go ok after just one day of being on it so it worked good but then seemed to give her pains in her bottom and made her to loose wanting to go all the time but not always able. Was meant to keep her on it but stopped as she was so unncomfortable and skidding her pants by night. She is five. She has eaten veg everyday but I am fearing her becomming worse again. why was you told no apple juice cece as dd lives on it diluted?

Poor little ones with constipation

My Dd1 suffered from about 9/10 mths until she was 27 mths.

I always gave her wholemeal bread & she used to have fruit & fibre for breaksfast. These are the worst foods for little ones to eat. They just get so blocked up & I had no idea this would happen, their bodies just can't cope with it. SO PLEASE don't give anything wholemeal AND get a piece fruit into them at everymeal - pears, kiwi, plums, cooked apple, nice wet fruit - no bananas though.

I took DD1 to a cranial osteopath & a paedatrition who prescribed SODIUM DOCUSATE. I used to add the dose to her bottle along with a dose of lactulose. The sodium docusate worked wonders.

Interestingly as soon as she started to do poos on the toilet she was fine - I think going had her hurt so much previously she would do her best to hold on, which of course makes the poo drier & hard to pass.

DD2 showed signs of being bunged up just after weaning, so fruit at every meal, nothing high fibre & she's fine. They both are, I think DD1 could win a medal for the poos she does !

Good luck & HTH

Chloesmumtoo your poor girl having to go to hospital, did she get totally bunged up?
Thanks mojomummy I will try and be more focused on giving on fruit with every meal, I do try keep forgetting!
Interesting what you say about the wholemeal foods, I always though I was instilling good habits for later in life.
if I can just get him to "go" every other day I will be happy, but 5 days is not good.

Yeah she did hedgepig. Real badly. Took her to a nasty emergency doc in desperation. I told him what she was like and that a suppository wouldnt even work and he said 'well what do you want me to do about it'. I was a bit shocked and asked if he could maybe give me a different one to try. He asked if I wanted her examined and I said 'if you feel you should'. He put on his glove looked at us all and said 'this wont be pleasant'. Poor dd is only 5yrs old!! She was so good and he done the proceedure and tutted and told us not good not good. I was scared out of my wits. He drew a pic and said what it was like and that she may not be able to pass it as it was so large and may need to go into hospital. Then he went on how she wont be put to sleep and would have to have it removed bit by bit,scrapped out. We were so so worried. He sent us off with an emima and said to try at home and if all fails to call back. It all failed and she was in such a way she couldnt move for discomfort even into a different position hours went on. dp didnt want me to phone them back and was distressed himself and didnt want her to go in. I was worried that something awful was gonna happen as she was in such agony and thought she was going to split her bowel or something. Phoned in the end and spoke to a different dr who told me to sit it out and nothing bad would happen and that they rarely do that proceedure at all. Felt better until morning and then of course paniced at what dr was right. One who had examined her or one on phone. We arranged another emergency app as it was weekend and happened to get the same weird dr. Just told him to refer me rather than let him scare us anymore. He did. She went in and they done nothing of the sort. Told her they wouldnt do anything to her and not to worry. Put her on movicol and after four hours let her home. It worked a day later and now I just think what a wicked doctor he was and do you know she was obviously that distressed by him she drew the same picture he did had in the surgery- for her grampy and wrote by it poo poo poo

Hi- would like to add something here about the wholemeal. It is good for most older children (unless there is a gluten allergy or something) so those who are writing about children who are 4 or over please dont discontinue it without good reason. I think for the littlies, esp those under 2 it may be different as the system isnt up to it yet. So advice for older/younger varies enormously, also regarding milk - and how much milk to include in diet.

Sorry to the OP as I dont know anything at all about milk allergies. But for the mum who tried and stopped Movicol - please dont write it off; it is really good. To begin with, you have to experiment with the dose to get the dose which is right for your child. Also if she is having accidents, that could just be the effect of the constipation - basically if you become severely constipated you lose the control and sensation in the nerves there (temporarily) so you dont necessarily know when you need to go, and you can have accidents like that. It takes a while for the bowel to heal again. If there has been pain, it also becomes a problem getting the child to go again as there may still be some pain while it heals and also just the memory of it being painful. In the meantime just be calm about it and keep up with the meds so as to break the cycle of being constipated. Well that's my suggestion anyway. Almost everyone I know who has tried Movicol has sung its praises.

Also I have been to specialists on this subject for a long time with my DD (whose problem is now under control ) and have never been told to cut out apple juice - in fact as far as I know it is a good thing. Diluted is better - lots of liquid is important. Only fruit we were told to cut back was banana. We were also told to limit the milk though (DD was 4 at the time). So would agree with that.

Thanks maisykins for your advice will bear that in mind about movicol. I was meant to keep her on it for a month to train her bowels as they thought she had lost the sensation to go but as I said had problems on it. Thought it was over stimulating her bowels somehow and she was crying with bum pain. We cut her down to just half a sachet morn and night in the end. However like you say I wont right it off. She is going at the moment but was worrying as she cried with a little pain on the last time. Keeping her fluids up as much as possible when she comes home from school and eating veg everynight!!! Will look like a veg soon only had one non veg meal since before xmas!!

Hi Please please please keep up with the meds,my daughter was the same from a very young baby,nothing seem to work it seem to go from too hard to too loose,4 years on we finally got a hospital appointment because of the constipation she was left with a bowl 5 times as big and saggy as it should be,you would not believe what this has done to her self confidence,schooling,friendships and the stress on us as a family(pooing in a swimming pool etc!)It really has very little to do with diet after a while so i would say please look into the long term effects before giving up
try and get hold of a booklet called talking about constiption by june rogers Director of promoconMBE

www.promocon.co.uk

Hope this helps,we have another two years of treatment before it hopefully sorts its self out,i wouldnt wish this for any other child

oh your poor dd. You dont really realize what can happen. Thanks for your advice and yes I will look into that book. I obviously need to learn alot more. Trouble is our dd has always had problems with all her allergies and eczema that the constipation always seemed less important. However we have had lots of ongoing problems with it and now is the time obviously to swat up more. I just thought the constant veg and weetabix and fluid was all we could really do. Wish you all the luck with your dd fensmum x

Thanks,i know what you mean it seems so little in the grand scheme of things.My DD is definatly picking up now she is on movical,but she has to have it 12 times a day
at the moment so she is less than happy!But you can see and improvement already.Hope it all gets sorted for your little one too
take care x

chloesmum your poor dd. I am shocked he could be so unsympathetic with a little child. From what I have read sometimes constipation can be causes by the holding cos they don't want to go in unfamiliar places,etc well he really wasn't going to help that. fensmum thanks for the link i will look it up. You dd situation sound awful too. I really think that drs/hvs don't take constipation seriously but as your story show it can have very bad effects. We are currently playing with the lactulose dose and trying to increase his fruit but if we don't get a good routine in a few weeks I will be talking to the Dr about Movicol, hearing your stories I have realised how serious it can be Thanks all

It was the consultant pedeatrician who told me no apple juice - DD too used to drink a lot of apple juice. He also said only one cup of milk per day as well. She was nearly 5 though. She also drank alot of milk at the time as well.

No idea why but I must say she is much better since we stopped it. I have noticed if she does have the ocassional drink of apple juice, say at a friends house it does bung her up a bit. Chocolate also does it too. Every year after Easter we have two weeks of constipation and have to resort to double doses of Movicol...

When DD first started on Movicol she was on a higher dose to 'empty' her out. She was pretty much incontinent and had to go back into pull ups for about 4 weeks while her bowels emptied themselves... It was very difficult for her, me and her poor Reception teacher. However it was well worth persevering with it as she now goes on a regular basis.

12 times a day fensmum!! That does sound alot, do you find she gets stomache cramps with it or anything? I had dd on just one sachet morn and night and that seemed to make her loose enough, then dropped to half morn and night but maybe I stopped to soon before the lower dose kicked it. Just couldnt bear her in pain (stomache and bottom discomfort). She is coping so far without it but I wont let her get bad again and wont hesitate now to start the med again after what you have said. Will maybe start off very low dose and work up if she stops going. I couldnt believe that doctor either hedgepig. Like your worst nightmare,I dont understand it. Although the people who saw him previous to us came out saying he was very strange! We overheard. Been to some emergency doctors before that have blatently said they dont give anything for constipation! No wonder our kids get in such a state. What sort of dosage do you have your dd on cece. That must have been awful for her in school. Its a worry. If that doctor I saw just prescribed the movicol in the first place we wouldnt have even needed to go into hospital. It did work to clear her out by the next day whereas nothing else worked! Better than the stress of giving all the suppositories and enema. Poor dd, I couldnt have put her through much more. Fensmum, how did they discover dd's bowels had become stretched like that.

Morning,she is on 12 a day for 2 weeks to clear her system out,then it will be reduced.She isnt having any tummy pain,she is just really happy its not her fault,we have taken the pressure off as much as we can,when she is at home she wears pull-ups etc.The paediatric consultant at the hospital felt her adbominal reflexes and colon area and could feel how enlarged it had got.
Apparantly this is very common but GPs are reluctant to refer children and by the time they get to see a consultant it can take up to two years to mend.
I would advise anyone to get hold of the bowel management nurse at you local hospital,we travel an hour to find one at Boston in lincolnshire but she was a great help.