Not sure what to do. May BU for posting here

[3littlesandme]

My almost 2 year old has been constipated on and off for around a month. Been to GP twice, first time prescribed lactulose and that did the trick until 4 days later when the constipation started again. Second time we were given movicol again, that worked for a few days and now she's back to the way she was.

Do I go back to the gp and push for a further investigation or just keep going with the laxatives?

She's had no changes to her diet recently, drinks plenty and has lots of fruit and veg. She does have her cuspid teeth coming through at the top, don't know if that is relevant.

My DS was on movicol on and off for about a year when he was that age, just increased the dose as needed, the doctor said it has no side effects and to keep going with it. He just grew out of needing it. But if you are worried, do check with the doctor.

@Outnotdown I didn't know it was a long term option, how many doses did you give him throughout the day? We're on 2 a day now.

Has the doctor explained that movicol and lactulose are just drool softeners? You have to drink plenty as the softener works by drawing the fluids into the poop. If she is already very constipated the softener might just be moving some of the stool but not getting the full blockage out. As well as fluids plenty of fruit in her diet will also help. If it were me I would go back and ask the doctor to review how much movicol/lactulose she has. The risk is that if it is left she may become more backed up.

Oh dear drool softners!!!! Obviously that should have said STOOL softners

No, you feed your child a better diet, ensure they drink more, but not fizzy crap and get them active and outdoors.
Also, if you can get them to drink hot water first thing that could also help.

No, you feed your child a better diet, ensure they drink more, but not fizzy crap and get them active and outdoors.

Judgemental, much? Digestive issues, especially in children, are often more complex than "feed them a better diet".

OP, if you're concerned then you could ask the GP what they think the next steps would be if the softners aren't helping. Could she be withholding? Sometimes if they've been constipated and had to pass a hard poo, or if they've had lots of loose stool and gotten a raw bottom, they associate pooping with pain so they get it into their heads that the way to resolve the issue is to just not poop. They keep it in and the issue gets worse, so they keep it in more, it's a difficult cycle to break but most kids grow out of it. There is no long term harm associated with prolonged use of Movicol.

Very judgemental, my thoughts too

Chopped prunes in porridge for breakfast sorted my daughter out. She had it every day and became regular as clockwork.

I not had experience in this with a child, but just wanted to say that children shouldn't have a high fibre diet. Too much fibre can cause constipation. I know this personally for me as an adult. You need a lot of water for a high fibre diet.

The nhs says " It's good for your child to try different kinds of starchy foods, but do not give only wholegrain or high-fibre foods before your child is 5 years old."

Prunes are excellent but are dry, so I'd go for the actual fresh fruit plum ( plum & pear crumble is lovely, you can reduce the sugar in the topping) Kiwi also good as is pear and rhubarb.

So a good balance for a child might be one slice of white bread and another of brown ( not granary or wholegrain) for a sandwich.

Fat is also important, so too little fat or too much can cause issues.

And teeth always seem to effect DS' pooing. Maybe she is not chewing as well due to some pain ?

Movicol is fine long term, my DS took it for years, then spent a few years in lactulose, all under paediatric care.

It turns out though that he has a lactose intolerance - changed to lactose free milk and he is now laxative free - after spending 6 years on them. Not picked up by the paediatrician because lactose intolerance usually leads to diarrhoea, but for a small number of people (many more possibly as they might be undiagnosed) it can lead to constipation.

@PlainVanilla where in my OP did I say she has fizzy crap?!

@shitwithsugaron how soon after did you notice the stool becoming softer and easier to pass?

@EwItsAHooman she attempts to 'go' several times a day but not for long, she could be withholding. But I can't be sure.

Thank you everyone else for the helpful replies

@EhlanaOfElenia lactose intolerance did cross my mind but I googled the symptoms and because it said diarrhoea is a sign, I dismissed it.

If you're concerned about lactose it's quite easy to switch to lactose free milk, or you can buy m by some lactose enzyme and add it to normal milk yourself (and then let it sit for 24 hours).

The difference for DS is absolutely phenomenal. I switch between being relieved that I've worked out (no thanks to the paediatrician) what was causing it, and fury that the medical profession at the highest level were absolutely no bloody help in solving it!!!' The paediatrician had actually released him from her care as he was 'managing' his condition just fine, but would likely need lifelong laxatives.

A sure sign that DS is withholding is that he'll almost constantly need a wee, it's from the blockage putting pressure on his bladder. That and seriously stinky farts.

In our case the weeing accidents were because the full bowel blocked off the receptors (or whatever they're called) in the bladder so that he couldn't tell he needed to do a wee until it was too late. Both bowel and bladder were severely distended.

She's not weeing more than usual and isn't farting much either.

I think I will call the gp tomorrow and get her some plums and some probiotics too. And also increase to 3/4 sachets of the movicol.

You can give Way more than 2 you know!!!

You can give Way more than 2 you know!!!

We were told to give around 4-6 a day if he has a blockage to help get it cleared then 2 a day as a maintenance dose.

She's been on it since last Thursday but I've only been giving 2 a day. I'll give her 4/5 tomorrow and see how she does

My LG had this problem for ages, tried the movical for a long time. The key for us was liquid. It didn't matter how much good food she ate, if she wasn't drinking enough she would suffer we started off by giving her Apple juice and water 50/50 for a few days, as much as she could handle and then watered it down further and further until she was drinking more a day than me. Even now at 4 she will drink 3 litres of water a day. If she slacks in the liquid we go straight back to square one.

Only increase by 1 packet a day.

At least the first time. Once you know what level she needs to be effective you can go straight there.