advice on constipated DD's diet (15mo)

[drivingmisscrazy]

We have a 15mo who (I think) eats pretty well, but she has had ongoing constipation - she withholds, poos about every other day. Things are better since we dropped her formula, but not better enough IYSWIM. She has 5ml of lactulose twice a day, plus plenty of water. Her diet looks roughly like this:

breakfast: weetabix with f/f milk and fruit (just swapped this for porridge)

mid-morning snack: banana, plus yogurt - sometimes an oatcake

lunch: egg, or beans, a little bread - plus avocado, tomatoes, cucumber. Fruit (grapes, pineapple, apple etc). SOmetimes pasta and pesto/leftovers

mid-afternoon: oatcake, dried apricot, dried apple ring

dinner: fish, chicken or sausage, plus sweet potato/potato, with vegetables (broccoli, beans, broad beans, peas etc), then fruit (blueberries etc etc ) again, yogurt if she hasn't had one earlier in the day

bedtime: 180ml full fat cow's milk

Is this a good diet? If so, why aren't her poos lovely and soft and easy to pass?

Thanks chummymummy - and well done!
WHat books did he get given?

He got some NHS/Movicol leaflets with descriptions of different types of poo on them. He carried these around for a while asking anyone and everyone about their toilet habits. They were good for getting him talking about the body/poo etc and realising that its all natural.

He also got a book about going to the toilet -from the perspective of a poo! I cant remember exactly what it was called but it was by an organisation called ERIC (btw see www.eric.co.uk) which deals with childhood incontinence.

Finally, he got a book called 'Charlie's super hero underpants' -which has become one of his favourites.

Hope this helps. I found that until we dealt with the 'mental' aspect of witholding poo/constipation, dietary changes would not work. I cant praise the consultant and dietary specialists at Leic Royal infirmary enough in getting us through this.

Great thanks, I've often wondered if there was literature for them. I'll see what I can get my hands on.

Am now wanting this

Wonder if anyone here has read it?

quick update - and thanks for the positive stories. We've been away and her routine all messed up. Have largely dropped bananas, reduced her milk, and tried to get smoothies, juice etc into her. She is eating well, and still taking lactulose, but there's been almost no difference to her - often 2 days between poos, lots of straining and withholding before she finally goes. But if she goes every day, the consistency is better, and softer, even though they are quite large.

We see consultant on May 31st which can't come soon enough. Assume he will prescribe some kind of laxative and look at her diet, so will keep food diary for the week leading up. On that - should I specify amounts? a bit hard, because what I serve is not the same as what she eats/drinks (e.g. thinks tipping her sippy cup upsidedown to make what she declares a 'meh' is hilarious).

She's otherwise in great form, having passed on her vile cold to me...

for babies we were advised brown sugar in the milk??????? worth a go. you do need to get it sorted a friend of mine ignored it and then came a really dreadful time trying to gt it sorted. child would hide behind furniture straining away. desperately upsetting for all concerned. kiwis relly are very good for pooing!!

have probably fallen off all of your radars - but seeing consultant tomorrow. I kept a food diary for a week - and as I thought, she really does eat a pretty good diet and drinks plenty of fluid (she loves her smoothies and juice - and can say both!) So I'm really starting to wonder if she has trouble with lactose - she did as a teeny tiny baby and this all started again in earnest when she moved from breastmilk to formula and now to cow's milk. She is now pooing every day although she wouldn't unless we watched her (on the upside she knows what the feeling is, and says 'poo, poo' quite a lot - thus picking up on the household preoccupation), and it is still painful/distressing plus big and harder than it should be.

She ate a ton of cheese tonight and then puked up everywhere about 2 hours later. The puking is something that happens every 3 weeks or so: we put her to bed, everything is fine, 3 hours or so after eating she wakes, crying, is unhappy, then pukes up the contents of her stomach (which always look less digested than I think they should IYSWIM). Once this has happened and she has been sluiced down cleaned up she is fine, cheerful and happy to go back to sleep. It's not a bug - but it often seems to coincide with very drooly days...

Any thoughts, ladies? Oh, you have bank hol...well I'll pop back tomorrow with an update

Ds1 had terrible problems with constipation. We took him off cow's milk/cheese/yogurt completely. Goat's milk is much easier to digest and there are lots of nice goat cheeses around that have the consistency of chedder. It made a HUGE difference. I also give him cod liver oil every night. Even flavored with lemon it tastes vile so we do it in an oral syringe with a little strawberry syrup added. Also mega-probiotics. Like in the 50 billions. Make sure you purchase from somewhere that keeps it refrigerated otherwise it is useless.

jabberwocky - that's interesting. Did you do it on the basis of medical advice? Because I think if the consultant is all sniffy about the idea we might just take her off all dairy for a couple of weeks to see what happens - she has a love/hate relationship with yogurt, appears to like milk, but never really made a fuss as we dropped feeds. I had wondered about probiotics too...

thanks for your input (I'd never have thought I'd generate nearly 60 posts talking about poo! parenthood, eh?)

Well, ds1 has/had a few autistic traits and ASD is practically synonymous with gut issues (impactions, constipation). So I read Ken Bock's book about it. He is an MD in New York who treats a lot of kids with these problems and this was the regimen that he recommended to start with.

don't think DD has any obvious ASD signs......consultant very workmanlike, practical, gave her clean bill of health and a 3 month supply of movicol. He said it's 'simple constipation', i.e. behavioural rather than physiological, but that left alone it can turn into a very difficult problem. Happy enough with that - have to go back in September, at which point I assume he will start to step down the movicol if all is going well. No dietary modifications -said her diet is as good a toddler diet as he's seen , so that's handy too.

after we went to a new kid's shoe shop that DP found (i.e. somewhere that sells something other than Clarks) and finally found a pair of shoes small enough for her - here - she loves them!

sorry, driving, i didn't mean to imply that you were dealing with an ASD situation, just that that is how our problems with ds1 arose. Still the treatment would be the same.
Ds1 was put on Miralax (similar to movicol I think?) but after a year I wanted to find something else. I just didn't like the idea of him constantly having to take something like that whereas pediatrician was perfectly happy for it to go on indefinitely!

jabberwocky (great name btw) - you didn't and I do know that there is a connection of some sort. Yes, he did say that it might persist for her whole childhood or resolve. If this doesn't work I'll certainly be interested in following up alternative solutions.

The thing is with laxatives/stool softeners, we found it very difficult to get the dosage right. The amount that the dr. recommended was way too much and ds1 had accidents. Whereas with the supplements things have settled into a normal routine, so to speak. By all means give it a go for the 3 months but I would take a look around at alternatives if the consultant wants to go longer.

My boy is 6 and half and been with-holding for 3 years I feel terrible. Real guilt, feel like I'm failing him. Have been prescribed Movicol by pead but it's just making him soil everyday and I'm running out of patience. I am making appointment to see pead can anyone help me I am at wits end. and it's seems like it's all my boy and me talk/argue about. He withdraws when he needs to go and when he's been he's like a different kid.
He loves fruit, drinks loads juice but just won't go
AAARRRGGGHHH!!!!!

fozziedebI'm by no means an expert on older children with this - DD is only 16 months, and now on Movicol which is doing what it should. It sounds like you are having an issue with dosage as jabber has said. Whilst I'm delighted that things are working as they should now, I am less than delighted at not really being given any reason/advice as to how we are to proceed without Movical...

I feel for you - and him - is there anyway that you can avoid conflict around the issue? It sounds easy, but I'm absolutely sure it isn't. Sympathies...