Chronic Constipation in a toddler

[Mammanat222]

J has suffered on and off since weaning - main symptom has always been pain passing stools and really solid poo.

He is now 17 months and I am at my wits end. He is is so much pain when he goes I am worried this is going to scar him and make potty training horrendous.

We have seen several different GP's some more helpful than others (only one examined him properly. The rest just fob me off with the whole 'drink lots of water and eat lots of fruit and veg')

J was given a months supply of Movicol and that did help a little but once we stopped the problem returned. My last visit to the GP resulted in her telling me Movicol is "far too strong for a child that young" - WTF? I wasn't asking for it, simply saying he'd had it before.

We did BLW and J has a varied diet, although he does enjoy his carbs at the moment. We try to get as much water as possible into him.

Sorry for the rant. I even went to see HV yesterday who just said I need to go back to GP.

Any ideas / suggestions? (cures / techniques to help him be a little less pain-free when he does go)

I have been thinking there could be some kind of food intolerance but my limited research isn't really supporting that idea?

I just don't know where to go with this?

TIA
X

See a different gp or push for a referral to a paediatrician if they won't prescribe movicol. It could be food intolerance related but in any event movicol will help with poos for now, stop the colon being stretched etc. my son has been on it for 2 years since he was just 1 so I don't understand why a 17m old couldn't have it

Ps - pressed apple juice (rather than concentrate) really helps too

Movicol is fine if he needs it. I think it is more important to encourage a regular bowel habit so that you avoid huge stools and withholding.

Think about his diet though.

A high roughage diet isn't a good idea for a small child, so things like weetabix, bran, or things containing a lot of fibre will produce large, solid stools. Sometimes this can cause pain and constipation.

It is better to give things like vegetable soup, cooked carrots, stewed apple, things that have already been cooked. Don't, for example, give large amounts of dried fruit, especially apricots because these need loads of water to pass through the gut.

There was a case years ago of a toddler who ended up with a life threatening obstruction due to having swallowed a whole dried apricot.

Thanks for the advice.

At present he isn't stool holding but that is my main fear - I don't want him to begin to have horrible associations about pooing. I know a boy who ends up in hospital every few months as he stool holds (He then has to have his system flushed out so ends up with a tube through his nose - it is incredibly traumatic for the poor child and his parents)

I know Movicol isn't a long term solution but it did help and I do think it is is the lesser of two evils, so I am going to push for another prescription.

Can I just ask northerngolidlocks why your child has been on it for so long?

Also juice is a no-no. J isn't keen on water but we've tried every juice we can think of (diluted) and if there is even a hint of juice in his water he refuses it full stop.

J does have cereal most days - mainly weetabix and shredded wheat but other than that he doesn't have much that is [obviously] high in fibre.

Your replies are much appreciated - thanks!

You can buy movicol. That might be easier than fighting with the GP.

I would drop the weetabix. Push the gp for a referral. My ds had movicol from 7 mths old until 2.4 yrs old, he's only stopped as he's now got a colostomy. Don't see why the gp wouldn't put your ds on it. We've never got anywhere with the gp, only my ds paediatricians know what to do, the gp's arent really experienced enough in it, so I would really push for a referral. Grapes, kiwis, strawberries and chopped dried apricot always got my ds bowels moving. Lentil bake if he will eat it using red split lentils.

My DD also suffers with constipation. Every GP we've seen has been more than happy to prescribe Movicol and their main concern has been the psychological effect constipation has on my DD (scared to poo, holding it in, making matters worse). We've found a diet high in fruit has really helped plus I monitor her poos - if she hasn't g

My DD has been on Movicol since she was two (now 4.5 years). It's brilliant stuff and depending on the under lying cause it does need to be used long term. DD unfortunately got a tummy upset just after potty training which scared her so she started withholding.

Constipation can cause the bowel to stretch creating a sort of pocket where the poo can collect / get stuck causing more impaction. Movicol helps soften everything making it easier to pass and giving the bowl chance to unstretch.

Once she's passing a stool everyday with no issues you can start gradually reducing the movicol dose. For example my DD's standard prescribed dose was 4 sachets a day which over time we've reduced to two, in another month or so we'll try reducing to one and eventually to one every other day but that's a long term goal.

Bloody phone! If she hasn't gone in 24hrs, we give 1/2 sachet of Movicol. GP has given us a repeat prescription for it. It's a really common issue with toddlers so try not to worry too much but definitely try to see another GP and push for a referral if you think there might something more serious causing it. Good luck.

Is your ds getting enough Vitamin D. You should have his levels tested. Vitamin D deficiency can have a huge impact on digestion (among other things).

Also try teaching him to poo by squatting on the toilet seat (ie feet/shoes on toilet seat and squatting). I know it sounds weird, but that position will help him go if he is constipated.

What milk is he drinking?

Avoid at all cost any of the toddler milks or formula, they are all high in iron and will cause this problem in a lot of children.

As others have said cutting out high fiber foods as well can help, seems counter productive but high fiber foods can have this effect on small children. so grains and bananas as well.

If he won't drink fruit juice will he eat things like Apple source, lots of fresh fruit and veg. Try limiting the carbs.