Chronic constipation in toddlers

[Emchris]

My 18 month old has had constipation ever since she started solids at 6 months. She was prescribed Movicol (stool softener, not a laxative) and advised to keep using it, gently wean and go back on it if constipation reoccurs. This works very well - she drinks a sachet daily and has normal poos. But every time I try weaning she quickly reverts to constipation - she won't poo for a day, struggles to push it out and then when it comes out it doesn't seem THAT hard but it does hurt her.

I know with absolute certainty that this is not caused by her diet. She drinks a lot of water throughout the day, and eats a lot of fibre-rich food such as fruit, sweet potatoes, lentils, beans etc. Her doctor confirmed that her diet is fine and that taking movicol every day won't harm her - her digestive system just needs a little help. He said that if I were to let her go naturally without the Movicol, it would just cause damage and she would start to have a negative association with pooing which would cause far worse problems in the future.

I still worry, though. I haven't found anything on the Internet pertaining to constipation in toddlers that does not go away regardless of diet. Has anyone come across anything like this before? Did it sort itself out, or will she have problems for her entire life?

Thanks in advance.

Toddlers are tricky because if they get a big uncomfortable poo it can put them off, then they hold in, go less frequently, which just reinforces the whole cycle. Once children are a bit more mature they can exert a bit more agency over it and cope better - so most likely will be a phase she grows out of. You are doing the right thing maintaining a daily soft stool, this means that the bowel will "remember" the right size of poo to send the signal that it's time.

Do keep using the movicol, at least while she's at such a young age, you don't want to risk poo withholding.

However, I know you say diet is good but have you considered it could be an intolerance to something she's eating? Could even be a food that normally you would think good for constipation.

Assuming this is her only problem I'd lean towards wheat and gluten, but could be something else.
From what I've read doctors tend to overlook this possibility.

@Scramble1805 thank you, that's a good point and I've never tried restricting different foods to test for intolerances. I'll give it a go and see what happens.

I think it's really quite common. I think also you are sometimes able to find a food combo that works for you. After reading one thread on here the other day I'd say dried apricots are worth a try. Many people had outstanding results with those usually quite by accident.

For my daughter what worked was a tea involving beans, with fresh orange juice to drink followed by grapes for desert. Let her run around with that in her and it usually resulted in her going naturally. We would do this after a few days of no movement. Maybe there is a combination out there which is effective for your child that you can use.

They do grow out of it!

Mine were the same. Still both on daily movicol at ages 17 and 13.

our 16 month old had bad constipation and still does occasionally at 19 months. We use movicol (half a sachet) and it helps her. Like your toddler her diet, water intake is very good and walks a lot everyday/ is very active. So the dr ruled that out.

we don’t use it as much anymore, perhaps once every 4 weeks when she does become constipated again.

I would say you are doing the right thing, wean off maybe once or twice a month to see how she is doing, if she can go by herself.

if her poos aren’t that hard I would leave the movicol so she can get used to the sensation. Once my toddler was getting daily movicol and her poos were soft she would still cry bcos she associated poo= pain. So I stopped giving it to her and made sure I was there for each poo and comforted her. It took two / three weeks but she stopped associating and her poos are mainly fine.

it’s thought isn’t it?! There’s no guide to tell you what to do step by step etc and as a mum you are so terrified of messing it up or giving too much / too little.

I hope she is better very soon

Ah, you have my sympathies. I can remember a GP saying to me that it takes the bowel about 18 months to fully recover after a really bad bout of constipation.

My youngest has Hirschsprungs Disease, but that's a whole new level of constipation. Movicol is great stuff...if you can get your child to drink it! My daughter is on 9 sachets a day.

My ds needs movicol daily and has been on it for ten years. He is hypermobile and his internal soft tissues cause more issues than his joints. I believe his muscles don't work well enough to move the waste along.