Tips for managing constipation in a nearly three year old

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I am looking for some tips on how to deal with constipation in my nearly three year old dd. She has been potty trained for coming up to a year but was on and off constipated prior to that. She will have weeks of going regularly then one day of bad food which causes a painful stool and we are back to holding which in turn makes the stools harder and the vicious cycle starts.
Dd is with me most of the time and has a very healthy diet, plenty of fruit and vegetables- she’s not fussy with food when she’s regular.
The problem started a few weeks ago when she was ill we let her eat whatever she fancied and she was also not drinking enough.
She is refusing movicol, we got some glycerine suppositories which worked but really traumatised her.
So anyone got any great ideas what we can do to encourage her to become regular again.
Any great recipes? She isn’t in the frame of mind for smoothies at the moment and is refusing my homemade date cake, and my date based Nutella which she usually loves. She is also refusing to drink much water, I even bought fruit shoots but she is refusing those also. She likes milk a lot so I have been watering it down.
I feel like I’m at a dead end here.

This can be a difficult thing to get through, we had something similar for a while.

There’s a book lots of people recommended - Poo goes to Poo-town I think?

And the Eric website is good.

We used bribery and it worked.

My daughter started with this at around that age.

ERIC is a great resource. We had a book called ‘it hurts when I poop.’ It’s a bit American by my dd really liked it.

Movicol is going to be the key here. It takes time though to find the right drink to hide it in and get them used to it. For us it’s mixed with water and then added to some chocolate oat milk. It took MONTHS for her to drink it regularly though.

Also try to get a referral to your local bladder and bowel team. Our nurse was AMAZING and really helped us.

@AdjacentPossible It’s Poo goes to Pooland. It’s an online app. You could try it but she might be a bit beyond it at 3.

Thanks all, we used poo goes to pooland when potty training, it worked well. I will try it again.
We don’t live in the UK at the moment so I’m not sure what’s available. Last time I spoke to a GP about it she just said get her to eat plenty of fruit and veg, my language skills aren’t amazing as we have only been here a year so it’s not easy to communicate like at home.
The pharmacists were helpful last time I spoke to them so I think I will pop in there today and see what they can offer.

Cutting out dairy will not resolve the ongoing withholding and constipation. You need to sort them out before trialling dairy-free, and trial it for longer than two weeks.

Have you tasted movicol? (Go ahead, a couple of mouthfuls won’t harm you.) It’s really weird, salty and something else. It needs a strong flavour to disguise it. I would not try to use a flavour she is familiar with. Go for something completely new.

Have a look on the eric website, it’s got everything you need to know with a solid evidence base
eric.org.uk/childrens-bowels/constipation-in-children/

We have had a breakthrough with the movicol. We have been given an unflavoured version which she will take in milk. She had a cup of it this evening then went to the toilet within ten minutes- I’m not sure if this is a coincidence or it really works that fast?!
We will keep up with it twice a day until we can see a GP.

Hide it in proper hot chocolate with sugar.

Coincidence. Movicol works by keeping water in the poo so when she is nolonger constipated it will take around 24 hours to pass through the body. As she has been constipated for a long time she will need to stay on a maintance dose of movicol when its all sorted.

Movicol is the gold standard for constipation and disimpaction.

She will also need to drink water,juice, whatever due to how it works as a pp said, by drawing water into the bowel. You need to keep going with it and not stop start it. A consultant once said to me that it can take as long as they’ve had the constipation to get rid of the constipation, the problem is long term constipation causes the bowel to become saggy due to stretching.

You can also put the unflavoured one in juice as long as you make it up with the right amount of water first. I always tried to hide the taste with ribena.

Another tip that I always forget about when panicking about hydrating them is that ice lollies are your friend. They think they’re a treat and the fluids are still going in.
Glad to see that the movicol has worked.

sorry if this has been suggested I haven't read all of the replies. I swear by prune puree baby pouches, my 3yo won't eat a prune but she will happily eat a pouch. I give her one every few days now but when she does get constipated she has one every day and it works so well to get everything moving.
for trying to get fluids into her have you tried ice lollies, jelly? Something random that works with DD is giving her my cup to drink from instead of her own.

try going gluten free for a couple of weeks.

Thanks all. I have managed to find some Jelly mix- I had no idea it would be so difficult to find! I will make it up tomorrow.
Ice lollies is a great idea we will add them to the list.
We discovered she likes orangina this evening- we gave her a little glass while we were enjoying an end of week aperol. She has also been drinking from my water bottle occasionally so we are slowly finding ways to get fluids in and she has had two sachets of movicol today.
Hopefully we will see some progress soon.

I used to buy the whitworth dates from poundland probably also other shoos. Iused to give two to my granddaughter and they seemed to help a lot.

Melon, and watermelon, instead of meals until it shifts? Sweet and delicious, and full of water.

Works for adults too.

My nearly 3 year old has always been prone to constipation but the past couple of months has been pretty severe. We tried to water down her milk, give only healthy food, plenty water, plenty exercise etc. No luck. Then we introduced prunes! Wow what a game changer they have been. Can’t recommend enough. We just give about 2-3 a day. I gave her them on way out the supermarket when she was hungry and looking for snacks already. I didn’t make a big thing, she saw me tucking in and I said they were gorgeous and like sweets. So now even my mega fussy older child sees them as a treat! If you’re worried about texture then chopping them up small can help with that, as I struggle a bit with the more squishy ones. Love pp’s idea of chopping them up tiny into porridge. Done like that they would be very much like raisins which most kids love

Also meant to add I watched a video on why prunes are quite specifically amazing for constipation, unlike other fruits and veg, quite interesting

You have got to get fluid, and the Movicol into her. @Candyflosscrochet is right. This could become much worse and you need to treat this as a semi emergency. She could get impacted and then you’ve got a longer term problem on your hands.

Chuck out any idea of healthy drinks for a while - if she’ll drink Capri Sun, go for it.

Novelty cups, novelty bottles, twirly straws. Buy a load of them and use them.

Get plain Movicol and mix it in things throughout the day. A particular low point for me was using a Calpol syringe to get Movicol into Ella’s fruit pouches.

There’s an app called Poo goes to Pooland which is for kids who withhold, though I wonder if your DD might be slightly to young. Check it out anyway.

Join Movicol Mummies Facebook group. Invaluable.

Eric website is good
Does your child dislike water? Even a dilute cordial with no sugar is good.
movicol is not always a god send can not work for some children - lactulose can be better
Pear fab, OJ, apple juice, lolly, water melon. Banana to avoid.
keep a drink at all times close.
after breakfast, lunch and dinner always try going to the toilet
bubbles and stories good even “try” after a bath as it’s not as hard.
Keep a diary of all food enter their mouth try and work out a pattern

@thewashingisoutside my daughter is a rubbish drinker. She loves warm milk which I have been diluting with water but not a fan of much else. She loves fruit and veg so gets a decent amount of water from that but obviously not enough.
@Rainallnight i hit the same low point a few weeks ago with paracetamol- she tasted is straight away.
Thanks @tipsforyou i have presented the prunes a few times but she wasn’t keen, my elder daughter LOVED them. I need to get around to making a dessert with them. She refused them in her porridge and told me she didn’t want raisins in her porridge 😂 she happily takes my date Nutella that I make in her porridge though so at least that’s doing some good.
She was quite gassy in the night so I’m hoping that’s a good sign things are moving?

From our experience, you’re not going to sort this with diet alone. Movicol is the way forward, and I echo PP on the ERIC resources and disempaction regime. I have you tried hiding it in flavoured milk or yoghurt? That god awful fake flavour of nesquik might cover the taste. Obviously not the ideal thing you want to be giving your toddler but really you do not want this to escalate so it would be the lesser of two evils.

I've bought tinned prunes before, whizzed them up with a little of the syrup to make a compot type mixture and layer with Greek yoghurt and granola with flax seed mixed in.

OP, you’ve got to really push the drinking. Fluids from fruit and veg are not enough for this kind of problem.