12 month old has chronic constipation/hard poos since starting solids 6 months ago

[Babydust250888]

Hi there
We've been here for 6 months with hard poos for my daughter. Ive had numerous GP appointments prescribing lactulose and movicol. Movicol works but is impossible to get in her properly. We've been advised to give two 5ml doses of lactulose a day alongside fibre rich foods and liquids. I do it all, all the p fruits too. Watching her push so hard is so horrible. She screams in pain
Im so stuck
Please someone tell me a cure here

To add, she has 3 meals a day plus 16 oz of whole cows milk between 2 bottles through the day.

It's so hard isn't it! I remember people suggesting we give her more fruit or water, which would drive me mad. As if we hadn't thought of that!
We used to mix Laxido with yoghurt (after making up with water) which would disguise the taste. It seemed more effective than Lactulose.
Is your little one walking? When my daughter started walking it really improved the constipation and we were able to stop the laxatives. She's likely to grow out of it in time but if she's still in pain go back to the GP no matter how many appointments you've had.

You need to talk to ERIC and get advisors on your team that really know what they're doing, OP. Believe me, we are 4+ years down this road now and the sooner you get this sorted the better. GPs don't always have the experience or expertise it takes to treat chronic childhood constipation PROPERLY. Lactulose isn't great longer term, there are better alternatives, and your girl likely needs disimpaction for starters. All the best x

We had some luck with sitting our 12 month old on a potty after meals for a few minutes with distraction like reading a book. I think the squatting position helps them to go, and the regularity helps them get into a routine and things gradually improved. It helped with potty training later on down the line too!

My little boy (10mo) was exactly like this and even had blood in a few of his nappies. He used to physically cling to me and try to crawl up me while crying in pain and would get so hot and sweaty.

It sounds strange but I’m convinced it was yogurt causing it. I removed different foods from his diet (mainly dairy etc) as a test and his constipation and stools improved massively. I phased them back in one by one and everything stayed fine until he happened to be back on (plain full fat natural) yogurt.

I wasn’t convinced yet so I stopped giving him yogurt again - everything improved - then put him back on yoghurt and we were back to hard stools with the crying/sweating/blood etc.

He hasn’t had yoghurt for a few months now and we’ve had zero issues. I’m not saying your little one’s is also yoghurt but it could be one single food that isn’t agreeing with her - something to keep in mind anyway.

Thank you so much. Did you find this with milk too or just yog? How much milk was he on

Can they eat nuts? I'd give them nut butter to oil the cogs, so to speak. My acupuncturist suggested thus when I had terrible constipation in pregnancy.

My 12 month old also has horrible constipation bless her, we’ve been prescribed Laxido for the last month and that seems to have helped, not sure what’s different to the ones you’ve tried but could be worth a go x

Can you reduce the milk and increase water?
If she is having 3 meals a day, 16 oz of milk seems quite a lot....

My DC is nearly two and still goes through bursts of this sadly, though much better now. You need to dose with lactulose longer than you think, as chronic constipation stretches the bowel, leading to more trapped stool. Plus withholding at this age is a big problem, when they get scared of the pain. 💔 I had to gradually wean it down, and were on 2.5ml for a good month.

Too much dairy is a huge trigger for my DC. They were BF until 18 months but on cows milk too, they can't tolerate more than 6oz a day total when combined with cheese / yogurts.

They also need to drink a ton of water with the meal - before or after doesn't help as much. If they're not keen I add a touch of miwadi.

I add pre soaked flax seed to yogurts, and try keep their gut healthy witn a variety of fibres. Too much insoluble fibre can make it worse, as it takes a huge amount of water to push through.

If your DC will eat corn / any food that remains visible in stool like blueberries, it's good to check how long it takes to pass the bowel. I think it should be around 16 hours.

We had very similar with DD who was constipated from 6 months with some particularly horrific episodes. We tried the GP over and over and saw a specialist when DD was about 19 months old and all anyone could do was prescribe Movicol but like you we really struggled to get it down her and made zero progress.

At one point they wanted us to try the disimpaction regime which involved monumental quantities of Movicol. We quit early in the end because it caused horrific episodes in the other direction but it did mean we had to get inventive with how we got the Movicol down which I think was key to solving it all.

Hiding it in DD’s morning milk was a game changer. It was the only drink we could almost guarantee she would finish at the time and on days she didn’t it went on her cereal or in her weetabix. We also got different flavours at the pharmacist. A chocolate one seemed to go down alright in the milk I remember.

We did this alongside regular prune pouches from the baby food aisle, really encouraging water and ploughing forward with introducing a wider diet. DD is nearly 3 now and we’re completely out the other side. Haven’t had to mix a Movicol since last Autumn, DD is fully potty trained and poos at least every other day if not daily with no issues at all.

I’d say if the Movicol works look up ways you can get it down and be as inventive as you have to be. I think we found good advice on the ERIC website.

Milk is isotonic, but food is obviously way less watery. Is she having water with the food, you don't mention any?

Basically for every bit of solid food she eats, she needs to drink enough water so that if you imagine it being mixed together, it's the consistency of thin porridge. (But don't actually mix it together obvs, it mixes in the gut).

Edit to add - some food is watery enough that you don't need to drink water too, iyswim. So breakfast cereal, actual porridge, soup. But if (say) her meal is a small bowl of chicken and rice, then she's need to drink about 50ml of water to get that isotonic

Prunes

The thing that helped most with my daughter was massaging her tummy gently after a bath and cycling her legs up and down. You'll find details online.

It does sound as though it might be CMPA.

I would join movicol mummies on Facebook for advice.
read the ERIC website.
Cut out dairy for 3 weeks and she if she improves.
give as much water as you can.
Give movicol along side the lactulose as much as you can, added to food when necessary.

Ahhh I feel for you, we have just been through this and it’s so hard. This could be my specialist mastermind subject though - are you ready…

• limit bananas, only give ripe ones
• no white bread, only brown and only sourdough
• flaxseed in breakfast
• high bran cereal from Asda for breakfast - like twice the fibre of bran flakes. You’ll need to grind it in a blender or soak it overnight (we do the ground version, just add milk and microwave in the morning, a bit like ready brek)
• get a bag of prunes, soak in water, and blitz in blender. Freeze in ice cube trays and add to cereal every morning. The pouches do nothing and are way more expensive.
• Offer sips of water constantly, at least every 15 minutes, and also make food quite watery eg breakfast

since we’ve been doing these things, my daughter has no issues but we did have problems for months and months from about 8 months - 14 months. Doctor also said when they start moving it helps their digestion so that’s helping too probably.

Edit - remembered another one - olive oil in food where possible!

Nope, he is breastfed alongside solids but also regularly has full fat cows milk in his porridge, weetabix, scrambled egg etc and doesn’t have any issues with that. Cows milk was one of the things that I eliminated from his diet for a short time and the first thing I phased back in because I thought it would be the culprit but he was fine.

Thanks for replying. Sorry for bombarding you with questions but so was he on a lot of yoghurt a day or just the one small pot made him constipated? Ive removed one bottle of cows milk and stopped yoghurt today so im hoping it helps