I don't know what to do

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Posting this on here and parenting cus I'm desperate!
My daughter is 1 next week, and since around 4 months she has had terrible constipation.
I have taken her to doctors on emergency appointments 6-8 times, and this last one has taken me demanding it be investigsted to get a paediatric referral, but it's going to take time to even get her seen and it's a problem now! She is on 2x 5ml of lactulose a day; they told me to keep increasing to this as it was the max but now they're telling me to do more! She has suppositories which traumatise her when I put them in and make her cry and scream, but nothing is working, not even the medication. She cleared her bowel on Thursday, she hasn't poo'd at all today and it's the same pattern repeating! She won't poo for 2/3 days until it's rock hard, then she will hold it in as long as she can until she can't anymore and it comes out so big she screams and bleeds, and all I can do it watch it happen. She doesn't drink enough water I don't think but even when I have tried giving her more it doesn't work, she is funny with food and I will try to give her more fibre but t doesn't matter what I do, nothing helps! She is in this constant cycle of pain and all I do is watch her suffer, it's so difficult and I'm welling up even talking about it! What do I do to help her? She needs to be checked out now! But it's will take ages for anything to happen..

Could she have allergies?what you describe sounds exactly like my friends dd.at the age of around 3 she was finally diagnosed with gluten and cows milk allergy.

I just have no idea, I suppose pedestrian will be able to find out but I'm just at a loss until then, she doesn't eat many things cus she doesn't seem to like you feeding her lumps but won't feed herself much either, so she has yoghurts often and bottles of milk, which I am happy to take away and see if it helps but I'm not sure what to replace the milk with and don't want her missing out on calcium etc, the whole thing is just so awful and all I can think about is her suffering until I'm in floods of tears, she comes and clings onto me crying and i can't do anything but try to comfort her

Have you read all the information on the ERIC website?
2 x 5ml lactulose is a very small amount and not adequate to treat chronic constipation and witholding.
You need a long term programme of movicol and suppositories.
If you havent studied the advice on ERIC you need to do that urgently.
You need a gp who is experienced.
Some are not helpful or knowledgeable.

Dont give extra fibre. You will make things much worse.

More than fibre I'd aim to increase her fluids - even if it means watered down fresh fruit juice and weak squash. She is likely impacted so more lactulose and lots more fluids.

She won't want to eat as when you're constipated you just feel unwell.

Have you insisted on a referral?

Forget about extra fibre - so don't bother with wholemeal bread or rice etc as this doesn't work for children and can make it worse. Her milk is enough for calcium.

Increase her water intake. Just let her have little and often regularly during the day.

Plus more fruit and veg if you can. Sneak in lentils to things like tomato pasta sauce, try her with nectarines and grapes. Sweet potato is good as well.

What is her diet like?

No, I don't even know what that is, the doctors haven't been great and no one knows what is wrong or mentioned more than five extra fluid and fibre, I will read up on whatever I can though,
Doctor said to give 10ml twice now but I thought it sounded a lot! I will try it though,
I insisted on referral Thursday but the system crashed so they couldn't even book it there and then and I had to wait for them to contact me

You need movico. DD was the same at that age and lactulose did nothing. As soon as she went on movicol things improved dramatically. Also agree with others that fluid intake is more important than fibre

Sorry movicol

DD isn't a great one for fibre but adores mushrooms.

Can you give her oranges, cut the segments in half to prevent choking. Also halved grapes and any other fruit she'll eat. Plenty of water will help, if she won't drink it, then you can add a bit of fruit juice to flavour it

Another vote for movicol. It's much more appropriate for chronic constipation.

Just read the Eric thing, there's not much on young children but there is a helpline you can call, thanks, and okay I will take her doctors Monday and ask for that, she will be fully backed up again by them though :(
I squeezed fresh oranges before but she didn't drink much at all and what she did have didn't seem to help, I will cut up some grapes etc though and try those.
Will also try getting rid of how much dairy she has and see if that helps, just very hard not knowing what the cause is but it's becoming psychological and I really don't want her to be troubled with long term issues

Sugar water can help. Just dissolve some in boiling water then use a calpol syringe to get it into get once it's cooled.

Really? Never heard that, once a day? I will deffo try this, easy to do and won't cause any issues giving it a go!

I think a couple of times a day is fine. Maybe give close to meal times, minimise effect on teeth.

Lactulose is inert sugar syrup so the same as sugar dissolved in water??

What about lukewatm milky tea? Without sugar. Tea helps get things moving.

My doc suggested smoothies for my DC at about that age. P fruits are good - prunes, peaches, plums alongside orange juice and grapes

I put Ellas kitchen 'prunes prunes prunes' pouch in a smoothie with some peaches, orange juice and water. Bit of a sugar hit but worth a go. I also find if I make drinking water fun that helped so sucking it from a clean sponge or sipping from a plastic cup - messy but fluids are what will help.

Movicol and a referral are what you need but could try a smoothie over the weekend.

Have you tried probiotics? I hadn't even thought of 'tis, but my DS had loads of issues poo'ing, would scream in agony, it was awful. Saw someone for cranial osteopathy for something else, this came up in conversation and he recommended these. We tried it, and it worked!! We went from lactolose 2-3 times a day to not using it at all within a few weeks, and haven't needed it since (18 months ago). I can't believe the change. We used the BioGaia baby probiotics, only ever used one bottle of it (you add s few drops to milk or other drink). I honestly would never have thought of using them or knew about them really but it made so so so much difference. Might not be the answer for you but could be worth trying.

I used to use prune juice or the prune Ella's Kitchen pouches on DD at that age, the pouches especially were surprisingly effective!

We have the same problem with my 10mo old. We swapped to lactose free milk and she goes every two days now. She used to go 10 days with nothing and would scream and bleed, it was horrific. The doctor was pretty useless and kept suggesting using both movicol and lactulose which still had no effect. She eventually suggested excluding different foods starting with lactose and it did the trick. Fingers crossed!

Also just to add we had tried all the things mentioned above - prunes, orange juice, sugar etc and they had absolutely no effect whatsoever. I'd always thought lactose intolerance presented as diarrhea but apparently it can also cause constipation. We do still give her yoghurt but I believe it's easier to digest the lactose content in that.

Lactulose works by using the fluids in the body so if she's not drinking much it won't work. Another vote for movicol here that's what my son gets it works by softening the stool. When he refuses that we use picosulphate.

I have similar problems with my baby, and found doctors were unconcerned by the constipation and tummy pains. I think you should remove dairy from her diet immediately. Alpro is a good alternative to yogurt, or you can choose coconut milk yogurts. Milk can be soya, almond or coconut. There are spreads like pure instead of butter. Dairy is in a lot of things, so you will need to cook from scratch most likely; but if it helps, it will be worth the effort. Try getting her to drink boiled water which has been cooled throughout the day, and have prune juice daily. Dehydration is a big problem with constipation. Also I'd recommend visiting a cranial osteopath to see if they can help get things moving more naturally.