Constipated 2 1/2 year old - 4 days without doing a poo - need help!!

[Corky]

My son in in his 4th week of toilet training. Last week he was weeing and pooing at home and at nursery - then suddenly at the weekend he does a hard poo which had a bit of blood on it and now he hasn't been since. He is in such a state and is holding it in now to the point that he won't even wee as he knows it relaxes his bottom and the poo starts to come out.

He eats hardly anything as he's at that age, drinks plently of apple juice with water and milk in the morning and evening. I try to get him to eat fruit and veg but the longer this goes on the less he is eating.

I am rapidly losing my patience with it as he now screams when i put him on the toilet or potty if the poo urge comes. He won't even do it in a pull up either.

I have just started him on lactulose today and also tried prune juice but he won't touch that.

Can't think of what else to do - I was really horrible to him tonight and feel so guilty now as I know its not his fault.

I'm going through exactly the same thing although we are not potty training yet.

Seems to all have started off from a hard poo that made my child bleed too. The doctor prescribed lactulose today, and luckily my child will drink prune juice (well at the moment anyway!). The problem is, as I'm sure you know, once they have had one painful poo, they think they are all going to be like that so hold it in, which of course actually causes it to be hard and painful. It is really horrible to see your child suffer, but very important to stay calm and sympathetic, otherwise they will stress even more (hope this doesn't sound patronising as it is really not supposed to).

I really feel for you and know what it's like.

My dd became really constipated during potty training and lactulose and senna combined (from the GP)were what helped her in the end.
At her worst she was doing one poo a week in her pants whilst upside down on the sofa screaming.

It is really difficult to stay calm when thy are like this (as I really wanted to say'for f*ck sake just poo and then it won't hurt) but it is the best thing you can do.

The lactulose and senna got her pooing again, to start off at night in her night nappy (as she relaxed going to sleep). Then as her whole system eased out she started going during the day and I went with her and cuddled her and rubbed her back and then gave her a 'poo treat' of a choc button/smartie.

It took her a long time to relax about it (I waited for about 6 months to take her to the GP so the problem was really ingrained).

Hope some of that is helpful.

It's important that they eat whole fruit and not just the juice. The fiber of the fruit is essential in keeping them regular. Also pooing position can be really helpful. Try sitting him on toilet and then having him lean forward so that his tummy is resting on toilet seat between his legs. It helps for you to be standing in front of him and he can hold your legs for balance. Separate his buttocks and gently massage his lower back. Make sure that he doesn't try to push the poo out while you are doing this. It will be much less painful if the gut does its own contraction thing and poo just slowly comes out. Can take awhile, so don't stress because that will just make it worse. (this is same position as putting baby on its back and pushing thighs up to stomach to get poo out)

Also, re position on loo, try giving him a step for his feet (after all we don't dangle when we are going - hard to relax like that!)

I really empathise with you - DS1 did this for about six months and it's the most stressful child-related problem I have yet experienced. I finally found a link to a Paediatrics journal on the web (link now seems to have been taken down unfortunately) that said the following:

1. Tell child that going to the toilet is his own responsibility, and that you won't constantly ask him whether he wants to go, or tell him to go (and then you have to STICK to your end of this bargain, which can be very difficult)

2. If he has accidents, try to keep calm and totally neutral about it - no anger, no sadness

3. Offer reward for any poos that do go in potty, loo (or even nappy to get you started)

4. Use a laxative (Lactulose is just a stool softener, I think), although you should probably talk to your GP about this first

5. If the child goes beyond three full days without a poo, you need to take action because long-term with-holding like this can cause problems for the bowel. Create a dull, enclosed space (bedroom or some other room from which all toys, tv etc have been removed), and tell him that he will have to stay in there until he produces a reasonably-sized poo.

That was the gist of it, and it really did the trick for me. We had a sticker chart - one sticker for a full day without peeing accidents, one sticker per poo (be generous at first), small rewards for every 5 stickers, and a big reward (a trip to Diggerland) when the chart was full up.

However, I should say that DS was a full year older than your son when we were having this trouble, so some of this might be a bit too much for him to take in?