Constipation in a 3.5-year-old: Movicol, potty fear and when to see GP

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Hi all,

My 3.5yr old is having his first bout of constipation and we’re not sure what the best course of action is.

For context, he has passed very solid poos on Friday and Saturday. On Sunday he was getting really distressed about going on the potty and also having a lot of wee accidents. We called 111 in case it was a urine infection but they think it’s constipation and have given us movicol sachets.

He then passed two hard poos that night. However he had wee accidents at nursery yesterday and is screaming every time we take him to the potty. He seems really worried to even go for a wee now 😔

My questions are - how long should we use the sachets for and are 2 a day enough? When would you go back to the doctor?
Also is there anything we can do emotionally? I’m really worried this one bout of constipation is going to lead to him getting a bit of a fear of the toilet. He has been potty trained for almost a year and never reacted like this.

For context, he is otherwise well, no temp and eating and drinking pretty well. We’re giving apple juice, apricots and pears to try and help.

We also stopped breastfeeding last week and I wondered if that could be a factor - like is there a hormone that helps them go?! I mentioned it to the doctor at hospital but she looked at me like I was mad.

Thanks all x

Is he getting enough liquid if you’ve stopped breast feeding? I would think that a possible likely cause? Do you mean potty, or the toilet? I would think that a child that age would have outgrown a potty a long time ago. Is he uncomfortable on it?

Did 111 just advise over the phone or did they see him in person? If he's not been seen then I would definitely arrange a GP appointment and try to get a urine sample to take for testing. The GP can do that and palpate his abdomen to get an idea of how bad the constipation is. He may benefit from picolax as well as the laxido if he's badly constipated. He may also need a disimpaction routine where you keep upping the laxido until you get a day or two of total diarrhea to be sure it's cleared the backlog. Search the ERIC website for more information on this. And keep the fluids going, that's really important.

@Nottopanic he uses either a potty or the child seat on a toilet, seems to like to pick and choose! He’s quite little. We’ve been trying to increase his fluids but this is a good point, thank you

@Ramblingaway sorry yes, 111 arranged an appointment for us at the out of hours. He got really distressed again today so we managed to get a GP appointment. She felt his tummy and thinks he’s not too backed up - advised carrying on with the movicol for at least a week until we reassess. My worry is how fearful he seems of going to the toilet at all now. Thanks for the ERIC rec, looks really useful

Movicol works by bring more liquid to the bowel and making poo softer. 2 is probably enough unless he has some dry bits inside him still. My DD has 1 a day and that keeps every going. The main thing that makes a difference to us is lots and lots of drinking and my DD doesn't naturally do that. I have to remind her.

It's common to take movicol for a while (think months not days) in this situation as the fear of it hurting makes children withhold and then it's painful and the cycle starts again. A long period of soft poo helps break that cycle and gets them into a good pattern without worry.
Look at the Eric website for more help.

BM does have an affect that makes them go. The two could very well be related.

The emotional side will probably be helped naturally as it becomes less of a struggle for him to go, just give plenty of reassurance in the meantime. As a PP mentioned, water intake is really important especially as you’ve recently stopped breastfeeding and perhaps this hasn’t increased accordingly - if you struggle to get him to drink enough, try getting a new cup/water bottle that he finds exciting, this usually works with my DC. Also would he eat the baby food pouches of prune puree? They are very good for constipation and you could mix into yoghurt or porridge if he won’t eat them alone. Hope he starts to feel better soon, it’s awful seeing them in that sort of discomfort 😞

Children often withhold after a painful bowel movement. So, assuming he's going to the toilet, not on a potty, I'd sacrifice a few toys and put them in the bathroom for now, so he's got a reason to want to be in there. If you were using a potty, maybe now is the time to switch up to the toilet to break the association.

Ice lollies and jelly are a good way of increasing fluid intake. There have been days when mine had had 2 or 3 ice lollies. Orange juice can also get things moving. Sometimes long warm baths help as well as the warm water eases any pain.