How to potty train DC with chronic constipation?

[AntoinetteCosway]

DD is 2.3 and in many ways I think is ready for potty training. She tells us when she's done a wee or poo (though not when about to), pulls her trousers down when she's gone (wherever she is!) and really doesn't like having dirty nappies. She's also fascinated by me going to the loo, loves flushing, washing hands etc. She's had a potty for a few months just to get used to having it around and does sometimes sit on it but hasn't ever used it.

The problem is she's been constipated since Easter. She's on Movicol and eats well and it's largely under control but about one in every four or five weeks are dreadful and she's in agony.

Does anyone know whether it's even worth trying to potty train? My worry is that it will be too traumatic when she's constipated. The GP says the constipation is one of those things and will eventually go away...she also suggested we potty train her just for wees. How on earth is that possible if she's still in nappies for poos?

Any advice gratefully received. At the moment I'm leaning towards just leaving it till the constipation's gone and praying that doesn't take another year.

well this is a tuffy... is there something that triggers the constipation eg: she is a bit stressed or she eats more than normal for a bit. Try potty training with wees and poos and if she has constipation you might be able to keep her on the potty in front of the tv to use as a distraction. What sort of pain? Is it her belly or pushing poos out? weird question but may help?

Oh, I feel your pain! We had the exact same thing with dd at that age. She didn't potty train until just before her third birthday but then it was really quick, and while she was just getting over the constipation, finally.

Movicol worked but what made the difference was a parent with experience (and on the advice she'd received from a paediatrician) telling us to treat as long as she'd been affected for, and not to reduce the dose of movicol too fast. It's a powerful laxative, and basically if they can hold anything while on it, they're still withholding (applies only if withholding is your dds issue and not true constipation). Whenever ours did a poo in her sleep, we cut it by half a packet.

Weirdly, potty training helped because she got rewards. And (warning, detail!) I think they do a more complete motion on the potty than in nappies, especially if they otherwise like to stand to go.

All the other tricky stuff for 2 year olds, like plenty of fibre and fluids, does help, but more important I think is no sudden dietary changes. Going on holiday and her not having all her usual homemade food I think is what a started all our problems. Later her diet wasn't as good as it had been but as long as it was regular, she was okay.

There's a great book, for older kids really but as mine got to 3 it started to work, Constipation, Withholding and Your Child, by Anthony Cohn (a doctor). It gives you a story to tell about Mr Poo getting cross and kicking their tummies if he doesn't get to come out when he wants. Dd still occasionally mentions it, at nearly 5, usually a sign that she needs extra broccoli and water!

Apple & pear juice mixed with prune juice and water helped too. Also dried apricots and lots of fluids if you can get her to take them.

Good luck, I remember how horrible it could be.

Thanks for the replies, particularly the book recommendation. She does eat masses of fruit (and veg, though not quite as much) and drinks a lot too. It's a nightmare really-the GP seems to think it's just an entirely random thing and not related to diet or lifestyle which in a way is frustrating as it means I can't change things to help her. She's down to half a sachet of Movicol a day-I've tried cutting it further but it quickly makes it worse again so it's interesting what you say about not cutting the dose too quickly. The GP suggested going to every other day but that very quickly makes it much worse again. The pain is dreadful-it's hard to tell whether she's straining to push out or hold in but she's clearly in agony, screaming, tense all over and red faced. Thankfully it's only once in a while now but when the constipation started it was non-stop for a couple of weeks before we got the right medicine at the right dose. Awful

I think I'm going to leave potty training for a while and play it by ear while she's still constipated. It's hard because I don't want her to get upset by nappies etc as she's clearly getting to the stage where she doesn't always want to be in them.