Advice Needed - Reston,VA

My son has been on Fiber Choice for months at the recommendation of his pediatric gastroenterologist. Because the chewable tablets are just fiber and a little sugar to make them taste good, they don't have the side-effects that a laxative can have. You definitely want to get this resolved early because I can tell you from way too much experience that this can lead to the child refusing to go to the bathroom and that can cause problems that take months or even years to overcome. Good luck! Oh, and blueberries often are quite helpful, too... and yummy!

Fiber fiber fiber, and lots of water. I love the Benecal stuff that you can mix in with any drink, even milk. It's a great way to sneak in more fiber. Fig newtons, dried prunes or raisins. Bran cereals and bran muffins. Avoid binding foods. Hope it gets better soon.

Make sure she is drinking enough water. High fiber vegetables works well. White bread is a no,no. Oatmeal for breakfast also is good. And finally I have found that an apple a day is true to fact. Keep a container with a cut up apple to snacks. If no better go to Dr.

Hi L.! My daughter went through this at about the same age. She was on Miralax for a year, which helped. Also, lots of fruit (even if we were going out to dinner I would always bring her fruit with us!) One suggestion that is not dietary - if she begins to withhold b/c it has just gotten too painful to go, have her sit on the toilet backwards. I know it sounds crazy, but my brother (who is a doctor) told me to have my daughter do this when she was withholding. It really made it almost impossible for her to hold it in. I always just sat on the bathroom floor next to her and encouraged her. It's worth a try :)

Before going the route of medications, I'd give her prunes--not just prune juice. Cut them up. There are lots of very moist ones available now (try Sunsweet)and they come with flavorings like orange essence if she'd like that. The juice is great but whole prunes mean LOTS of extra fiber as well as prunes' legendary benefits to, um, digestion. My kid thinks of them as candy, they're so sweet and soft these days! If you personally hate prunes, do NOT let her pick up on that, though--introduce them as a huge treat even if you have to munch on them along with her.

Also double-check that her "eating well" is including a lot of fruits and veggies and not so much dairy (as others have noted). Keep the yogurts and kefirs but cut out all cheese for while and see if that helps. Also, reduce her starches -- kids love pastas and breads and I find they constipate my daughter if she has too much of them, even the healthy whole-wheat kinds. And remember as someone said, lots and lots of water. As for the antibiotics, yes, they can constipate kids or adults but only temporarily while you're taking them--they would not be the cause of her current constipation if she's not on them right now.

Try having her drink a LOT of water. In my house we call it "fresh cold water" which, for some reason, sounds more appealing and exciting to a pre-schooler or toddler than just "water".
You may also want to get a fiber drink and have her drink it every morning, or get some of the benefiber that dissolves into anything so she won't even know it's there.

Limit milk, cheese, chocolate... you probably know all this.

Just be consistant.

If this all fails you should take her to her family doctor to exclude any medical conditions that may be causing the constipation.

Good luck!

I would push water intake, big-time. Almost always if a little one has constipation troubles it is related to needing more water... not more juice or milk or other liquids, but pure water. My oldest had this trouble as a pre-schooler, and finally what turned things around was upping her water intake by a lot. We had to get creative sometimes: you can watch Caillou after you've finished this cup of water... After your water is gone, we can go out to play, etc.. Small (4 oz or so) cups at least 8 times a day is what made things begin to move on down the road, so to speak.

Good luck!!

grape juice is excellent....i give my kids welch's grape juice......of course fiber too....any green veggies.....add some benefiber to any liquids

Do not give her what they call the brat foods until she has recovered. B=ananas, R=Rice, A-applesaauce, T = Toast. And add pasta to that list. My daughter went through the same thing. Have her lie on her back and bicycle her legs. Water is good, If you are giving juie make sure its real juice and not corn syrup with sugar

My daughter is 8 years old and has suffered from constipation and the discomfort associated with it for many years. Despite a good diet like your daughter has, her digestive system is slow to process things. And, you wouldn't think she was having a problem because she has pooped nearly every day of her life, but the problem is, her poops are hard and she doesn't eliminate everything when she poops, so she gets backed up. The first few years were difficult because she would only tell me that her tummy hurt. After a lot of tests and dietary changes, I finally found an excellent pediatric gastroenterologist who understood and treated her condition correctly. Eventually, she had to have a "clean out" done at the hospital because she was so severely backed up, but it did help her. And she also had a colonoscopy, an upper GI, an acid reflux test and a number of biopsies done, just to eliminate other possible conditions. Thankfully, there weren't any. So, yes, we have had experience with constipation and it's a daily challenge.

Your daughter's diet sounds very good. I wouldn't eliminate dairy from her diet, but I would try to increase her fruits/vegetables to 5-6 daily servings. Also, serve brown rice instead of white, whole grain breads only, oatmeal, apples with the peel, and lots of water and natural fruit nectar. Limit the white sugar and white flour.

My daughter has also been on Miralax daily for the last 3 years. I was told by the nurse that they wean their patients off of Miralax 1/4 teaspoon at a time. Miralax has been great, but I would get a doctor's opinion on the dosage required for your daughter. I would keep her on the EXACT dosage prescribed until the doctor says it is OK to take her off of it. It may be years, but it's important to be consistent with Miralax.

Dr. Scott Sirlin is an excellent pediatric gastroenterologist and I would highly recommend him. He recently opened up his own practice in Loudoun County. I think he's in Ashburn, VA. Unfortunately, he no longer takes my insurance so I had to go to Children's Hospital, but I've been quite pleased with Dr. John Snyder too. Thankfully my daughter is doing much better and we've only had to visit Children's Hosp once or twice.

I sure hope your daughter feels better soon. Hang in there. You're doing well by establishing these good eating habits early in her life. She will appreciate your efforts when she gets older and eating right is just a daily habit for her! It's a lot of work now, but it is worth it!

Hi, my daughter (5) had what we thought was a problem with constipation along with consistent abdominal pain (constant, low-level pain, one spot), which we attributed to the constipation. It turned out that she had a helicobacter pylori infection. I would get her checked out to see if she has an infection of some kind. Antibiotics can really mess up their stomachs while they are taking them -- but usually that clears up within days after they are off the antibiotics and the stomach flora usually shoots back up to normal levels within 2 or 3 days -- esp. with yogurt or probiotics.

I agree with Lisa - continue with what you have been doing with yogurt, etc...but also try taking out dairy products which can severely constipate - and substitute with almond milk or soy, etc and see if that helps...also make sure she is getting tons of water and fiber. FiberOne cereals have a lot of fiber per serving and most of them taste really good too - caramel delight is my favorite! Lots of oats/oatmeal, less sugar, and 100% apple juice may also help!

My son has been on Miralax on and off since he was about 3. He too eats well, lots of fruits and veggies, but was still constipated. The Miralax makes it softer and easier to go. I never heard about the antibiotics thing but my son was on antibiotics a lot too for strep since 9 months old and ear infections before that. But the Miralax works great. It is over the counter. Good luck.

My son who is 8 now has always had trouble with constipation. He would go several days before using the bathroom. He had all possible tests done and found nothing wrong. He is not the best eater. He eats dairy, grains, fruit, and chicken. He just always disliked going to the bathroom, since he was a baby. He purposely would hold it, until he made himself miserable which can exacerbate the problem making the stool hard and large. The doctor put him on over the counter MiraLAX every day. His problems have completely gone away. He does have to stay on his daily MiraLAX. Hopefully he will eventually grow out of his problem. Talk to your pediatrician about MiraLAX. You put it in a drink. It is completely tasteless. It works better than any fiber supplements. Good Luck!

For those using Miralax, please Google and read about "Miralax Toxicity." My son struggled with infrequent bowel movements from before his 1st birthday to well after his 3rd. He would go 7-10 days without anything then have a baseball-sized BM. I constantly asked the doctor about it. He said it might just be his 'pattern' and he'll grow out of it. Finally when he started leaking watery stool around the mass in his colon, he was diagnosed with Encopresis. He put him on a capful of Miralax a day (the adult dose - he was 3). That didn't sound right to me so I started reading up on it. I stopped immediately because of the potential side-effects that are not talked about on the drug/medical sites.

Instead, I tried all of the more natural remedies - started with an enema clean-out, fruits/veggies, fluids, probiotics. Didn't really seem to work. In the end, the solution was to get at the behavioral root of the Encopresis. Kids with Encopresis usually have some painful event that causes them to fear having a BM. Maybe a bad diaper rash or upset stomach. They start holding it in so they don't have to experience that pain. At first it's voluntary but then the holding becomes involuntary. They feel the urge to go and their body automatically kicks in and starts holding. We had to un-learn that. I used a program called Soiling Solutions that reteaches them to let go by using timed suppositories and enemas. Of course, they have to have soft BMs to get it to work well. I upped his probiotics (make sure you have a good one - I used Baby's Jarro-Dophilus bought at Whole Foods - 3 billion probiotic bacteria per gram). I also feed him a pureed mixture of equal parts raisins, prunes, dates and prune juice. I would give him about 1/4 cup mixed in with yogurt or as the jelly on a PB&J sandwich. Finally, he had an Activia yogurt each day. I think these three things helped keep him soft and able to go each day.

I also saw my 7 month old son starting to hold his poops in. Immediately I started him on the same diet and didn't let him go more than 48 hours without a BM. If he did, I would use a baby suppository or enema.

My thoughts on suppositories and enemas are that they are not as bad as most make them out to be. My children did not become dependant on them. I view them more as a tool to help the child void, remove the hard blockage and make way for the softer stuff that the child can then void on his own. Of course, that assumes you've been pushing a good diet and lots of fluids.

Hi!
Been there! All the P fruits are the recommended measure - i.e. peaches, pears...apple juice and milk can be constipating...fiber, water and exercise are great! Not too much water, though...

Miralax has been recommended to me, but I don't know if it is okay for use in children; you might want to check it out. Good luck! Happy New Year! :) N.

Hi L.,
Someone else mentioned Miralax earlier, and I wanted to endorse that. It IS NOT a laxative, so don't worry, and she wont become dependent on it. My daughter had a minor abnormality in her anus, and she a small amount with her bottles for the first 2 yrs until she had more muscle control. It is like adding fiber, but much surer. The most recent use was when my oldest (4 y/o) had surgery and was VERY constipated from the medications. It took a few doses, but when she finally pooped, she jumped up and down cheering. Any drug store will have it. I recommend starting with a smaller dose than recommended, but you can add a little at a time every few hours until she goes (if the dose is going to work, you will see it within 2-3 hours at most).

Hope she has some relief soon.

S.

My son has always suffered with constipation but his is due to his fussy eating , as your daughter has quite a good diet I would speak to her Dr to check it out. In the meantime you could try Miralax (available at CVS , Rite Aid in the laxative isle). It's a stool softner rather than a laxative , we use this with my son so that he had BM's that he can control.

I just wanted to pass along the analogy my doctor used for me -

"think of your stool as a sponge - when it's dry it's hard and when it's wet it's soft - so make sure you drink enough water"

To much dairy can be binding for some people so I'd make sure she's not having too much at least until this clears up. Good luck!

Have you mentioned it to her ped or nurses on call? One thing they told us to get for our son when he was constipated which seemed to help was Milk of Magnesia. Also, try not to give her more than a couple cups of milk a day. We were giving our son too much.

L.,

My daughter has had constipation issues since about 1 month old. We tried everything. When she was 2 and we had tried every home remedy out there I asked her ped and was told to use Miralax. Its safe and we have had very few issues with constipation since then. Plus, its a flavorless powder that can be mixed with any drink which makes it easier to get her to take it. I give it to her for 2 days then I skip a day. This seems to work the best. I hope this is helpful. Good luck!

S.