Constipation in a Potty-training Toddler

I know milk and milk products cause constipation... maybe cut these out for a few days until you get to the doctor. Just a thought.

We have that problem in our family...but it's not related to an accident.

Children in our family are EITHER born with near adult sized large intestines OR twisted intestines. In many ways, in this day of surgeries the twisted intestines are easier.

Maybe some mums would be horrified to hear me say that, BUT holding and rocking your toddler as they cry in fear for hours at a time IS heartbreaking. It's hard on them, and it's hard on us. It doesn't get any easier, either, until their rectums and bones catch up to their intestine size. Well...it gets easier as they grow and as they gradually get used to the pain...but not easier in any other sense.

I would highly second taking her to the DR. to see if this could be a temporary thing. PLEASE try and remember to make it as non-traumatic as possible.

If it's NOT temporary...here's what's worked for us:

1) Regular diet : ie NO high fiber, milk of magnesia, etc. It seems counter intuitive...but for some reason it works. Perhaps because the void response doesn't happen until the intestine and rectal passage are full, and those types of foods are actually VERY dry and solid. We notice a huge difference when our six year old is eating a high fiber diet...he's miserable...and it stops him up like a cork.

2) Lots and lots of liquids. The more you have, the less your body is concerned about extracting every last drop of moisture from your wastes...and the wetter the softer.

3) Patience. Patience. Patience. A whole lotta love. It's NOT their fault. They're not only doing the best that they can, they are also learning to face their fears AND to intentionally do a very painful thing. Repeatedly. Many, if not most, adults aren't capable of doing that.

4)An ounce of nonchalance & a lot of positive reinforcement. The nonchalance comes into play, because if any of this gets traumatic, or gets a big deal made out of it, it's actually harder...because we, as humans, tend to put off things we're scared of. Also, our void mechanisms are tied into our emotional responses. While EXTREME fear can cause a void response, none of us are going to do that to our children!! For positive reinforcement: "I know it's hard and scary, honey, but I know you can do it!!", "You're a good, brave girl." etc., are phrases that build confidence and recognize the struggle your little girl is going through. Conversely "I TOLD you to drink your juice.", "You should have done this before bedtime/we left for the store/etc." just impart more guilt and make the whole thing scarier...Not only is it going to hurt, but Mum's going to be mad if I don't do it right. Really, who needs drama about the bathroom?

5) Lube. Good quality, expensive, lube. And just a fairly large dab on the surface skin, no need to go interior, unless they want to start applying it themselves. In a pinch, vaseline will work.

Good Luck,
And for both of you, I hope it's a temporary thing.

Hi S.,
We too have struggled with issues from medically induced constipation. My son went through cancer treatment when he was 15 months old. The chemo and pain killers created havoc on his intestines.

The pain from pooping often causes children to hold in their poop due to fear. (This is relatively common in children who have not had any medical issues). This in turn makes the poop larger and harder to pass and the vicious cycle continues.

We found that Miralax was the wonder drug. Under his doctor's supervision my son was on it daily for several months. We needed to keep his poop soft and his intestines moving. (His intestines were paralyzed during treatment so we essentially were trying to retrain them). This did the trick. His poop was loose, but regular.

As part of this treatment we also had him sit on the potty after dinner every night for a couple of minutes. It’s the body's natural response to want to have a bowel movement after a meal. A year later he still does this nightly "sit". 80% of the time he has a bowel movement.

My other words of wisdom are get fluids into your child. Water is probably the best, but juices are great too.....a fluid is a fluid. When my son was on treatment, the nutritionist recommended pear juice. Guava nectar has a lot of pear juice in it and was a favorite of his during treatment. (Now he will not touch the stuff). It might be worth a try.

Good luck!

PS. I also found it can take a couple of days for Miralax to get through the system.

S. - Hi there, I know how awful it feels to watch a child suffer trying to go to the bathroom. The little girl that I nanny has had the same problem (she was two).
She would not go for days and then when she did it would be adult size if not bigger and there would be tears and crying with even a little bit of blood. I talked to her parents over and over and they FINALLY took her to the doctor.
The doctor said that she had been stopped up for so long that the end of her bowel (right before the bottom) was "expanded" and the waste would sit there, get hard, and then when she would have to go it would just be so painful for her.
She is on a "metamucil" like powder every morning and it really seems to be helping. Her pediatrician said that she should be on it for AT LEAST a month until she regularly has a poop a day and it is soft. She is still on the powder (although I think it's more from her mom not giving her the powder every day) but it has helped IMMENSELY.
I would immediately take your daughter to the doctor. You don't want her to tear her rectum or lower bowels with hard waste sitting in there. Imagine how awful it must be for her to have to go potty and KNOW that it is going to hurt. Poor baby.
Good luck, L.

Have you tried removing the Dairy from her diet? My two year old can't drink MILK, she has to have soy milk or she gets constipated no matter what she eats.

The Mirilax works well in applesauce.

Also...PEAR SAUCE if she can think it's like dessert..it's very sweet if you steam up some pears and puree....mix in the mirilax and it is also another thing that is not constipating.

Good luck, we have the same issues.

J. Van Riper
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S., My childen also have dealt with constipation. Hydration is an important key factor for sure. We use Innergize which is a great tasting body hydration drink that comes in powder form that you mix with water. I will sometimes have my daughter drink it at the time she is having difficulty and it will help her in less than half hour. Having some on a daily basis is the best though. It comes in lemon, orange, and cool punch and tastes great! It is sold thru a company called Reliv and we are distributors as our whole family has seen marvelous health from their nutritonal products. Let me know if you want more information. ____@____.com

I haven't read through all of the responses below, but it looks like you have some good info regarding the chiropractor (our chiropractor specializes with children and she's GREAT: Dr. George @ ###-###-####), and looking into dairy or other possible food allergies. A definite key thing (also already mentioned) is hydration. I've also occassionally given my older son (4yo) half a tablet of the FiberChoice supplements. They're chewable and he likes the flavor, and they're really good (especially if taken daily) for your digestive system.

Good luck!

It sounds like the beginning of IBS. irritable bowel syndrome. You are doing a lot of the right things that should work. My instinct is to go to the doctor (and what you are doing), because with all the fiber and fruit that should be relaxing her bowels, it still isn't working. You are doing what my doctor told me to do. It took me about three weeks to normalize. I would also restart the potty training as soon as possible, reassuring her that her body just had a little misstep, and is not ready for the potty training.

Miralax is wonderful! Stop with the milk and dairy (at least that is what our pediatrician recommended) and definitely continue with lots of fluids, especially water.

Chiropractor! With her being in a full body cast and just how much kids grow. I totally recommend getting her checked by a chiropractor. There are so many things connected to being out of line, including digestion and bowels. Check out http://www.chirotacoma.com/index.php they are located in Tacoma, but they have some info on their website. If you call they may know of someone closer to you. They only charge me $15 to have my kids adjusted. Hope your little girl gets better.

My daughter was constipated (stools every 5-7 days) because she didn't eat enough quantity of solid food to push the poop out. The doctor had her on 1-2T of mineral oil added to every cup of milk she drank -- there was some brand I got at the pharmacy that emulsified into the milk (and didn't leave a slick on top). That made her stools softer and easier to push out. We also did diced pears, apricot juice and oatmeal or cheerios (soluble fiber) to help her via diet.

My daughter had terrible cycles of constipation, painful pooping experience, which led to constipation again. On and on and on throughout her potty training. Thankfully my neighbor, a pharmacist, recommended Fletchers Castoria. He used it for his son who had the same issues. It was heaven sent for us. It is rootbeer flavor so she would take it without a fuss. And what is really great is that it isn't a strong stimulant like many laxitives or suppositories. It is very gentle and natural and makes going easy. Once she realized that it didn't hurt to go she got over it all very quickly. We did keep on hand when she got older for bouts of constipation and it was great. You will need to ask the pharmacist for it. They don't keep it on the shelves. Good Luck.

Hi S.,

Wow, it sounds like you're doing a great job keeping options open, being non-judgmental, and not being attached to where she's pooping. Good for you.

I think the chiropractor suggestion makes a lot of sense, considering that the problem began with a broken leg and a body cast. If something's misaligned, it could be causing limited nerve conduction in the nerves that supply the intestines. I see you're in Seattle - not sure which part, but I know a couple good chiropractors in Seattle. Let me know if you'd like names.

Apart from possible structural misalignment, the 3 most common causes of constipation are low hydration, low fiber, and low exercise. A general guideline for hydration in an otherwise health person is to take the weight, divide by 2, and drink that many ounces in water daily. And then if you're giving your daughter insoluble fiber supplements (like Metamucil), increase that water intake furhter! You need to make sure the fiber doesn't just expand and sit there, but actually move all the way through.

Also, it sounds like one of the responders has a particular medical condition in which fiber doesn't seem to help, possibly related to enlarged intestines. This isn't generally the case (speaking on medical average). Usually fiber is a good thing.

Is your daughter active since breaking her leg? I'm assuming by now it's healed, since she's young and kids heal fast. In adults, it's common to see an increase in exercise solve or at least improve constipation issues.

There are also supplements (certain minerals), certain foods, and herbs that can help. A naturopath is a great resource for this, and can help you avoid chemical laxatives. For example, ground up flax seeds offer both fiber and lubrication, and are frequently helpful, although since I don't know your daughter, please don't misconstrue that as medical advice - I'm just speaking on averages and giving an illustration. If you're interested, I'm a naturopathic physician myself, and can probably help you find one in your area of town.

Good luck!
D.