Constipation in 2-5 year olds

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Questions

• 3-yr-old's chronic constipation and now fear of potty
• 4 1/2 yr old girl constipated for 1.5 yrs now
• 2 yr old with frequent constipation & large stools
• Constipated 3yr-old: should I worry?
• Two-year-old's long term constipation
• Chronic constipation - 2YO
• Potty training a child with a history of constipation
• 2-year-old is constipated since introducing solids
• Foods that help with Constipation
• Mineral Oil and its alternatives

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3-yr-old's chronic constipation and now fear of potty

March 2011

My three-year-old started having on-again, off-again bouts of constipation last fall, with her most recent bout remaining for 3+ weeks. The situation has been so relentless, that I just want to scream or cry or both. We'd already been through the drill on what to do in this situation: offering her as much constipation-battling fruits/juices as possible, Miralax when that doesn't work, and if worse comes to worst, suppositories/enema. It always ends in the latter result and is excruciatingly painful for her and horrifying for us to witness.

I keep trying to get her back on track by keeping her on constipation-preventing foods, but she's picky on top of it all. I offer her as much as I can, but in the end, she refuses it. She doesn't even want apple juice. I've resorted to giving her baby food jars of prunes, which she will actually eat. But still, that hasn't been enough to overcome/prevent the constipation.

To compound all of this, she is afraid of sitting on the potty. She hasn't tried using the potty for a year now. Her inflexibility worries me and I have tried every strategy in the book in regards to toilet training - if she won't even sit down on it, we can't go anywhere with it.She seems to have irrational fears that have persisted more than a year. (Another one is that she won't sit down in the bath tub. She's never had a traumatic bath experience.) In every other way, she is perfectly normal and very bright. She's articulate, artistic, imaginative, affectionate, etc.

I think that our moving around has something to do with all of this (we had to move two times, from out of state, within a one-year period), but we've been settled in one place for almost a year now. Has anyone else been through anything remotely like this? What am I missing?

Out Of Ideas; Feeling Isolated

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Oh dear, I feel for you. Please look up 'encopresis'. It sounds like this is what is happening. Highly doubt is due to your recent moves, etc. Our daughter also had this problem and was so painful, until we realized, got aggressive in the treatment, and helped her gain confidence through this. I think it is likely that your daughter has had large, painful bowel movements and is now afraid to have one on the toilet as a result. Our treatment now is regular miralax (daily), but initially we gave Magnesium Citrate (by mouth) to clear out the bowel (agree that enemas are far too traumatic at this age) and then we kept her bowel movements incredibly soft for over 6 months, so she could gain confidence that it would not hurt. Proud to Poop

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Hello, We had a very similar situation with my daughter at 3 - 4 years old. After a couple really rough months (for me one of the more emotionally wrenching times as a parent was seeing my little girl crying in pain on the toilet), we put her on miralax every day, and we continued the miralax for an entire year. I put it in her water (sippy cup) and she never knew it was there.

We also got a book called ''It hurts when I Poop!'' that helped a lot. The first time I read it to her, she sat on the potty for the first time in weeks. I couldn't believe the effect it had!

I know that miralax every day is totally creepy (my daughter got a bloody nose the first day we gave it to her which freaked me out plenty), but after reading some internet forums of older people suffering with lifelong constipation, i felt that it was important to treat this aggressively. Now my girl is 5 and very healthy with perfect toileting!

p.s. don't let people tell you this is just an emotional power struggle. whew, glad that's over!

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Re constipation - you could try probiotics for a few weeks and see if that helps with her constipation. That's a easy fix. She probably can't swallow capsules but you just open them and put in apple sauce or mix with juice. Or there are chewable ones, a good one is Kirkman Bio-Pro Chewable Wafers http://www.kirkmanlabs.com/ViewProductDetails@Product_ID [at] 184.aspx this really has helped my son who had the opposite problem - constant diarrhea but it can also be very effective with constipation.

Enzymes taken with meals also help break down the food and Houston Enzymes has some good ones such as http://www.houston-enzymes.com/store/product.php?c=1&p=4 which is also chewable.

Those are the easy approaches, the next thing to do would be to remove problem foods such as casein or gluten.

Constipation is a sign that things aren't going so well down there and in holistic types of medicine, stool problems are taken much more seriously - not that she has a serious condition but that there may be digestive and absorbtion problems that can be relatively easily fixed. If it keeps up, I would take it a alternative pediatric doctor, they don't see constipation as a normal. anon

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I am so sorry for your daughter! My daughter also had terrible chronic constipation, and it got to the point that she was too scared to go to the bathroom. Here's what we had to do for about 8 months: Stop potty training. Miralax every day. Kiwi every day. In moderation: cheese, milk, blueberries, and breads.

Basically we had to get over her fear of going to the bathroom; the more her fear was the more she would hold on worsening her constipation. Warm baths always helped, and we would read to her while she sat on her little potty. Sometimes if it was really hard we'd let her watch tv- anything to grab her attention from what was going on. We did get through it, but it's still something we watch for today (she's 9,) especially when we travel. Good Luck!

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You are not alone! Our now 4.5 yr old has similar issues, though it is now much better. Things that helped: book called It Hurts When I Poop, available on amazon, that explains the digetive system, the importance of some foods over others, and will let you child realize she is not the only one. Also I heard about Lil Tummies chocolate flavored laxative from this newsletter -- it is gentle and works well and my picky eater will take it. Also, every morning and evening, my child gets Pedia-Lax Fiber Gummies or Hero Fiber Yumi bears. They taste like candy and REALLY help keep her poop from being so hard. Like your child, mine is a picky eater and drinker so it is very difficult to keep her from having hard poops, so just trying to change her diet doesn't work for us. We found the fiber bears and laxative very occasionally worked better for us than the suppository becasue, as for you, that was traumatic for her and us. I feel for my kid, because hard poops hurt, and sometimes cause tears which then really makes it hurt, and so the child natually tries to avoid pooping by holding it in as long as possible...which just makes it harder and bigger. If your child will eventually sit in the tub, we found the warm water helped ours relax, releived some pain, and there was a period when she was able to make her B.M. in the tub. (Maybe she won't sit int the bath because she has already realized that the resultant relaxation makes her want to go.) We've finally transitioned to the potty. We used bribes of new toys, candy, whatever it took. More recently, when it was obvious she had to go, my husband shut her in the bathroom and said she couldn't come out until she did it. Exactly what you aren't supposed to do! She emerged after 20-40 min of crying (heartbreaking!) proud and happy. After 3-4 times of this, she has taken to going on her own, and is very proud. Overall, this problem is not easy and I recommend talking to your doc for other ideas because the longer this goes on the worse it can get. anon

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My 4 year old daughter has also had some pretty major bouts of constipation. We give her half of an adult dose of miralax every evening. Her doctor says it is very safe and that it is very difficult to get kids at this age to get enough fiber in their diet. She still doesn't poop every day, which I think would be better, but she no longer spends agonizing hours on the toilet trying to go. Terri

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Hi: I have had serious struggles with constipation myself so I am hoping that some of my experience can be helpful to you.

First, on the potty anxiety-does she hate the potty because she associates it with the trauma of needing to use a suppository/enema? Could you start by rewarding her for being brave every time she has to use the suppository or pass a hard stool? I went through a period of 6 months where I could not go without suppository and rewarding myself with a bath every time I had to do it helped calm the upset this was causing me. I know she doesn't like the bath but perhaps there is something she really loves that could be incorporated into her "pooping regimen". The other thing that really helped me was to educate myself about the digestive system so I understood my problem from the science perspective. Have you tried explaining to her how it goes from food to poop or reading the poop books together?

Now, onto the poop itself:-)

Here are the things that have helped me. When things get really bad I have to do them all every day

1) Re Miralax, have you tried upping the dosage? Miralax is the same compound as is given for a bowel prep for colonoscopy so in high enough doses it must work. For me, I often need to take 2-3 caps a day for a few days. Ask your pediatrician for the real safe dosage - its much higher than it says on the package.

2) Have you tried Metamucil? Some brands do get gelatinous and have a choking risk for a toddler but the orange flavor Metamucil brand tastes pretty good and does not thicken much at all.

3) Try not only adding "good" food but also eliminating all bad food (ie nothing processed, no white rice, white pasta, only whole wheat bread.)

4) Does she like pumpkin or butternut squash mash? These are magic for poop.

5) Try the following regimen each morning: Right after wake, some physical activity (doesn't have to be much-just enough to get blood running), then some hot lemon water (if she will take it), then a whole grains breakfast.

This can all be a lot of work however if you throw them all together for a few weeks you will likely see some improvement.

Finally, if none of this works, just want to make sure you know about Fleets Liquid Glycerin suppositories for the really tough days. I find this product to be a lifesaver for me and much less upsetting than wax suppositories or an enema.

I really hope this is helpful to you. I so sympathize with how upsetting these issues can be. If none of this works, I have some more ideas however they are a little gross.Feel free to contact me through the moderator if you want to know

Good Luck! Knows Her Poop

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4 1/2 yr old girl constipated for 1.5 yrs now

August 2008

Our girl has had very hard poops and/or total constipation for over a year now. Sometimes she'll even hold her poops (knowing it will hurt coming out) for days at a time, which has forced us to give one enema so far. Our MD at Kaiser had her on Glycolax precription laxative for months, that hardly worked. Then they recommended drug store laxatives like Benefiber, etc. Still not much luck. One MD recommended we take her off dairy, which we (mostly) were able to do over two weeks, but that didn't help either. We are divorced parents, so my daughter goes between two households and is being raised vegetarian. Unfortunately, she eats a lot of starch (white rice, pasta, pizza) and probably a fair amount of canned/frozen/processed food as well (at the other house, which is where she resides 75% of the time). She does like prunes, but not enough to affect things. Both homes have been integrating whole grains for some time, and the primary household likes to use high fiber processed nutrition bars. Also being used are chewable multi's with iron, chewable papaya supplements, and 4 Tbs. of flax oil a day. And even still, hard poops persist. We have found a great ND who can do nutritional and allergy testing, but it is going to be an expensive endeavor, which i am hoping to avoid as money is super tight (we're talking up to $200 for a consult). My daughter is very active and is in a Montessouri school about 40-50 hours a week. As such, I've long suspected she doesn't drink nearly enough water during the day. She is going to be five soon, and I feel like she already is developing weird food issues and body issues. Any advice from experience we'd greatly treasure it! - Pooped Out

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It's possible your girl isn't getting enough water, and it's also possible she's got a gluten allergy on top of dairy (or instead). Try taking her off of all gluten (wheat, barley, rye, oats) and see if that makes a difference. On top of that, it seems to me that 40-50 hours in day care for a 4 1/2 yo is a lot of time away from mom and dad, esp. with divorced parents. Is there a way you can address possible emotional issues?

Having had the same issues when I was in grammar school I can see now that it was about control, for me. Of course I didn't know it at the time. No one could make me poop...it was the one thing in my life I COULD CONTROL.

I'd definately go for the nutritional consult. It could easily be food allergies, which is WAAAYYYY easier to deal with then emotional issues (and food issues can affect emotions A LOT!) Good luck, anon mom

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I could have written most of your post about 3 years ago.

The solution to your daughter's problem is incredibly simple and easy, but you must be absolutely consistent, do not miss even one day.

One teaspoon of Benefiber every day in about 2 ounces of liquid. That's it. Problem solved.

Now let me explain. I have an 8 1/2 year old daughter that has had such problems - from infancy - that she had a vagal response with profuse sweating and her eyes rolled back in her head when trying to pass a large, hard stool. The vagal response was what the pediatrician diagnosed. (If you don't know vagal response read the book Midwife, the vagal response made the midwife think the birthing mother was dead.)

In the end, my daughter's pediatrician said that no child should have to suffer such severe pain for something that can be so easily solved. So we started on Benefiber and it worked from about the second day forward. No loose stools, just those that ''regular'' people have.

My daughter has tried lots of liquids with Benefiber and Gatorade is what she seems to prefer. The slightly salty taste makes the Benefiber taste-free. The Benefiber bottle says there is no taste, my daughter swears there is a taste - the Gatorade works.

We were so comfortable, we stopped Benefiber once for two days, the stomach cramps, hard, large stools started back up as though she never had started the Benefiber in the first place. We started back up the Benefiber and haven't missed a day since and my daughter has NEVER had another episode. Thank You Dr. Garcia (Oakland Kaiser)

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I recently posted a similar question about my son and got a lot of helpful advice. I am not sure what the trigger with your girl might be, with my son were probably several hard poop that hurt him and since that he decided that withholding it would be better and not painful.
I have addressed both his diet and my own behavior to the process. I started making it more matter of fact and avoided focusing on it and stuck to a strict schedule for using the potty. For the diet I can recommend the following: - eat fresh fruits BEFORE meals - apples, pears, plums, peaches, apricots are all helpful, especially helpful before breakfast in the AM. - boil a mix of dried fruits and have her eat the fruit and drink the water, it is actually quite tasty - fresh squeezed kiwi juice works wonders as well as the fruit in itself - of the vegetables - cabbage, carrots, tomatoes work really well, again consumed before the main meal, fresh. Cabbage is helpful cooked too. - I realize you are a vegetarian, but you need to decrease the starches a lot, pasta and rice especially do not help. We pretty much stopped eating rice at home and eat pasta once every 2-3 weeks. - legumes - beans, lentils are helpful - buckwheat, it is a great substitute for rice, as any whole grain, btw. - not sure if you can find this but a teaspoon of rose leaf jam works wonders - some say that probiotics help, I am not convinced about that, but it doesn't hurt to use them.
If all else fails - Miralax is the medicine that continues to work for my son. I think we are all wired differently and some just can't go very regularly. Good luck, I feel your pain. Z

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Is she getting enough liquids? My son wasn't until we handed him a cup with a straw. Now he SLURPS liquid down and poops fine. Before we figured out that he problem was really liquid intake, he was on Miralax which did soften his poop. It's an OTC med, just recently moved from prescription. straws are cheap!

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I was in your shoes a year ago. It was my son. It is very common, especially if a child has had hard poops-- they get afraid of letting it out b/c it will hurt! It only compacts the problem, literally. What happens with encopresis is that the holding of the poops causes their colon to stretch out. What I was told that no amound of fiber will help this b/c the bowel needs to shrink down to it's right size which is why doctors want to prescribe a laxative such as Miralax that will keep the child pooping so that the colon can come back to it's original shape. After almost a year on the laxative, I was worried that my son would be on it forever! I did not want that but I also didn't want him to go through any ''episodes(writhing, screaming, painful poops. leaks!)'' at school. I spoke with a homeopath. She felt confident that she could remedy the situation. We decided to do it over Thanksgiving since we'd have 5 days at home. So, the Tuesday before Thanksgiving was the last time my son got Miralax (but I didn't tell him!). Then on Wednesday morning, he recieved a homeopathic remedy. Believe it or not, we haven't had any issues! It really worked! It was amazing how quickly he responded to the remedy!

One time about four months later he backed up again. She came right over and gave him an emergency remedy and seriously, he pooped within an hour. Two days later, he came down with a fever and the homeopath really felt like the constipation was an early symptom of his oncoming flu!

As a side note, since the first remedy was administered, I have been giving my son chewable probiotics, DHA's and EFA's and a Metamucil cookie EVERY morning! He is and always has been a great eater. Lots of veggies and fruit. He's not a huge starch eater. I also think drinking water is very important. The homeopath is in Pleasant Hill and she is Klara Fischerova. You can reach her at 925.297.7293. I can't recommend her enough! I know there are many who question homeopathy but I am telling you, we tried everything and nothing helped but this worked! He didn't know, so there was no placebo effect. Here we are 9.5 months later and no more Miralax and no more hard poops! Good luck. I know how stressful this is, not just for your little girl, but for you too, watching her go through this! LogicalMama

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Iron is constipating. Our doctor advised us to throw away the vitamins. Actually you are probably seeing how demoralizing it is to be unable to poop. Miralax worked wonders for us. anonymous

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I'd meet with the teachers and discuss how they can help ( dried and fresh fruit or popcorn as a snack?) Encourage drinking at school with a drink in her cubby?

Our pediatrician recommends Miralax ( 1/2 of the white capfull mixed in liquid per day as preventative for our 38 pound 5 year-old) which has helped. Summer we can skip some days since we sometimes have just fruit and green beans for dinner ( after more balanced meals). The dose can be more if it's not enough to keep the child regular.

If you don't want to use it daily, you and your ex. might want to track if she's pooped or not and give her Miralax the next day after she's not pooped. Since it takes 4-6 hours to work, you can mix it in a drink- bottle with apple juice for her to have with lunch at school. That way she can poop at home in the evening.

We've found that the long-range plan is for our whole family to get more fiber. We've started having blueberries from Trader Joe's or other fruit for desert! Good luck! Jean

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Stop the iron supplement, as they are very constipating. Your pediatrician can order a blood test to rule out major food allergies (dairy, wheat, soy, etc). It's not very sensitive but a negative result usually means you don't have an allergy, so it's a good starting point, and probably covered by insurance. And start cutting out the processed foods! Fruit and oatmeal is better for her than a high fiber power bar. Hope this helps.

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You mentioned that you're a vegetarian family, but you didn't mention a high fruit and vegetable diet necessarily. (Perhaps you were thinking that that was a given, considering you're vegetarians?) So, something to think about: increasing her daily fruits and veggies intake. Also, the iron supplement might be aggravating this problem. Good luck! Mailisha

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First and foremost, check with your pediatrician. There could be some physiological reason for the constipation. With that said, if you cannot get it right away, try water and prunes (a jar of baby prunes work well). My 8-year-old nephew had the same problem for many, many years until he last visited us. I suspected that it may be his diet; I don't think his mother watches what he eats. While he was here, I was able to control his diet by removing all simple suguars (e.g., soda, candy, cookies, cakes), having him drink more water and introducing whole prunes. On the very first day of trying, he pooped. Two days later, he had two massive poops! This really had a positive impact on his self-esteem because he was often concerned about soiling his underwear, particularly at school. The ongoing constipation would create an urgent need to evauate, something he could not control. Good luck! Michael

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Hello- We went something very similar. We ended up seeing Dr Tom Cowan in SF. http://fourfoldhealing.com/ He gave us some herbal remedy (Chinese I believe) that worked wonders. We had tried everything before. He does not take insurance but if you have a PPO you can submit it yourself for partial reimbursement. Best of luck. It's a trying situation. cindy

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I didn't see your original post, but saw the responses, so I just had to chime in. First, how I feel for you and your daughter: 1.5 years is a long time to be constipated. My son was constipated from 1.5 years to 3 years. We tried everything: no sugar, only whole grains, fruit and veggies, no pectin-containing fruits, lots of water, no dairy, homeopathy. Well, hydrating and fibering-up just wasn't enough. The rectum muscles stretch over time, and lose their ability to push: they need an opportunity to constrict, and your daughter needs a break from the pain (and to disassociate pain with pooping). Miralax saved us: I rejected laxatives for so long, and they saved us in the end. Talk to your ped: it's time for the laxatives: it will get her over the hump. ms

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2 yr old with frequent constipation & large stools

March 2008

My son is 2 yrs and 3 months old and since day one has been having problems with his stool. He was exclusively breastfed until 6 months so during that period the explanation was that most breastfed babies have infrequent stools. His were about every 3 days and were runny and abundant. After starting solids we noticed that he still had problems so being mindful of that we adjusted his diet insisting he ate as much as possible fruits and vegetables and drunk plenty of water. These days he eats all of that, drinks fresh squeezed juices not from the box, barely eats any sugary or salty snacks, rarely eats rice and I try to restrict bread. He has generally good appetite and eats quite well but is still a little on the skinny side. He eats only home made food, a lot of soups, whole grains only and yet he is still having problems passing stool. He would have a good week with passing a stool every day and then all of a sudden will have sometimes up to a 3-day long constipation. I have a feeling that as soon as his stool gets a little harder he can't go. He often cries when he is pooping and we have just started getting him used to using the potty but haven't really pressured him to do it. He normally does it standing in his diaper, twisting his legs a little and sometimes I have a feeling that he tries to hold it instead of pass it. His stool is normally big, I'd say close to the size of adult's one, and soft. Probably 4-5 times he has had some blood on it too, even though not in the last 9-10 months. Has anyone had similar experience? I am afraid that he has some chronic condition like enlarged colon or a fissure. Drs have not been extremely helpful telling us to do what we already do. I wonder if dairy or meat can cause that somehow. Please, if you have heard of similar cases let me know. BZ

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Can't comment on nutrition (sounds like you're trying the right things), but 2 additional thoughts: 1. Does he get enough exercise? Being in motion, running around, even doing some baby yoga twists could help get things going. 2. Offer him the potty or toilet insert more often, beginning by just going there for practice & fun. At 2y3m he's very likely ready to move on from the diaper, especially given that you say ''I have a feeling that he tries to hold it instead of pass it''. (Tangent: I used ''elimination cummunication'' with my 1st one late, with my 2nd from birth, and he has been using the potty exclusively since 19m. EC authors often talk about babies/toddlers signaling to parents their more-than-readiness by holding it in and not using the diaper.) Best of luck to the little tummy! Constipated mom, regular kids ;-)

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Yeah...oh....yeah did we have that problem. Watch his starch intake (I.E. pasta, bread, rice, potatoes, etc...). Up his liquid intake a lot, try calcium fortified juices and cut down on the milk. Also, our doctor recommended a half a cap of Miralax in 8 oz. of juices once a day, lessen the dose as the situation improves. It's a gentle over the counter stool softener, and it works like a charm. We give our 2 1/2 year old a half cap every few days now, just to make sure he doesn't get backed up. I will say while we were going through it, I came to find out it's very common. Good Luck.

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For peace of mind, I would suggest seeing a doctor. If it's bright red blood, then it's likely from the hard stool. If it's dark, or black blood, then its happening earlier on in his digestive tract and that is a bigger concern. In terms of diet, I would try feeding your son foods that are warm or atleast room temperature and I may try feeding him less raw food fruit. Baked apple, cooked vegetables, lots of water, the whole grains you are feeding him---all good foods. I would also recommend massaging his abdomen on a regular basis beginning around his decending colon, massaging his whole lower belly and abdomen and coaching him with taking deep breaths. Work slowly, with care, and intuition. holding is nice. If you want some alternative care modalities, Chi Nei Tsang and Acupuncture are great choices. Best of luck!

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I'm all too experienced with these cycles of constipation, and as frustrated as you are in dealing with them. Our daughter's began when she started solid food at 6 months. She's now 2.75, and has good months and bad months. Though I'm sure diet plays a role, I also understand from our ped. that there are physical changes that the colon/rectum goes through every time it experiences a ''back-up''--the rectum itself stretches, so it can hold much more before the urge starts, and the nerve endings themselves stop sending signals that it's time to poop. So the cycle continues and gets worse. Our main ''strategy'' besides promoting all the right foods and trying to avoid all the wrong ones is to use a stool softener (we use both Miralax and an organic fiber powder) daily in a bottle of oat milk (more fiber!) to keep the stool very soft. Then it's up to our daughter to learn to recognize and respond to the urges, and not hold it in (which I've definitely seen her do, for hours at a time, and it's agonizing to watch).

In part I wonder (nonscientifically) if it's possible that some kids have extra-sensitive rectums in the first place, so that if they have a painful pooping experience, they're more likely to clench up and say ''I dont' want to go through that again!''

Whatever it is, I sympathize with your situation, because the cycle is very hard for a parent to watch without wanting to intervene. Ultimately, each little person has to learn how to poop for themselves, and apparently it requires some UNlearning, too. Our latest attempt is to offer a longed-for lip gloss as a prize for being able to poop 3 times in a row on the potty. She's done it quite a few times, so we know she can, and she seems VERY motivated by this reward. And anyone who can poop on the potty regularly is clearly a big girl, and ready for big girl lip gloss. I'm hoping that what we're creating is a commercial version of a bio-feedback loop, where she learns to tune in to those urges because of the prize that will follow.... Who knows. Anyone else tried this or any other route to help ''re-awaken'' the urge? like poop through a ??

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My son has the same problem. We've tried fruit everyday which helps but when we take a day off, the constipation starts again. I definitely think it is diet related but it's hard to narrow it down specifically. I think it's something to do with dairy. His doctor recommended taking Miralax for a few months which has helped so far. He's been consistently taking it for a few weeks now and is regular. We'll see what will happen when we take him off of it after a couple of months. Anon

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Dairy, egg whites, and wheat are the three biggest causes of food allergies, these could all cause constipation. Dairy particularly.

Breast fed babies poop more, not less than formula-fed as general rule.

I think your son is allergic to one or more foods. I would eliminate all three. I think that egg yolks are usually not the culprit, but make sure. If your son's stools improve then slowly add back foods to see which is the problem.

Also, make sure your son is getting enough probiotics. You can get a powered form at a health food store. Best of luck

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Just one thought - some children (not all) get constipated from cooked apple products such as applesauce or apple juice. Also bananas. If you haven't already, you might try prune juice, apricots, or pears. They sometimes help. anon.

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You are right--it is not normal for a 2-yr old to have frequent constipation. Doctors will tell you that ''everyone is different, some people move their bowels once a day, others less frequently....'' This just doesn't make sense when we consider that a healthy infant does, in fact, poop several times a day. Why should that change so dramatically as we age? I believe it is because our gut flora (bacteria) gets messed up. Of course, there could be specific medical conditions causing your child's constipation, but if doctors haven't been able to help you, you have nothing to lose in trying to clean up his gut: give him probiotics, digestive enzymes and a magnesium supplement. No harm in giving him 500 mg (or more) of vitamin C per day, either--both magnesium and vitamin C can have a stool-softening effect, and both serve great roles in the body. The probiotics are to support the growth of good bacteria, which is needed for proper digestion and elimination. The enzymes will help ensure his food is being properly digested. And yes, dairy can absolutely contribute to constipation, particularly pasteurized milk (refer to http://www.realmilk.com/rawvpasteur.html). So that would be a good place to start--by eliminating pasteurized milk. Best wishes. Tracy

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My now 8 year old daughter had similar issues beginning in infancy. Finally at 7 years old she had an episode of vagaling while trying to pass a stool, (Vagaling is a type of losing consciousness) we took her to Kaiser Oakland and saw Dr. Garcia. Dr. Garcia was kind and gentle with my daughter. She talked to her about how a child, anyone really, but especially a child should never have to have this type of pain.

My daughter now takes a teaspoon of Benefiber mixed with Gatorade in the morning and again in the evening. Why Gatorade? After about 5 months of playing with putting it in yogurt, cereal, other food, orange juice, water, milk, etc. we found that my daughter likes it in Gatorade the best.

My daughter has not had a single episode since. There was a period of time where my daughter chose to cut back to once per day. She got some stomach cramps that reminded her of the old pain and chose to go back to Benefiber twice per day. Been there and happy not to return

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My son had this problem when he was about 3 1/2. Now he is fine.

His (new, good) doctor put him on Miralax (over the counter). A tasteless substance you mix in juice. Now he has regular bowel movements, every day or two. The initial few months are a little difficult, as at first the dose can make loose stools (sometimes necessary if the child doesn't want to push since it hurts them.)

His (old, bad) doctor put him on Milk of Magnesia. An awful substance that reminded him of his problem and he felt punished at having to take every day. Don't go that route. Kids get this problem, they get awful stomach pains, they don't go for days, they may stop pushing, their poops are very large or even spherical. It actually can stretch the lower intestine. It's a medical problem. anonymous

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I agree with the miralax suggestion, as I have had to deal with my 4 year old, and his complete phobia of pooping at all, because of a bout with constipation. After that episode, he decided he was done pooping altogether, which is scary because it can lead to a multitude of health problems, including MORE constipation becasue of holding it in, and even social embarassment.

The other thing I do, is puree yams, carrots, and cauliflower to sneak into spaghetti sauce, macaroni and cheese, and chili, as he refused to eat his fruits and veggies. I also put constipation relieving fruit into pancakes and oatmeal, as well as giving him fruit leather. (The good kind that are flat and full of fruit from Whole Foods Market, not the roll-ups that are full of processed sugar.)

I do this because of two things. 1.) It gives him the nutrition and natural health aides that he needs in order to soften his stool, and 2.) it enables me to make efforts on the side in order to get him to eat his veggies with less of a battle because I know I don't have to worry about whether or not he's getting enough to promote a healthy and problem free digestion of food. He's getting it from the food that I sneak in there. The results have been amazing since I started concentrating on making sure he got plenty of fruits and vegetables in his diet.

I started with the miralax,(So that he HAD to go) and weaned him off by means of sneaky fruits and veggies that he didn't know about. While that was going on, we started with one bite of veggies at each meal of sneaky one's, and now we're pretty much at the point of him eating 3 ''knowing'' bites at each meal with no fussing. It's a work in progress, but it's what has worked for my very strong-willed child, and my peace of mind, because now he's pooping in the potty saying ''Mommy! Come see this!'' K. B.

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Constipated 3yr-old: should I worry?

October 2006

my son has had infrequent (every 3-7 days) bowel movements for the last 1 1/2 years -- since he stopped breast feeding. They are always large, and cause pain, although only occasionally hard and compact. We have tried everything: mineral oil. prune juice, homeopathy, decreased dairy, increased fiber and water consumption (as much as I can considering that he loves refined carbs). some remedies have partially helped, but he continues his cycle of a few days of happiness followed by a few days of clingy unhappiness preceding the poop. He is like a changed child after the BM: our whole household feels relieved and lighter. His preschool teachers don't believe that he could have a psychological problem -- he is so relaxed and easy going. Our pediatrician has told us that some children nauturally poop less frequently and we shouldn't be concerned. My questions are: 1. Is it really normal to have such emotional swings related to bms, to poop so infrequently, and to dread the pain of pooping? 2. Who should we go to if the pediatrician offers no help? should we demand certain tests? are there possible conditions that she has overlooked? We have tried a homeopath with some success but couldn't get messages returned when the treatment stopped working. 3. how will my son ever learn to poop in the potty if he can barely accept pooping in a diaper? he can't go to kindergarten with slippery mineral oil poops sliding out uncontrollably. Thanks

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If it seems painful to your child, I would be worried. My 6 year-old son has had constripation problems since he was several weeks old. We tried everything you mentioned with limited good results. About a year ago, the pediatrician prescribed Miralax, which has worked really well. You might want to talk to your doctor to see if this might be a good alternative for your child.
Susan

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I am a child psychologist and I think you could use some help with this from a psychological point of view. Most MDs do not know much about the psychological issues that accompany witholding stools. Anne

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See another pediatrician. Symptoms of ball-shaped poops, very painful hard poops, anal leakage, infrequent poops are symtoms of a problem that affects a few percent of young children. My son had this problem (started with not liking to poop, progressed to holding in poops), and his pediatrician prescribed Milk of Magnesia to soften up the poops (NOT fiber or metamucil once he is already constipated, that just piles up more poop inside). We moved & changed pediatricians and his new doctor offered a daily medicine that is taken for 6 months to break the cycle of painful poops, which we probably are going to start on soon. (This is instead of Milk of Magnesia, which is yucky to ingest.) His new pediatrician said if there are painful poops, crying from being constipated, anal leakage, or if it is an issue you have to think about almost every day, you should think about going on the medicine. I feel for you, my son had many miserable days where he was crying and crabby from a sore tummy from being full of poop, missing out on activities, and many miserable painful poops too. Also, it's not good apparently for the intestines to be really stretched out a lot. There's probably more info about this on the web. Good luck anonymous

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Fiber makes poop soft and easy to come out. Children often eat small amounts of fiber rich foods and that is ok, but that means these foods need to be offered everytime they eat. It doesn't have to be whole grainy stuff; fruits and veggies, fiber rich cereals work well for young kids. For example to whatever your son usually has, add 1/4 of an apple with breakfast, bran chex with snack, whole wheat crackers or 1/4 of fruit with lunch, fig bar with snack, cooked baby carrots at dinner. This is not something to ''try'' this is a lifelong health habit, that is good for the entire family. I have seen this work well for many children with difficulty pooping
pedi professional

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Try probiotics. We use Baby Jarrow. It is a good bacteria that takes the bad bacteria with it when leaving your system. Probiotics are along the same lines as the acidpholus (sp?) that you find in yogurt. You might also seek the help of a holistic type chiropractor. Both of these suggestions helped us when determining that our daughter was lactose intolerant and having digestive issues. Good luck! Couldn't live with out probiotics.

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Two-year-old's long term constipation

March 2006

Ever since my two year old was born, she has had severe cases of constipation, hard stools. She is a big eater and therefore poops really big. No matter what I have done, it wont help her constipation. Can toddlers have hernia's trying to push the stool out? If so, what would a hernia look like? I tell her pediatrician but of course she would just only say its normal for kids to have constipation, eat fiber, drink a lot of fluids and then dismisses the fact that my daughter's constipation has been going on ever since she was born. Her constipation doesn't happen evertime she poops but nearly half the time. And when it happens, its pretty bad. I have done everything to prevent her constipation but to no avail. Will this cause damage to her anus in the future? I am really worried about and feeling like Im useless helping her. I have heard about cranial-sacral therapy for kids, will this help with constipation? Help

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My daughter had a terrible problem with constipation starting at age 6 months. I tried everything and finally when she was 5 I saw progress by using this product (which I discovered on the BPN web site): http://www.earth-friendly.com/juiceplus.php3. She drank that juice for about a year and that brought things under control. Now she is 9 years old and is fine. Good luck! Marion

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This worked with my daughter who had the worse case of consitpation that no medication would cure. This also has worked with many of my pediatric patients. Approximately 20-30 minutes after dinner (the evening meal), to take advantage of the gastro- colic reflex, have your child sit on the toilet (or potty chair). Feet must be able to touch the ground. Have your child read something (picture book or mail order catalogue will do-- something to keep your child's interest and help them relax for 15 minutes or so while they are sitting on the toilet). Do this every night for 2 weeks straight. Even if you don't get results at first. This will take care of constipation if you are consistent. If you can continue this for 21 days you'll make it a habit! Evenings are generally better than mornings time wise! anon DOC

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Does your daughter drink cow's milk? I read a book by a harvard public health physician and researcher. He cited a study where a group of kids with severe constipation were taken off cow's milk and were switched to soy. Within two weeks, the constipation disappeared in two-thirds of the kids. If she drinks cow's milk, it's worth a shot. Good luck! Anon

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Chronic constipation - 2YO

Nov 2004

I am at my wits end. My 2-year-old daughter has been suffering from chronic constipation for about 1 year now! And it seems to be just getting worse. She is constipated more often than she is not. This has affected her moods greatly. I notice she is more sensitive and aggravated when in a constipated state (which has been all the time lately) and talking all the time about '' ouwie poo-poo''. We were first advised by our pediatrician to use mineral oil, which has been in her daily diet for at least 10 months now. This does loosen her stool but we still often have bouts of ''ouwie poo-poo''. I was than recommended a prescription drug called Miralax. This caused a lot more talk of ouwie poo-poo to the point of tears. I believe she was suffering from the side effects, which I had read to be bloating and cramping. I than told her pediatrician that we wanted to see a gastrointestinal specialist. She told us no specialist would see us unless I kept my daughter on the Miralax for at least a year. Meanwhile this stuff has not been tested on children and claims to be addictive. Sooo, now I am seeking alternative approaches. We have seen an osteopath just once. She did some cranial work and she told us not to give my daughter any grains! No rice, no corn, no wheat, no rye, no oats, etc. This has been near to impossible to do. If she can't eat grains, I can't eat them in front of her. I am 8 months pregnant and eating this way does not feel right. I have lost 2 pounds. Besides, my daughter has showed no signs of improvement. She has been suffering with days of constipation. I am willing to continue with the osteopath, but cannot stick to this no grain diet. We have kept prunes, raisins, pears avocado, tofu, nuts, and eggs in her diet, and have stayed away from bananas and other foods known to be binding. The only vegetable I can get her to eat is broccoli and sometimes spinach if it is disguised in a quiche, but I worry about the cheese because it is binding. Sorry so long winded here but I really need advice and truly believe that my daughter may have a more serious internal problem than just constipation, but I can't seem to get her doctor to take her and me more seriously to send her to a specialist. Any advice will help Please.

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To help your little one with constipation, I have a few tidbits of advice. I have four children, and I went throught this with my son when he was about the same age, as have many of my friends. A few things are essential: First, not one bit of REFINED flour--stick exclusively to whole wheat pasta, bread (and check label for transfat and high fructose corn syrup, both of which complicate digestion). Mash potatoes with the skins on, make yams which are very high fiber, etc. It's hard, but not forever, and good for the whole family. The sprouted breads are especially helpful. Second,give her flax seed oil every day for the omega oils AND the laxative effect-I'd also say cod liver but for the questions about mercury. Best to give it in a cup of whole juice--prune or concord grape, no sugar added. No peanut butter unless it is crunchy and unrefined, no sugar period. Honey is okay--it's pretty laxative. It really helped my son to have oatmeal and grapes for breakfast, a crunchy peanut butter sandwhich with honey on whole grain bread with seeds every single day for awhile, along with whole milk vanilla yogurt for the cultures to keep the intestines healthy (no other milk products), and then a simple dinner like beans cooked in broth with carrots and onions, and homemade cornbread with whole grain flour and unprocessed corn meal, along with a can of corn added. And give only water as a beverage except for the flax seed juice. Aside from diet, I also think this problem arises first because kids can suddenly ''control'' their bowel movements, and so delay going if having fun (note that few unpotty trained kids have this issue). Then they have one incident, and it is terribly painful, so they hold it more, and the problem escalates. So I'd institute a rough and tumble play time every evening after dinner (since exercise also ''loosens'' things up), then a relaxing bath--I used to read to my son in the bath just to keep him in there as long as possible. What started to happen was that he would then REALIZE he needed to go because he was relaxed and in touch with his little body`, get out of the tub and go poop, then would get back in to finish the bath. I also put lavender oil in the bath, both to soothe him to sleep AND because any oil will lightly coat the anus and help the feces slide out a bit more comfortably if there is irritation. It takes about a month but this regime will clear things up WITHOUT meds, which I personally believe are problematic and can exacerbate the problem by creating dependence. Good luck! Cheryl

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After much drama around poop in our baby -- our doctor finally determined that she just has a very efficient colon -- meaning its a super-sucker of all the water and she's left with hard poop that she can't pass. After trying things (including removing all grains, boosting all kinds of fruit, and variety of laxatives and suppositories) we are on a low-dose of Milk of Magnesia twice/day and it works great. It is non-stimulant, so there aren't painful side-effects, and it is non-habit forming. We're just gonna' be on it 'til she gets over this. Jennifer

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I am so, so sorry your daughter is suffering like this. My son had constipation since he was an infant. He suffered for 7 years. The doctors (we saw more than one pediatrician) were not concerned that my son could go a week without a bowel movement. They said it he would outgrow it, that it was a regulatory issue, etc. We tried all the usual stuff -- prunes, fiber, fluids, mineral oil, etc. Nothing worked. Still the doctors saw no cause for alarm. We, like you, worried that something was seriously wrong.

In desperation, we tried the elimination diet. Basically, you remove most things from your diet for about 2 weeks then reintroduce items one at a time and see the effect. It turned out my son was sensitive to dairy, corn, and soy. Dairy in particular will make him constipated immediately. Even goat's milk will make him constipated. I am still kicking myself for listening to the doctors for so long and I am furious at their cavalier attitude towards constipation. However, I am grateful that we (quite blindly) stumbled upon the solution to my son's problem. I wish you and your daughter the best. Anon

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Very often digestive problems can be caused by misalignment in the spine....vertebrae are out of alignment which affect the nerves, muscles, organ function etc. I can highly recommend taking your babe to see Dr. Charlie Prins, a chiropractor on Solano ave in Bkly. Charlie not only does chiropractic adjustments (gently too) but he also uses a muscle testing technique called applied kinesiology to find out which parts of the body are deficient, what the body needs nutritionally, etc. Charlie has been treating me for a few years and has helped me totally change my diet to a more healthful one that is unique for my body. He sometimes gives me homeopathic remedies for virus's, various weaknesses and various deficiencies. He can test for food allergies using AK. Charlie is also a dad and works with babies, kids and adults. He treats me and has treated my older son for food allergies/constant colds in the pastand is a nice guy as well. Good luck finding someone who can help you. His office number is 526-6243. By the way, when I was an infant I had a similar problem due to an ingredient in my formula (wasn't breast fed). My mom says our family chiropractor (in 1953) cured me. anon

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We also went through a terrible time with constipation with our 2 year old. She would hold it and then be afraid to go. We actually had to disempact a couple times manually, and it was like digging out rocks. It was horribly traumatic for all of us. We tried the mineral oil route also, but what finally took care of the problem was metamucil crackers. They sell them in safeway. We had her eat one every day with a cup of water, and she started going again on her own. I guess it makes the urge too strong to not go. We probably did this for about 3 months or so, and that was the end of that. Good luck! saved by metamucil

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I would talk to another pediatrician, if possible. Or call around to some GI doctors to find out if what the pediatrician says is really true (that they won't see her unless she stays on the meds). It is hard to believe that ALL GI docs practice the same way.

I also recommend seeking other types of help. I have used ''alternative'' medicines for most of my kid's health and medical problems, with great sucess. One easy thing you can do is give your daughter a firm but gentle massage on her tummy. Generally, you would massage in large circles, clockwise, which eases the intestines (I would probably consult a book to get the specifics on this type of massage).

I also highly recommend the well-known and loved Homeopath, Christine Ciavarella. Her number is 510-524-3117. She is a wonderful resource and exceptional with children. I can also recommend a fabulous chiropractor who does lots of cranial sacral work (similar to an osteopath) on infants and children. Her name is Chinabear Joseph and her number is 510-272-9019. Both my kids have seen her since they were infants and my husband and I see her regularly. I hope this helps. Feel free to contact me directly if you want more info about the folks I reccommeded. awinger

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Hardness of stool is related to a balance between diet and water in the stool. Sometimes it helps to work on water intake so the body does not pull as much liquid from the stool to make it hard. Make sure she is drinking 6 to 8 glasses of water throughout the day. Also, consider trying different types of fibers (Psyillium, beet, pumpkin, flaxseed) to help as different people respond differently to each one and some will constipate one individual and soften another. For me corn bran is constipating but beets and Uncle Sam's cereal with flaxseed help. Still making sure I drink enough is the most important factor. a parent who deals with it herself

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My daughter was constipated from birth. We finally took her to see a pediatric gastroenterologist. We went to one in the city, Dr. Linn. They are really comprehensive. We have also to been to one at Children's Hospital, but they were less thorough with us. You might want to go see the practice in the city and let them have a look. They helped us through a very difficult situation. anon.

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try Karo syrup or molasses in milk or juice. Our pediatrician recommended these when we had this problem with our daughter. The sugar (especially in the molasses) reacts in the gut and eases digestion and therefore constipation... jas

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dear mom, I've been there and am there sometimes with both my children. My son is now 5 and the constipation problems started at 12 months. My daughter is 2 1/2 and it's off and on with her for about a year. Like you I tried many, many natural, diet related things under our ped's. care. Even accupuncture and herbs. My son at 18 months could go days (up to 8!) without a movement. Needless to say, it hurt;his tummy, his mood, everything. Then with our doctor, I said it was time for mediciation. It's a life saver and worked easily, Lactoluse is the name. I highly recommed it. It changed our life, made going to the bathroom easy. For a month we did it 3 times a day, then once under control, 2 times a day, then to 1 time a day. With my son we did 1 time a day for 2 years. Now he only rarely needs it and it still works. My daughter has need some -one time a week for about 6 months, now only occationaly. No side effects. Unless you call happiness, joy and an easy potty time, side effects. I called them trilling. Also, think about switching doctors. You want a docotr who you feel is listening to you and your child's needs! you deserve it. hope it helps. been there

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Potty training a child with a history of constipation

Feb 2005

My almost 3 year old daughter has a history of constipation and is taking miralax. She has shown interest in potty training and has all the text book ''potty readiness'' skills. She is however more interested in underwear than actually using the potty. She was wearing underwear at pre-school and her teachers thought she was doing great sitting on the potty, however she was actually starting to hold everything and became very constipated. She is great at the holding part but not ready to use the potty. She is now on a potty training break, prescribed by her doctor. The most important thing is for her to just go and not hold. She has excellent social skills and we are worried that she will sooner than later be separted from her peers at school because of the potty issue. We have the opportunity to switch her to what might be a better school but may not be able becuse of the potty issue. Any ideas on next steps. She is still interested in potty training despite her recent constipation. Help!

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My son (teenage now) was constipated from the time he ate his first solid bite until he was 3 1/2. He was withholding, sometimes for 10-14 days, it was awful. We tried every laxative, enemas, all to no avail. Our wonderful pediatrician (now retired, sniff) suggested this: Get a family of dolls and a doll toilet and some brown clay. Set up a game where the family is going about their business and the doll kid (you be the kid for this game) says ''Mommy I have to go poo. No, I don't want to go poo''. We were supposed to then sit back & get insight into whatever was bugging him & let him play his fears out, watch him play the scene out. Well, he jumped up & said ''I HAVE TO GO POO!'' & ran off to the bathroom & was never constipated again. It was astounding. Sometimes a kid can work stuff out through play & we can't even see what they're working out. The worst that can happen is you have a nice set of dolls & some brown sculpey.... Jenny

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Start feeding that kid foods that will be harder to hold in, and increase liquid consumption (a belly full of fiber, but dehydrated, leads to straining to poop). Nice, natural ways to ease her out of constipation include: oatmeal, watermelon, & grapes. Increase her fruit [juicy fruits, not bananas] intake overall for awhile until her body realizes that pooping is nice, not hurty. Most kids are glad to eat fruit, because of sweetness. These provide such a nice, natural lossening of the stools that they should start coming out with no pain - and she won't be able to hold it for extended periods; she will have to GO. After awhile, you can go back to a more normal amount of daily fruits to keep things balanced.

To add variety, make fruit smoothies that include plain yogurt and cinnamon she gets to sprinkle into the blender - one sprinkle for each year of life, so she doesn't dump the entire container in.

If one parent goes Big Potty at the same time each day, your daughter could be added to the routine, even if it's ''Mommy will go first, and then it's your turn to try to poop''. She doesn't have to be in the bathroom while you're going.

OR, her routine could also be to try right after a warm bath (which encourages muscle relaxation).

This doesn't specifically address the psychological component of holding one's poop in, but food is a good, natural thing to use in addition to working with the stressors. Having several successful poops-with-no-pain is a great way to get past psychological barriers.

Healthy Poop Promoter

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This week's advice about the doll, doll toilet and brown clay is both hilarious and helpful-sounding! I also recommend swiping the anus with a little olive oil, to loosen things inside. Don't push in, just use a finger or a baby wipe with a little oil on it and one wipe on the outside, just like if you were using toilet paper. The anus will absorb the oil all on its own. anon

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2-year-old is constipated since introducing solids

Dec 1999

My 2 years old boy is chronically constipated since I introduced solid food in his diet.He has very big and hard stools that are very painful to pass. So far, I have been giving him mineral oil - 2 teaspoon - everyday and try to have him drink prune juice as often as possible. Otherwise, his diet is quiet good : he drinks quite a lot, and eats vegetables and fruits in a regular basis. Still, as soon as this diet is not respected, even for a day, I'm sure he will be constipated again and have a terrible time going over it. Does anybody have a suggestion or have experienced the same trouble and find a durable solution ? Thank you in advance.

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My 14.5 mo. old daughter had pretty hard stools when she first started eating solids too. Besides the fruit and vegetables, I made sure she got plenty of WHOLE grain foods for fiber, and every morning (until just recently) I gave her one ice cube of pureed prunes mixed in with her cereal. I also avoided rice and bananas. After a while, her body changed and now she deals fine. Good luck

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My daughter(22 months) also suffers from constipation. I have her drink at least 8 oz's of water per day. (I add the water to her milk) plus prunes. This seems to help her pass softer stools. Good Luck.

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My daughter had the opposite problem one summer - much diarrhea. I looked this up in my Doctors book of Home Remedies for Children Rodale Press. For constipation, one thing they mention is a spoonful of corn syrup. And they mentioned that this is the primary ingredient in many fruit juice popsicles. So while she was getting too loose from them, your son may benefit from this treat. Check the label; there is one made without corn syrup. You want the ones WITH corn syrup. Also you might try reducing cheese (I have no idea why this works for some kids) and of course starting the day with a cup of prune juice.

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Mineral oil is a petroleum product that *takes* minerals from the body. I advised a client who rubbed it on her very dry feet to stop. It can also inhibit blood clotting. Constipation (as well as diarrhea) can be a symptom of a food allergy/sensitivity. I would suggest seeing which foods might be clogging as well. To support his gut, it would be helpful for him to have a probiotic (acidophilus, for example), some body work (clockwise massage of large intestine, some Jin Shin Jyutsu, Epsom salts bath), and maybe some flax seeds in an appropriate form (high lignan). Of course, adequate exercise is essential.

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This has been an ongoing almost-problem for our 20-month old as well. WE find that as long as we make sure she has as much cantelope or seedless grapes each day as she'll eat, the problem is under control. I suspect cheeries, zucchini, and other fruit/vege type things would also do the trick. If I run out of cantelope or grapes and she goes for a day without these, elimination is difficult and painful. Good luck.

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Foods that help for Constipation

For constipation in people of all ages, my sister has a solution that works great and has no side effects (except the obvious). Here it is: Drink water until your eyeballs float.

Seriously, she recommends keeping a large glass of water generally at hand, and getting into the habit of sipping from it frequently. It works well for her and for a lot of other people, and it's good for your body in many ways. (My own experience is that it's better not to use mineral water, because the carbonation can lead to gas. Tap water and spring water both work well.)

I agree with you that it is important to solve constipation problems in very young children as quickly as possible, because little ones may react by holding back their bowel movements for fear of discomfort, which just adds to the problem.

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A few weeks ago, there was a thread of discussion on encopresis and constipation. Somebody wrote that she'd found Juice Plus Fiber online and was going to try it out. I also tried it out, and it has solved my 3-year-old's constipation problem! It's pretty expensive (about $36 for a case of 27 juice boxes), but it worked! My son has nice soft poo-poos now that he can't hold in. (He doesn't like the juice boxes because the boxes aren't the same color he's used to, but we poke a hole in the box and surruptitiously squeeze the fiber juice into a sippy cup with regular cider or apple juice.) The juice isn't thick or pulpy -- it looks and tastes like regular apple juice. They also have orange and grape juice, but I haven't tried those. Here's the website, in case anyone's interested: http://www.earth-friendly.com/juiceplus.php3. Thanks so much to the person who wrote about it in the first place! Hannah

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If it is difficult or painful, people resist going.

Water would seem to help, as well as some foods, but one thing I would recommend is PRUNE JUICE!!! This works amazingly well (I used it during the week or two after I gave birth, when fear of painful bowel movements can be very high!).

I'm not sure what a good dose of prune juice for a child would be; be careful-- it works very well. For me, a glass (8 or 10 ounces) was plenty. For a 3-4-5 year old, perhaps 4 ounces. Experiment, but start on the lower end. If I recall correctly, it worked within an hour or two.

I would not recommend any prescriptions unless necessary for a reason other than as a stool softener at least not until after two natural fluids were tried regularly: lots of water and some prune juice. My son suffers from constipation. By trial and error we have discovered that Fiber One (General Mills) bran cereal daily works for him. BUT, Fiber One contains NutraSweet so I do not want to give it to him anymore. The first ingredient in Fiber One is wheat bran. So, I bought some at El Cerrito Natural and have been feeding him that in the morning.

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My son had problems with constipation, and I knew from personal experience how constipating wheat bran can be. Instead, I fed him sweet potatoes and yams, with a little bran mixed in, and a good spoonful of molasses. These are all fiber-full and have a laxative effect, also. Sometimes I mixed applesauce in for a sweeter flavor. He really liked this mixture and ate at least one meal of this every day for a long time.

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I saw the posting on bran to relieve constipation. I would like to share something with the readers that really helps for me, and perhaps it will help others too. I have suffered from chronic constipation since I was a teenager, and my doctor always advised me to drink a glass of warm water first thing in the morning. For a while I disregarded his advise, and I actually forgot about it until a few years ago. I still don't drink it every morning, but when I do, I need to go to the bathroom within a half an hour. Sometimes I drink a glass of relatively hot water which usually does the trick within a few minutes. It might not work for everyone, but it certainly won't harm to try, especially for children (if you can get them to drink warm water that is).

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On a sideline: I have found that for my two boys, apple juice in any quantity causes diarrhea, not the opposite, and have heard this from some other parents as well. Not a scientific opinion, just an observation.

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Somebody correct me if I'm wrong, but from what I understand apples are a very good source of fiber and should not be restricted, but rather recommended, to relieve constipation. Another thing that might help is making sure he gets lots of water to drink. And you probably know the old trick of eating prunes/prune-juice. Going on walks (on foot, not in a stroller) is another generally healthy thing that is supposed to be good for all sorts of things including helping the poop along. If all that isn't enough, there is such a thing as stool-softeners which might make things easier.

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Try honey. It's a gentle natural laxative, and it's easy to mix with other foods.

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Mineral Oil and its alternatives

Feb 2000

We are having some success with lactulose, though it does cause gassy abdominal distention. Because of the gas, we'd like to switch from lactulose to mineral oil but we're having a hard time getting it into him; even cold and blendered, the oil quickly separates from the juice and is pretty unappealing. What's the least gross way you know of to get mineral oil into your cutie? Thanks!

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instead of mineral oil which is almost impossible to get a child to take (do you blame them?!) try Milk of Megnesia every night (about 10cc's) if that isn't enough you can do it morning and night. Our son actually likes the taste of the M of M - we put it in a dropper and he sucks it right down.

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Re: getting mineral oil into a small child. There are gelatin capsules that contain oil. You swallow the capsule, the gelatin dissolves in your tummy, and the oil does it's thing. Whether or not you can find these with mineral oil in them I'm not sure, but it's worth a look. Try health food stores. I had to take mineral oil for a spell as a teenager and it is indeed slimy, gross stuff to have to swallow.

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There are emulsified versions available, although I haven't seen them lately in the drug store. I can't remember the brand name, but a pediatrician should know. The emulsified version should mix with juice very well.

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My child is also quite constipated. Diet doesn't seem to be the problem - and she drinks quite a lot. In her case, it's probably hereditary. We give her fruit juice, in addition to milk to help the problem. We also felt she wasn't getting enough mineral oil, as it seperates so quickly. So, we switched to Milk of Magnesia. It's tasteless in milk (although the plastic cups get medicinal smelling at times) and seems to be working better - although not perfectly. It's a non-dependency creating solution, no more harmful than mineral oil - or so we've been told. Feel free to write with any more questions. It's really a somewhat distressing problem (although there certainly are worse ones) - so if I can be of any help, I'd be glad to share my experiences. Janice

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You sound frustrated by your son's problems, and I don't blame you! Good you are still nursing. Please do not use mineral oil. It is a petroleum product that leaches minerals from the body-- no one, especially a small child, needs that. Suggestions to try- soak 1/2 tsp flax seeds in 1/2 cup water overnight. Whirl them in the blender with some of your milk or other palatable liquid and offer to your son. OR you can add 1 tsp HIGH LIGNAN flax oil to his food each day. Applesauce os supposed to clear up both diarrhea AND constipation. Stay away from grains for now (potential allergens for which constipation may be a symptom) and slowly introduce starchy pureed vegetables (into which you incorporate liquids). Good luck to you!

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I met a nursing woman whose son (18mos) had terrible constipation and she indicated that it had been relieved by her taking flax seed oil thus passing the benefits along through her breast milk. I believe it comes in capsules which makes it easy to take. It is my understanding that consumption of mineral oil (even in small amounts) can lead to deficiencies of vitamins A,D,E, and K. Good Luck.

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Mineral oil is really safe--lots of children use it long-term without problems. The emulsified preparation is called Kondremul and it is easy to mix with other food or liquid. Other preparations are Milk of Magnesia that one reader mentioned--cherry flavor isn't bad-or Lactulose, a prescription med, very expensive but your insurance may cover. Do check in with your health care provider if your child is constipated and skipping days--you want to resolve this problem before you're into toilet training!

(Some children don't have a bowel movement every day, but when they do it's soft and comes out easily--you don't have to do anything about that!) I'm a health care provider and I sometimes see children who have been constipated and holding back their bowel movements for quite a while, and it's a tough problem to solve.