Infant/toddler chronic constipation

[Cdu6gd]

Hi all, I'm new here and need some desperate solutions/advice for my baby's (now a toddler) constipation issues please!

She is 13 monts old now and her constipation began as soon as she started solids at 6 months. She's been breastfed only this entire time. Up till 6 months, she was pooping daily and it was soft and runny, as it should be. As soon as I started her on solids, she strained to poop, usually pellets or nothing at all. I would see her straining all day, with nothing coming out. Eventually what helped was holding her in a specific position (her back towards me, holding her legs up). This worked for a bit, till she started to resist being held that way.

We had a few trips to the A&E where they gave her enemas/suppositories to unblock her.

Eventually took her to a pediatrician at 8 months. My daughter has a sacral dimple - which the doc advised getting checked out with an ultrasound. Nothing came back. Had an x-ray of her abdomen done. There was nothing alarming.

Doc prescribed movicol pediatric plain 1/2 sachet a day. That did not help. Oh, I tried all the dietary changes- fiber, veg, prune juice etc. So I decided to up her dose to 1 sachet a day and after 3 days we had success. I continued the 1 sachet for about a week and then reduced it to 1/2 a day.

Now at 13 months, she is on 1/2 sachet movicol a day...although I need to up the dose to 1 sachet a day if I feel she is straining or her poop was too firm the previous day.

My questions:

-Anyone else going through this/been through this?? Can't seem to understand why this is happening! Is it a physical or psychological (witholding etc) thing with her?

- Has anyone ever come across a connection between a sacral dimple and constipation??

- Whenever I try to stop the movicol, the constipation returns and I have to do the disimpaction again with 1 full sachet for a few days. Has she become dependent on it??

- Whenever I help her to squat, she poops alot, despite it being firm. Although now that she is older and aware of things, I'm not able to get her to squat...

I find that the best advice comes from other parents/caregivers who are going through the same thing , as opposed to the docs, who are quick to prescribe the meds/get tests done and give a quick fix solution!

Thanks in advance!

[DPLT]

We’ve been dealing with chronic constipation for our sons whole life, he’s now 6! I would try keeping her on a Maintenance dose for a while (maybe a month or so) and then try stopping it. Movicol is a softener so sounds like it is doing it’s job. Position is 100% the right thing to do. From past experience our son withholds now because he thinks it’s going to hurt. I wish I knew then what we know now, keep her stools soft as you don’t want her knowing and more importantly remembering it’s always going to hurt. Exercise also helps with our son, trampoline and cycling (when she get a bit older) Sorry probably isn’t very helpful but good luck

[Cdu6gd in reply to DPLT]

Thank you so much, all advice is so welcome! It reaffirms that I'm on the right track.

I will keep the movicol maintainence dose up and not worry too much about getting her off it just yet. She is starting to sense my anxiety around her pooping and like you said, don't want her being too aware of it.

Gosh, that is a long journey you've had with your son's constipation, so frustrating. Did the docs ever do any physical exams on him- ultrasounds/x-rays etc.? Are you any closer to understanding why he has been chronically constipated?

[DPLT in reply to Cdu6gd]

Yes he’s under a bowel specialist now and a dietician. I’m going to be honest we’ve had a very long road and had to battle every step of the way! He had a couple of x rays last year once we got referred to a specialist and he was admitted to have a manual disimapactation, biopsy’s along with a week of Kleen prep, a ng flushing his system out as he was so compacted. He is also dairy free now which has helped. He has definitely been massively let down over the years but he’s on the right track now. We’re taking advantage of all this time at home and working really hard to get him into a good strong toileting routine as he has massive issues surrounding the toilet, he will Not use them outside of home with is difficult now he’s at school and he definitely struggles with anxiety. It’s had such a massive impact on his life! He has had all the tests under the sun and is on masses of medication and they are still putting it down to chronic constipation. They’ve told us he’s likely to be on medication until his early teens. But you know what with all this he has going on you would never know, he is the happiest little boy and always smiling, he’s my inspiration!

I personally think he was dairy intolerant from a baby, this all started when he was 3 weeks old, he was such an unhappy baby, which has led to the constipation which has let onto the witholding in turn has had massive consequences for him. All just badly managed, as I say I wish I knew them what we know now. Happy to keep in touch for reassurance x

[Cdu6gd in reply to DPLT]

Thank you! Every little bit of advice is so helpful.

Glad to hear that your little boy seems to be responding to the toilet routine/exercise/meds. It is hard work keeping on top of it all the time, but anything to keep them healthy and happy!

Can I ask please- was he breastfed/given formula as a baby? My doc too seems to think that my little one could be dairy intolerant. She has been breastfed the entire time (birth till now, 13 months)...and so I wonder how the dairy in my diet did not affect her for the first 6 months of her life. Also, I only started her on dairy at 9 months (which I have now decided to stop)...and yet she was constipated since starting solids at 6 months. I think it is unlikely she is dairy intolerant, although I have stopped consuming dairy myself.

[DPLT in reply to Cdu6gd]

Initially breast fed but quickly onto formula as he went to scbu with low blood sugar levels so he went onto formula to bring them back up quickly. So formula fed. Dairy intolerance can cause cause constipation or diarrhoea. My advice would be to keep a good diary and see if there is any patterns. He was very unsettled as a baby, used to cry a lot , his knees used to always be up near his chest, very windy and poo’d all the time which I think is why he hated nappy’s so much. I wish I knew then what I know now. There is so little help out there!

[Rainbowmmy]

My daughter is in the exact same situation. She was breastfed and she had no problem except for that she didn't poo daily. (But she never strained or anything and I've been told that she didn't open her bowl daily was normal.)

As soon as we started solid, things gone so bad straight away. I took her to gps and firstly they prescribed something (I can't recall the name, gee, you know the very sweet syrup medicine!) but that didn't do anything. Next, we tried Movicol and that did its trick. She was on 1 to 1/2 sachet everyday. Whenever I tried to cut it off or down, she returned to constipation.

I asked gps if they could refer us to pediatricians but they refused it as Movicol worked for my daughter despite the doctors didn't give us any advice on how to wean it or how long we should carry on. I just don't lik that I don't know where this journey is going to.

Just like you, I feel bad she is taking some medicine everyday and I worried that it might make her dependant even though I've read that Movicol doesn't make bowls lazy. However, now I really think that she doesn't withhold is much more important than we're using Movicol, medicine in her daily life.

Not much help or advice, but just wanted to tell you that you're not the only one here. I'm going to carry on what I'm doing and really slowly reduce the amount of daily dose of Movicol and see how it goes. Good luck to us all. Xx

(Sorry for my messy English. It's my second language.)

[Cdu6gd in reply to Rainbowmmy]

Thank you so much for your reply!

Gosh, it does seem like we are in a very similar situation.

I have to say though, through these 7 months of constipation that we have been dealing with, there was 1 month in between when things were going very smoothly.

When my daughter was 10 months old, I started helping her to squat (and place toys in front of her) everyday after her breakfast and lunch. And she would poop almost within a minute every time. She pooped once a day for about 20 days. I was sooo relieved that things were improving, that I gave her 1/2 sachet of movicol every 3 to 4 days.

And then, we hit a roadblock. She got constipated. And then started resisting when I helped her to squat. Etc. Etc. And the cycle of constipation/witholding/resistance resumed.

This makes me feel that if I get her into a good routine and the right squatting position, we can hopefully overcome this.

I've just ordered the baby bjorn smart potty (I read that it gives the baby a deep squat) and read up loads on EC.

She is currently on 1 sachet of movicol a day. When the potty does arrive in a couple of weeks, I plan to try and get her to sit on it after meals everyday. I do realise that she is older now and will probably resist- but the routine and position worked for me in the past and gives me hope!! I really want to avoid a situation where she is on meds for a long time...

Will keep you posted!