Major constipation- help!

Hi guys,

I'm hoping someone out there might have a bit of advice. My DD is 14 months old, still breastfed and taking solids, but really bad at drinking water/ milk/ juice/ anything other than breastmilk. At the moment she's having a pretty horrible time with constipation, and I think it's related to her low fluid intake.

She'll only take a bottle at daycare but not at home, she'll have a few sips at a time from one of the four or five different sippy cups we have at home, and she'll also have a few sips from an open-mouthed cup if we hold it. My breastmilk supply is dropping fast as she's just started sleeping through the night and is now down to three or four feeds a day (until about six weeks ago she was feeding around 20 times per day/ night- crazy but true!).

She's upped her solid intake dramatically in the last couple of months, though she's still pretty picky. She gets about four serves of fruit a day, plus a wholegrain cereal with fruit puree for breakfast, meat and veggies for lunch, and a veggie and rice/ pasta dinner every day. For a while after this diet change, she was pooping like a newborn, three or four mega nappies a day.

Now, though, she's really struggling to poop at all. She gets out maybe five or six tiny hard pellets (about the diameter of a twenty cent coin) each day, and today despite her usual struggles (she goes bright red in the face and has to sit down wherever she is to try to get it out) she's got nothing out. Nada.

Obviously this is not good in an urgent kind of way- I'm taking her to the doctor tomorrow- but I'm wondering if anyone else has had a similar situation, and what you've done to fix it.

I've tried prune juice, prunes, bran, pureed apples and pears, you name it. I just think she's not getting enough fluids because she's no longer getting as much breastmilk and she won't drink properly from any other source.

I'm on the verge of weaning her anyway (or rather, she's kind of weaning herself), but I'm feeling like maybe I should speed it up so that her only option is to take a bottle or cup. Then again, breastmilk is currently pretty much her only source of fluid.

Arghhh! Help, please!

Claire

Does she show any interest in cups at all? We had similar non-drinking problems here, until we got him a cow sippy cup :D

Then it was a drink bottle that is a smaller version of my bottle. She's getting to the age of choosing stuff - take her shopping, get her to choose a cup and get her attached to it. It'll make it easier I hope - it did for us. Now he gives me my big bottle to match his little one, and won't stop drinking!

In the meantime, try a little brown sugar in water, it clears them out.

Yes, have and still do have prob with DD. Luckily she drinks very diluted fruit juice and we have to be sure she gets heaps in the day. Be careful with some foods like bran as it needs heaps of water to help it pass or it makes the prob worse. We have been to a GP and tried all sorts of chemist items- coloxyl drops was the best by far and still need to resort to it occasionally. It is best for us to get fluids in any way we can- so even if it is weakened choc milk (for example!!) it is better than constipation, in my opinion! I still even hold the drinker up to DD's mouth because if it is just left lying around she wouldn't touch it. Straws are a great novelty and encourage intake.

both my girls have had constipation issues from not drinking enough but I got them to choose their cups and all seems a lot better lately. I also added more fluids to meals, ie soups, noodles etc, but the one thing that seems to have worked the best is porridge, brown sugar and milk at breakfast

Thanks so much for your speedy replies!

Kazbah, I think the brown sugar in water might be something she'd take to- she has a bit of a sweet tooth already :) I'll try that tomorrow. At the moment, her idea of "choosing" her own cup is to take home all of them :P She's very entertained by cups, loves to carry them around, but has a super short attention span when it comes to actually drinking from them.

Katie, the straw cups have been the most successful so far for us too. We've tried a range of diluted and even undiluted fruit juices, but she's still not all that keen- apple juice today was more successful than usual. I gave her some Milo last week working on the same theory as you (any fluid is fluid!) but that got the veto, too. Maybe I should move onto Coke or Fanta next (kidding :P). Thanks for the pointer about bran, too- that might be part of the problem, ironically.

Kitten, she used to have porridge for breakfast and liked it. Thanks for the reminder- I might start giving it to her again. And I was just thinking about soups today- definitely a good idea. I've been giving her jelly and watermelon and things with high water content on occasion but for some reason hadn't thought of soup.

I'm not sure if this is true, but someone was telling me that watermelon has a diuretic effect, so isn't a good fluid substitute.

I have found that sultanas are great for clearing out DD. She loves them to, so it is easy to get lots into her.

Hi Clair

My LO has just gone through 2 weeks of constipation in which she bled on twice because of hard stool. Besides giving her prune, pear and peach juice as ridiculous as this sound I actually helped her pass her stool. sorry tmi...When I know she wants to poo and is struggling I would take off her nappies and hold her in a swatting position ie between my legs with both of my hands behind her knees and she is completely off the ground, legs spread out and bottom towards the ground (like somebody is holding you from behind when you give birth on your back). If this is still doesn't help, I let bottom rest on my knees and with both hands massage her bottom hole and gently pushing the skin apart when poo is passed to help the passage.. sorry I know it sounds yucky but I will do anything to relieve her distress. I think that if I didn't help her as I did, she wouldn't be passing stool every two days as she did when she was constipated. It is good to report that she now poos daily with softer stool and no help from mummy.

Good luck. I know the stress when the LOs is constipated.

Hi Claire,
I am responding to your post about constipation, as I am going through similar with my daughter although she is 26 months now.

She had a couple of little bouts of constipation before 18 months which I managed to resolve with upping fluid, giving pear/apple stews and prunes. At about the 20 month mark she again developed constipation which has now been ongoing for 6 months and I have been everywhere for help. I think it came on as a result of her not having enough fluid for a few days for much the same reasons you mentioned but this time nothing I did resolved it.

I visited a couple of doctors, (one of whom told me that some children 'just have sluggish digestion' which I refuse to believe! My DD was fine with digestion up until that point!!) and a nutritionist. I sought advice from other mothers and on BB here. None of the advice worked. My DD has a really good diet (the nutritionist was stumped).

I finally went to another doctor who really listened to me, acknowledged it was not her area of expertise and referred me to a specialist.

Well... today I finally got the appointment with the specialist and I am so relieved. What he had to tell me made such perfect sense and we are on the road to recovery.

I don't want to go into details here as I really don't think it is right to hand over medical advice when every situation is different and I am not trained to make medical judgements ;). However, my advice is that if you try all of the advice that is standard for constipation and none of it works - get a GP referral to a specialist. There is a solution that is simple and it is really important to get sorted out. Children can become chronically constipated which can lead to a stretching of their bowl - further constipation and at the very worst fecal incontinence. It is incredibly traumatic for them and for mothers to watch. The key is that children's constipation should not really be treated in the same way as adult's constipation. There is a whole other approach.

I hope you are not getting to that stage yet and that you are able to knock this constipation on the head with the suggestions you have been given so far as they are all pretty good remedies in a normal circumstance. If it goes on though, don't hesitate to seek help!

I am just on cloud nine today to have my questions answered and my plan of action! We have a bit of a path ahead, but for the first time in a long time I feel positive and realise there is a solution.

Finally, you have some great advice for ideas to increase your DDs fluid intake. I used all these tricks too. I also have a crazy number of cups of different styles as I find that new cups/drink bottles will capture the attention of my DD and guarantee more drinking. I dilute her milk so she gets more water, give her home made icypoles (Milk and water or water with a splash of juice or hydrolyte) and offer drink to her allllll the time! That has all helped us so much! I also try to model as much as I can and mention whenever I am having a drink.

Good luck, let me know if you want any more details of my experiences.

Hi again,

I've seen our child health nurse this morning to ask for some advice, and she thought all our solutions sounded good (many of which we implemented in the last two days thanks to advice we received on here).

We've now been giving her:

Porridge with brown sugar and yoghurt for breakfast (thanks Kitten!)
Apple juice in a pop-top bottle, which she's actually drinking (thanks Kazbah!)
Prunes at snack time (turns out she LOVES them- I haven't had them around before because I love them, too, and I'm too tempted to eat the whole bag :P)
Watermelon, pears and sultanas (Holly, I checked with the nurse re watermelon and she thinks it's both okay and a good source of extra fluid- thanks for the tip re the sultanas!)

Kahlan, the nurse also suggested exactly what you described, plus suggested adding a bit of Vaseline to the mix. I'm hoping to avoid that one!

She also suggested something called Parachoc, which is a liquid paraffin oil. It coats the poop and helps it slide out more easily. I got some at the chemist this morning- but as it happens, I haven't needed to use it yet, because this afternoon she FINALLY started popping out the poops. They're very pruny and full of oats, so it's clear both those approaches have been successful! She's done four big ones already, immediately started eating again (she'd gone right off her food, which the nurse advised is because their tummies are so small they feel full when they're backed up) and has gone to bed so much happier tonight.

I've never celebrated a poop so much <wry grin>.

Lastly, jackrose- thank you for sharing your experience. I hope we won't need to go down that road, but I'll certainly keep it in mind for the future. DD suffered a major lack of oxygen at birth, causing severe brain injury (from which she's fully recovered), and damage to most other organ systems as well. I'm always worrying that things like this are signs of some undiagnosed problem she might have as a result of that (she's had constipation on and off since she was born). So, hearing your story was very helpful- I'll know to keep a close eye on it if she has further trouble.

Cheers again everyone- you've all helped immensely, and my little one is so much more comfortable as a result.

Claire