20 Month Old Constipation

Updated on February 22, 2010
C.R. asks from Everett, WA
28 answers

Hi all,
My daughter has had problems with constipation off and on since she was born. She used to drink prune juice for me out of a bottle, but now that she's older she wants nothing to do with it. She was (and still is) breastfed, so the bottle thing never went terribly smoothly to begin with. Anyway, for about two months she's been going at least three days without pooping and when she does it's hard and she says it hurts. This last round, she didn't poop for five days until yesterday; she was terribly miserable yesterday - I let her run around the house naked, tried to get her to dance - so she finally went on the floor and screamed all the way through. Now, today, she said she needed to poop but cried and said, "Please, no!" Poor baby... If she goes until Monday this same way I'm calling the doctor (again), but what will they even do about it? They've been telling me to avoid the things I already avoid and to try pear juice, etc. She doesn't really do juice, just water and milk.

My worry is that she might be deficient in some vitamin that allows her to absorb fiber or something - I really don't know what I'm talking about, just a theory. Her pediatrician said she doesn't need vitamins anymore because she eats so many different foods... This doesn't make sense to me. Adults need vitamins because they struggle to get the RDV of nutrients, how could a toddler not need them? Some days they live on air! What ones do I use? Those Poly-vi-sol ones are terrible and she won't even open her mouth for them (they separate from milk and water and make it oily/chunky) and everything else says not until age 2. I have a few actual questions, really I guess:

- What do I do about her being afraid now?? I can't blame her...
- I already limit bananas, apples, yogurt, cheese and processed foods - what else should I be avoiding?
- She will EAT prunes, so I've been giving her those yesterday and today, but I don't want to overload her... What else can I be giving her to help her along and make sure this doesn't happen again?
- Is a vitamin deficiency a possibility? What vitamins do you use with your not quite 2 babes?
- Why now so severe? I can't even imagine what I've changed in the last 2 months. Our diets are pretty much the same, no big event or life change has happened. She may get slightly less exercise, but a matter of an hour or two a week at the very most - could that be the problem since she's already prone to constipation?

Thanks in advance - I appreciate your help for my poor, sweet baby girl.

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So What Happened?

Thanks everyone - It sounds like giving her some powdered stool softener might be the way to go for her. Just to let everyone know - she eats TONS of fruits and veggies with every single meal and for snacks - peas, broccoli, squash, blueberries, peaches, you name it! That's all she'd eat if I'd let her. Of course, I'm a mom, can't let it go if anyone thinks I'm not caring for my baby properly. She does eat cereal - her favorite snack is Cheerios and raisins - but I think I'll try that All Bran. I hadn't thought of that one. I was giving her Raisin Bran, but it's got quite a bit of high fructose corn syrup - not a fan of that.
Thanks again!

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K.R.

answers from Portland on

When my daughter was a toddler we used Miralax for constipation. I mixed it into her water or juice or milk when she wasn't looking at let it sit for a while so it dissolved completely. Then I gave it a little stir, and she never noticed it. The doctor had us use it for a month straight, every day. It only took about 4 or 5 days for her to be going normally again, but the doc. recommended a month to give her plenty of time to break the association with pain/discomfort. Anyway, it did the trick, and now she is 6 years old, and we very rarely need to use it again to relieve an occasional problem. Good luck!

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W.C.

answers from Seattle on

Peaches!, raisins, and lots of delicious fruit drinks with prune or peach in them. Once she has soft stools, her fear of hard stools will lessen. Try something like citricel--it's for adults but if you cut the dose, it might work for her. Oh, don't push too many prunes, because supper loose stools are just as bad and stingy and therefore painful as hard stools.

Yes, lack of exercise does make difference at her age.

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C.B.

answers from Portland on

Try sweet potatoes. It seems to work for my 18-month old though he still skips days and usually cries in pain when he poos ;( But it's much softer & more regular if I'm religious with a daily dose of sweet potatoes. And he likes them pretty well!

I usually steam one, sliced into several chunks then I refrigerate and use them for a few days. He loves them roasted (baked) like french fries with a little oil & salt.

Good luck, we feel for you.

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J.S.

answers from Seattle on

My son had a similar problem. He was constipated most of his life from about 4 months old to age 7. The doctors told me to give him more fiber. It didn't help much. We used glycerin suppositories and mineral oil hidden in milkshakes (only when he was school age). We finally figured out that he had a problem with high fructose corn syrup. We took him in to the children's hospital and had him tested on a breathalizer machine. Anyway, after cutting back on fructose, he is much better. I would recommend continuing to speak with your child's doctor. Keep asking until you get answers!

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K.K.

answers from Austin on

My son has the same problem, but his favorite foods are dairy products and bananas, so we have to give him prune juice. We mix it with apple juice and water it down a bit. My son calls this mixture "Pumpkin Juice" and he loves it. The apple juice really helps tone down the strong flavor of the prune juice. We also give him whole grain fig newtons as a snack. It's a double bonus because he gets his "cookies" as a snack and we get more fiber into him.

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J.W.

answers from Seattle on

Constipation as a rule is not due to a vitamin deficiency, sometimes a vitamin overload. Apples and applesauce are an excellent source of fiber and would be a fruit that you would want to give when someone is constipated. Milk and cheese are known to 'bind' a person, and bananas can have a calming effect on the bowels. Increase her water intake. Add fiber, such as metamucil to her cereal or water. Exercise is very important. She may be a child who doesn't want to void, so they will hold it in, and then the pain will occur. If you are breast feeding, have you changed anything in your diet as of late? Again, increase her fluid intake, add fiber to her diet, applesauce is good. Yougurt isn't a constipating/binding food, it helps with the digestion. All else fails, use a warm water enema or baby laxative after the 2nd day to avoid an impaction. Not voiding will cause the all the stuff one should eliminate to back up in one's system. And by all means, be talking with your pediatrician.

Sometimes this is a control issue, the child as learned they can control something and will do so. You need to find out if this is a physical issue for her or an emotional/mental one.
Best wishes.

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A.W.

answers from Milwaukee on

My oldest daughter went through the same thing when she was younger. Her pediatrician suggested mixing prune juice half and half with 7-up to cut down on how awful prune juice tastes. This worked pretty well until she got old enough to realize what she was drinking and refused to drink it anymore. We ended up having her put on a prescription strength laxative, it was a powder we mixed in diluted apple juice. It helped tremendously. My oldest is 15 now and still once in a while has issues with constipation. It's nothing we were or were not doing, some kids just have these types of issues.
Try the prune juice/7-up combo in a sippy cup and see how that goes. I completely sympathize with you, C.. Good luck, and please let me know how your little girl does. :)

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A.C.

answers from Cincinnati on

Here is some info on "idiopathic constipation":
http://www.cincinnatichildrens.org/svc/alpha/c/colorectal...

Also there are a number of things that can cause constipation such as food allergies. Sometimes probiotics can be helpful to help regulate the digestive system (make sure you ask the doctor before starting them and if she is on antibiotics for any reason you would want to space out the timing of the probiotics and antibiotics). You can also try massage (there is a massage technique for constipation - here is a video on it http://www.youtube.com/watch?v=Z-ECcq_Ul5Y

Good luck!

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A.M.

answers from Bellingham on

We are dealing with the issue of constipation with our 2 1/2 year old and it started getting bad around 1 1/2...we were weaning at that time and I think that started it. We have had to go through suppositories, X-rays, diet change and a lot of Miralax. Now we are having the issue of a child who is purposely holding it because he is afraid. This is called encopresis and now we have an appointment scheduled at a clinic. I was surprised to learn that even when we were giving him a lot of MIralax (which is non habit forming and only works to bring water into the intestines and bowels so is is soft) and his poops were very soft I thought he was no longer constipated because they weren't hard, even though he was only going once every five days, unfortunately this is still considered constipation and ideally kids should go as often as adults (once every day is ideal) We just had another X-ray and are so sad to see that he has 3 months of poop inside him..no wonder he is in pain! Anyway think about using Miralax to help clean her out (talk to your pediatrician) and know that you definitely want to deal with this issue before things get so bad that your child develops negative ideas about pooping. Once they get older it is so much harder to force them to eat right, drink enough water, and it can become a big emotional battle to get them to push when they say it hurts. Our whole potty training is on hold and now we are dealing with the emotional problems as well. Good luck!

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M.P.

answers from Eugene on

It sounds like you are really thinking things through trying to help your little girl! She's lucky to have you! It's totally understandable that she's afraid to poop now. I would be too if it was hurting each time! What helps me and my daughter when we're in a situation like this is for me to talk to someone about how hard it is for me to see my little girl hurting. If I can get out my sadness or anger at seeing her in pain, it frees me up to really be supportive of her while she's in pain and reassure her that it will get better. Allowing your daughter to express her fear, through tantrums and crying, while you just listen supportively (reassuring her you're so sorry it hurts and you will do all that you can to make it better) will help her rid herself of the fear. It sounds like you are doing an excellent job trying to find the cause of the constipation and clear that up, so now your daughter can work on getting over the fear that it's going to hurt each time. The more she releases emotionally, the less likely she'll be to hold the poop in which may be making the situation worse. Reasoning with her won't help though if she associates pooping with pain, when she feels like she has to go, she'll just hold it in due to the fear. I believe the more you can just listen to her fears supportively with no pressure on her to poop, the more likely she'll be able to go when she has to instead of holding it in. I hope this helps, I know how hard it is to see a little one hurting! Also, two extra things that may help: a rolled up towel to put between her lap and tummy while trying to go potty (my daughter still talks about this simple act a year later! It must have been more comforting to her than I knew at the time.) and adding some olive oil to a berry smoothie can work wonders at "loosening" things up. I hope you both get relief soon!

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K.H.

answers from Washington DC on

To get her on a regular poop schedule I would use miralax , it's a stool softner not a laxative and you add it to drinks and it has no taste. My son suffers the same way and we have to use this with him. Start with a higher dosage until you find the dose that she needs , it may take a day or 2 for her to go but when shr does it should be a normal formed poop just soft and not hard and painful. Drinking water is good and it is good that she likes it , what is her diet like? Does she like fruit and veggies? Try fruits that will help soften (so not bananas) maybe grapes , clememtines , and some high fibre cereals like bran flakes , all bran maybe.

Hope this helps

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J.G.

answers from Seattle on

I haven't read the other responses, but I have a couple of food-based ideas you may want to consider. 1) grind up flaxseed or buy pre-ground (keeps well in freezer) and add it to her cereals. Another good option is salba seed, sometimes referred to as chia. Both have good fiber and good fats, and help with getting water to the bowels. 2) my dr suggested a TB of dark Karo syrup (must be dark; note this is not HFCS just plain CS) to be mixed into a beverage or a little water, which can be given 3x a day and helps soften the stool.

I wonder why you were counseled to avoid yogurt; a probiotic would seem to be beneficial here esp if your girl has had many antibiotics. I think it's worth considering giving her a probootic in form of a supplement - I think they even have kids' ones.

Good luck - I know it's so hard to see them suffering!

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S.P.

answers from Seattle on

We struggle with this as well. My daughter's constipation really got bad when she decided she wanted to be potty trained at 2 yrs 10 months. We do all of the same diet things you do as well and it doesn't seem to make a difference. I videotaped her screaming on the potty and took it to her doctor. We began her on adult doses of miralax a little over a year ago. She was very afraid to poop on the potty but thankfully, was continent and actually put on a pull-up herself to poop. We finally got her going on the toilet at 3 yrs 4 months. We are trying to wean her off of the miralax now (down to half the dose every other day). She still gets in to "trouble" every once in awhile. I know it is important to "get on this" as soon as possible as I have friends who's daughters are struggling with encoparesis in kindergarten. Their poor bowels get so stretched out that they can't feel when they have to poop and they have lot's of accidents. Please don't be afraid of the miralax and find a doctor who can help you.
I find it all to be quite a scarey struggle for myself as well. I'm sorry your family has to go through this too. You are not alone!
You are a great mom. You are definitely the best parent for her. Take care. S.

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J.S.

answers from Seattle on

Hi C.,
My 1 year old son has had chronic constipation for too long. We've tried a lot of the things that have been suggested, but my poor little guy still struggles painfully :( I hope you are able to find a simple solution in your daughter's diet to help her, but our next step is to take Cole to a Pediatric Gastroenterologist. If diet changes don't help your daughter, you might talk to your pediatrician about seeing a specialist. Good luck!!
~J.

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T.H.

answers from Portland on

These are really good questions you are asking. I am not a doctor and I can't say I have the right answers for you and your child. But I can tell you what I know from my own experience. My son who is now 2 1/2 has also struggled with constipation since he was born and still does. He does have acid reflux which the doctors say can also go hand in hand with constipation but who knows what the real cause is. My son can and will eat his weight in fruit and still get constipated. The gastroenterologist has us using Miralax (you can get at any drug store). It is not a laxative so it is not habit forming. You simply mix it in any liquid. It has no odor and no taste. So we just pour some into his beverages each day. In really bad situations we have given to him through a syringe to get it in quick. We also use Little Tummies which again the doctor told us is safe to use several times a month. In really really bad situations we use suppositories which work within 10 minutes. The gastro. told us we need to ensure that he is giving us at least 1 poopy diaper a day the consistency of pudding. She said that in young children if they have to struggle too much and/or if it hurts then will be afraid to go - as it sounds like your child is - and then hold it. This can lead to a life long of problems. (Not to scare you).

With regards to vitamins. We spoke to our pediatrician when our son was under a year about our concerns he wasn't getting all his nutrients. Even now with him eating a variety of foods he doesn't get all his needs met each day. Getting veggies in him is a struggle. So he is and has been on a prescription multivitamin liquid (sorry can't remember which one). It doesn't taste the best but he is used to it now. We are also now mixing pediasure into his milk to help ensure his nutrients. The doctor told us that was great to do. But it didn't help his constipation.

Hope some of this helps. Good luck.
T.

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L.R.

answers from Portland on

Not sure I can help much, but since she will take water, push fluids, especially when she eats prunes (because they are dehydrated, she needs to get the water that was taken out of them, or it could cause problems).

I doubt it's a vitamin deficiency. But then I'm not a doctor. I do understand a little of how fiber works, however. Fiber is bulk. You can see it in celery, but most of it is too small to see. Anyhow, this bulk is kind of like a broom for the intestines. It also acts as a sponge, so that things don't get too dry (if you drink enough water). So fiber isn't really absorbed.

My big recommendation would be to try cutting out dairy completely. Not your breastmilk, but other forms of dairy. That would include dairy in your diet, since she's getting it through the milk. You didn't say if you limit the above-listed things in your diet or not. It might be a good idea to, at least for the dairy. Sometimes the casein in cow's milk can cause constipation for children. Most people don't know this, but casein is very species specific, and cow's casein is very difficult to digest, even for adults. Considering that she is breastfed, she is getting plenty of nutrients from you, and you can find all kinds of replacements for milk, like soy milk, rice milk, hemp milk... Seriously, try it for a few weeks and see how it goes.

I hope you figure it out!

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K.D.

answers from Kansas City on

My son had the same problem. He had his first experience with constipation when he was 4 mos. old. It continued until potty training (which took a little longer). I've talked to my doctor about it, but they weren't too much help. There wasn't anything "wrong" with him, it was just the phase he was going through. They ensured me that it would get better.

We started with the glycerin supositories, and also used miralax. But what I continued to use (which worked just fine and was less expensive) was benefiber. I would add it to his chocolate milk in the morning and sometimes in the afternoon. It has no flavor and he drank his milk like normal. I liked the benefiber better because , to me, it wasn't "medication."

Good Luck!!

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A.H.

answers from New York on

what about veggies and fruits ... you don't say what she eats. i hope she is eating greens... like peas, you can shred spinach in soup... you can add a spoonful of prune juice to water.. just a little.. what about olive oil... try a drop of two in foods... what about wheat bread, cereal, grains, try some granola on top of yogurt... what about watermelon, peaches, blueberries really work. i hope she is eating a well balanced diet.. this will all help. spaghetti sauce will help too.. good luck

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P.M.

answers from Portland on

Poor baby; poor mommy!

My 4yo grandson tends toward constipation that sometimes ends up with a painful or "stuck" movement. A few times, his parents have used a liquid glycerine suppository as an emergency measure. It stimulates and lubricates, making the movement quick and less uncomfortable. While he doesn't want the glycerine up his tender little behind, it doesn't actually hurt, and he's always grateful and relieved afterward.

That's best used as only an emergency measure, however. Plenty of hydration, and maybe a supplement like Miralax, are better for routine use.

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M.A.

answers from Seattle on

I suggest increasing her fiber (veggies, fruits, whole wheat cereal/breads), increase water intake, and increase physical activity, Good luck!

K.T.

answers from Eugene on

One thing that i have found works great is Apricots - I get the Mariani ones at Costco but i am sure any of them work!

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N.P.

answers from Portland on

i have two random thoughts:
1 is: have you ever considered eating a gluten free diet? i know it sounds really hard but when it works it just gets easier and easier. gluten in tolerance can lead to poor absorption and mineralization and in my children causes loose stools (and terrible terrible eczema in my older one) but i have friends whose children suffered terrible constipation as a result. if she's starting to cut back a little bit (although, as a mom who has nursed two through toddlerhood, i can also imagine that that statement could make you laugh out loud...) that could explain the situation suddenly getting worse? just a random thought - and one i wish i had tried earlier - because you mentioned having this inkling that it could be related to diet or absorption. it's amazing to me the way children and mamas seem to have hunches about what to eat and what to avoid.
2 is: flax seeds? maybe you've tried them, but we grind them up into meatloaf and put them in smoothies and our naturapath says that they, pardon me for saying so, but, "fluff" up the poop a little bit. there i said it.
finally, our kids get cod liver oil every day - that might do wonders for your little one. there is a berry one that is straight up delicious. (it's called berry frutol.) (our naturapath's office carries it: sara ohgushi, on burnside.)

but mostly i just wanted to say that it's so sweet that you are so concerned for her. i wish it was enough! but i do think it sure helps lead you to some solutions, even when you don't find the "answer".
that might not make any sense. but i have to play tinker toys instead of retype it.
good luck.

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S.L.

answers from Portland on

Hi C.,

I just looked up your Poly-Vi-Sol vitamins--it has iron in it, which can actually cause constipation. That's probably not the sole cause of your daughter's constipation if she's had problems since birth, but it could be a contributor to it. When pooping hurts sometimes kids hold it and that just makes them more constipated so it's a vicious cycle. It sounds like she eats very healthily. It's a bummer when you want to help your babe so badly and all the conventional wisdom doesn't help. This is the part where I would turn to an alternative provider like craniosacral therapist or naturopath to see if they can offer any fixes that are gentler than either doing nothing or taking what an MD might prescribe. Good luck. Let me know if you find your solution. It seems like I hear about this problem a lot!

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N.B.

answers from Seattle on

Hi C.,
I know what you are eating will affect her since you are breast feeding. I rep for a green manufacturing company and we have an awesome fiber product with pre and probiotics. I don't sell or distribute and it would be great to help you out. Please give me a call so I can talk with you and see if we can help her out.
N. B
###-###-#### (h)

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S.D.

answers from Boston on

My 12 month old has difficulty pooping sometimes. She'll cry and force and cry and you just feel so bad for her. So, this is gross, but when this happens, I use a pediatric glycerin suppository. Just slather it with vaseline and stick it in there. It helps the sphincter muscles get the poop out.

But, to keep that from happening, I feed her stewed prunes at least once or twice a day - I put the prunes in a small pot and put a little water in with them. She loves them and I even put the water in her sippy with some more water.

She loves bananas, but I try not to let her eat them too often.

Good luck.

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B.B.

answers from Portland on

We use yogurt to help my son. Usually the organic ones have more active cultures and less sugar and work pretty well. We have also found that applesauce and pears work the best for him to keep him moving. We try to use whole grain breads and pasta for the extra fiber. Also, we have him drink water all day. The large intestine absorbs water so if a child is holding their poop in then too much water gets absorbed leaving the fiber dry and hard. We offer water at every meal and have it available all day.

K.M.

answers from Portland on

my son had this problem for years when he was little. one thing we did was give him a tablespoon (or two if it was really bad) of mineral oil every day. i would put it in orange juice and he would drink it most of the time. it is flavorless but oily, of course. good luck!
K. m.

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J.O.

answers from Portland on

My dtr. chews the Gummy Vites that are the Omega-3 ones. She loves them and even thought she also is still nursing, they give her the extra oils that help make her poop softer. Good Luck!!

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