complications of constipation
Our daughter is getting close to 3 years old. She enjoys sitting on the potty, will wipe, wants to flush and occasionally suggests "going potty" on her own. But she will not actually go. We have as yet gotten even an accidental pee in the potty. She doesnt seem to be aware of when she needs to go pee, and has even pee'd in a diaper within 10 minutes of sitting on the potty.
I focus on pee rather than poo here because she has a major problem going #2. I don't think she has ever had an easy time going poo. She will actually go for days sometimes before pushing something out. And that something is always a hard, big and very uncomfortable lump or two. Yesterday she actually laid down on the floor and in the process of pushing, she was grunting and scooting on her belly across the living room. She cannot seem to push in a sitting position at all. She has tried to go poo on the potty, I tell her to try, I ask her to push and she does. You can see the tummy muscles going but she cant go sitting.
We try prune juice, which she seems to be o.k. drinking. We try oatmeal, but its touch and go for her eating it. We give her lots of fruits, minimize the crackers....
We really want to potty train but how do you do that when she cannot sit to go poo???
Re: complications of constipation
You really need to fix the constipation before focusing on the PT. I am a pedi colorectal nurse and we see so many patients that have struggled with constipation for too long because the pediatricians don't treat it aggressively enough. Most kids with constipation will improve with some prune juice or more fiber, but there are many kids with severe constipation that need more aggressive management. If she has painful bm's she will hold them, which will make the stool harder. Over time this can stretch her rectum/colon, which only makes the problem worse. If the bm's are too big/hard it can cause a tear or fissure which can bleed and be painful and make her hold the stool more. She should have 1-2 soft formed stools every day. Once the constipation is under control I would focus on the PT with a sticker chart or some other form of positive reinforcement, but I wouldn't do that until the constipation is resolved. I'm not trying to freak you out I just want to prevent you from getting into a cycle that I see so many kids get in to and then by the time they are school age they are soiling their pants at school and getting made fun of because their constipation is not well managed. Many of our patients end up on daily laxatives and do so much better, but pedis are afraid to suggest them and parents are afraid to give them for some reason.
Other things to watch out for that can cause/worsen constipation, (which you may already know):
applesauce, bananas, all white foods (white bread, pasta, rice, potatos)
Thank you so much!!! Such a wonderful response! We will schedule and tt our pedi about further help for her.
Can you suggest some higher fiber "appitizing" foods for toddlers?
Unfortunately there aren't a lot of easy ways to get extra fiber into them. Even though they are expensive I keep those puree pouches on hand when DD is having a day that she doesn't eat a lot of fruits and veggies. She's pretty good about eating casseroles so I sneak brown rice or wheat pasta into them. We only do whole wheat bread except for hamburgers and stuff. There are fiber gummies for kids that you could try and probiotics may help as well. I hope the pediatrician can help get you on track, but if you are still struggling feel free to email me. You can PM me and I'll send you my email address if you are interested. Best of luck!