Four Year Old Constipation Is Chronic And Debilitating

by Meg
(New York)

Four year old constipation is chronic and debilitating...

We have shared custody of our just-turned-4 granddaughter and the mother feeds all food that is processed, lots of junk, and either she doesn't want to take the time or maybe incapable of understanding the significant health problem that has been created.

Because we have her just every other weekend and every Wednesday afternoon, we can do little.

The granddaughter retains her bm until the body won't allow it, and frequently she will not make it to the toilet.

She is increasing the time between bms and when they "escape" we have anal fissures and quite a bit of pain, screaming, and bleeding.

We (my son and I) took her to her family physician just this past week and the doctor informed us that as the time between bms increase, the fecal material builds up in the lower colon.

Because it can't go back up, the colon starts to bulge. Once the constipation reaches that point the child's ability to recognize that a bm is approaching is drastically reduced.

She also suggested that holding the bms was a symptom of retaining some type of control when the parents broke up.

The physician suggested Miralax, 1tsp/day; beefing up the fiber (which is the normal diet for us); making sure she drinks (she won't do it on her own); and exercise (the mother doesn't so the child's life is sedentary).

Also suggested was a pediatric enema to start the process. Did that over the weekend; took 36 hours for a resolution and it occurred in the bathtub: the little sprite never felt it coming.

Because we have her the least amount of time, I fear we are fighting a losing battle, and I can't imagine this child going through this for years.

I'm at the point now that I will be pre-packaging her meals and snacks so the mother need only take them from the fridge and serve, or microwave and serve.

Anybody with suggestions?

Dear Meg,

Oh, your poor little granddaughter.
I'm sure this is so difficult for you to see her suffer and be so limited in what you can do to help.

The suggestions the doctor made regarding the water, exercise, and improved diet are very important. You can only do as much as you can do in that regard, which is your main challenge.

I'm not a big fan of Miralax, but I'm not completely opposed to it either. Because it is a laxative, I don't like to see regular use of it over a long period, particularly in one so young.

I would prefer to see her use something like salba grain that is naturally going to improve her bowel motions, as well as bring added benefits because of providing the essential fatty acids and other nutrients of a natural whole food.

Salba has no real taste and 1 Tablespoon per day can easily be added to any food she eats, like cereal, yogurt, etc.

It would be so helpful if her mother can be brought to see the importance of encouraging the little one to sip water throughout the day as much as possible.

It's really hard to say if the stress from the divorce is a contributing factor in the bm problems or not. It could be, of course, but it could just as easily be from the very poor diet and lack of sufficient water. Many toddlers suffer from this same problem without a stressful situation thrown into the mix.

Regardless, I hope that you will be able to continue to offer the emotional and physical support your granddaughter needs and that she will be able to regulate her bowel movements so that she can go without pain.

The current pain and discomfort she is experiencing is quite likely causing her to try to "hold it" as long as possible to avoid a repeat of the pain. This is common, but hopefully if she can begin a pattern of easy bm's she can reverse that habit.


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