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View Full Version : Another poop-related/constipation post ;) Soft but infrequent toddler poops



brittone2
01-31-2006, 02:05 PM
So DS has been having soft poops for months now. We're still doing Miralax but have cut down on the amount over time. When we were using it quite a bit, I noticed that DS's poops are super-soft/not formed) and he doesn't seem to have any issues with passing it, other than doing his little dance and saying poo. He doesn't like it, but it doesn't cause him pain and hasn't in months. THe catch is, even with the Miralax (including when we were using it a lot more) he still will sometimes not go for 4 days. That happens routinely. So despite it being super soft for months, the frequency hasn't increased.

So I talked with his ped about this a few months ago when we went in. I basically said I'll let him go 4-5 days at most, and then we do a baby fleet. Ped said yes, it is a good idea to draw the line somewhere obviously and he agreed that was fine. I hate doing the fleet, and I hate that it is habit forming, but I'm only willing to let it go so long. He felt that DS's intestines were probably a bit stretched out from his previous constipation/holding pattern but that it would return to normal eventually.

So the deal is...I have no idea where to go from here. Is it a big deal or not a big deal that he goes 4-5 days without pooping, then poops (but soft and without any pain), often 2 days in a row and then back to a 4 day wait. I feel like maybe his intestine is just stretched at this point to accomodate 4-5 days worth. I don't know how it would ever go back to normal though. I could use the baby fleet after him not going 4 days and try to drop that number down eventually, but it is habit forming and therein lies another problem. We regularly give him flax/hemp oil (yes sounds weird but similar to flax but has a better ratio of omega 3s and 6s) and probiotics.

Even if I couple the miralax with something like Milk of Magnesia, flax oil, a metamucil cookie, you name it, he has soft poop but won't go more often than every 4 days, and even then sometimes 5 and it may require a baby fleet at that point.

THe ped didn't seem concerned but we've been using Miralax now for 4 months or so. I'd like to see him get back to some version of normalcy.

DS does better without rice and minimal cheese/dairy, but I haven't noticed any other dietary issues beyond that. He dislikes juice (and shouldn't have it due to a cavity he had at 18 months), and things like pears, plums, blueberries keep him soft but still don't increase frequency.

Sigh. I never thought I'd think about this as much as I do. I contemplate a visit with a gastroenterologist fairly often but he isn't in distress with it in any way anymore, and I hate the idea of subjecting him to testing, etc. I know it will be a while before we could even get him in to see a specialist. The regular ped seems to think this is all pretty okay....but I am worried he's got some overstretching. I don't know how they can fix it though if keeping it super soft and loading him up with flax oil, miralax, etc. still doesn't increase the frequency. No distress on his part for months...I get distressed though! ;)

LucyG
01-31-2006, 02:57 PM
Beth,

I was told by the nurse practitioner at our visit today that the goal was to help my DD go every day, or every other day at the longest, right now. I'm not sure if that is just for starters, or a long-term goal. We will be doing 1 t. of Milk of Magnesia each day to see if that helps. The CNP did not feel any masses or lumps in DD's abdomen, and said it appears to be nice and soft and not impacted. So, I was relieved to hear that. She suggested scheduling regular potty sitting times 3x per day (DD is potty trained.) to help her again develop the feeling of needing to "go." So, no advice for you, really, but I just wanted to share what we found out. I would think that if your DS is not distressed or uncomfortable, you are probably in a good place for now. HTH!


http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif[/img][/url]
nursed for 2.5 years!
And . . . Blessing #2 due in March!

lmintzer
01-31-2006, 02:59 PM
Hi Beth. How long did he have trouble with constipation, pain, or fear? Both the Peds GI and the Behavioral Ped. told us that this kind of problem takes as long to resolve as it does to get going. In other words, Jack had been struggling with constipation and holding for a year or more, so it's taken that long to get back somewhere near normal (we're still using Miralax and Mineral Oil but he's going every day after dinner).

Have you or the ped. thought about doing a single x-ray to see what the intestines look like? It might be useful just to see what you're dealing with. It could be that he's still stretched out. It might be worth bringing up.

4-5 days sounds a bit long but not terrible, as long as he's going a fair bit afterward. I wonder if he's voluntarily holding during the interum, though . . .

dogmom
01-31-2006, 05:01 PM
Actually I was just doing research on this today. (Actually, I was trying to find out if my DS freakishly large stools are something to be concerned about.)

They seems to be some agreement that once every three days is not out of the realm of unusual for a toddler. So a child that had a problem, once every 4-5 days seems to be not suprising. Yes, there are things that can happen to stretch out the intestine and lead to longer retention. It does appear to take time to recover. The problem with any laxative in any age is the body will adjust to it and get addicted to it. It is sometimes normal for adults to go days without a stool. I was always taught in school to ask the person what "THEIR" normal was. I doubt there is a magic answer. I suspect no laxatives will "fix" the stretching, just time and growth. I think the goal would be to have him not have hard, uncomfortable stools. Maybe you can see what happens if you go 5-6 days, if you can stand it, and it stays soft. Sorry I'm not much help. It IS distressing to try to figure out when/if to give meds.


Jeanne
Mom to Harvey
1/16/03
& Eve
EDC 6/18/06

lmintzer
01-31-2006, 05:17 PM
Actually, some laxatives are not addictive. It is stimulant laxatives that are cause for concern. Miralax is an osmotic laxative. It draws water into the stool, which softens it and helps with the passing of stool.

Though every 4-5 days can be normal, it's only okay if the child is not voluntarily holding during that time period.

octmom
01-31-2006, 06:12 PM
>Actually, some laxatives are not addictive. It is stimulant
>laxatives that are cause for concern. Miralax is an osmotic
>laxative. It draws water into the stool, which softens it and
>helps with the passing of stool.

I understand the same is true of milk of magnesia. Since it is OTC, I assume that it may not be as powerful as Miralax, but it sounds like the same basic idea.

Jerilyn
DS, Sean 10/03
DD is scheduled to arrive via c/s on March 21! :)

"Baby makes days shorter, nights longer, home happier, and love stronger."

brittone2
01-31-2006, 07:28 PM
Thanks everyone. He's never had any masses that the ped could feel on palpation and I can't feel any either. I will definitely keep an xray in mind...I've mulled that over a few times.

The constipation issues have probably been around for close to a year in some form or another. It didn't get really bad until we moved this past summer when DS was 18ish months or so and he had a huge painful BM.

I guess it will hopefully resolve in time. I try not to stress since he doesn't seem like he's in pain but the other factor is that he's never been a big eater and I always wonder what kind of influence this has over that. He is improving in the eating department lately though so I'm also trying to chill about that ;)

Here's the other thing, and maybe some of you can help me out here. My ped and everyone else I know says Miralax is not habit forming, but if you look at their website and go to the prescribing information, it says it shouldn't be used for more than 2 weeks and long term use can be associated w/ dependency. So that's been bothering me...I'm okay with it since it is doing the job, but I really hate the idea of super long term use of this stuff. I don't understand why every M.D. insists this is not habit forming but the RXing literature suggests it can be, kwim? (not that I have a choice).

I did recently let DS go 5-6 days without a poop and did very little meds. He had a formed poop but didn't seem in distress. I was all worried that it was somehow too hard because I've been so used to super loose ones from the Miralax (not formed at ALL but not truly liquid...sorry on the TMI) but it is probably what normal toddler poop is supposed to look like.

I guess he'll be fine...we'll just keep up with keeping his poop soft and hope that's enough to eventually get him going on a more frequent schedule. I'm just frustrated that he seems stuck at going every 4 or 5 days no matter what I give him (M.O.M., Miralax, flax oil, etc. or any combo of the above!!!). I don't think there's much I can do to change that though.

I appreciate it everyone :)

dogmom
02-01-2006, 07:34 PM
Sorry, addiction is a bad word. All the literature indicates any long term use of laxative can lead to the body adjusting to it which can result in some kind of dependency. Stimulates can be worse, but all can possibly result in some sort of dependency that will take time to recover.

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202319.html

Jeanne
Mom to Harvey
1/16/03
& Eve
EDC 6/18/06