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My daughter is a little over 3 yrs old and has had problems with having a bowel movement. It happened after her eye surgery for strambismus 6 months ago. I do not recall if she had very hard stools at that time. I do remember her having a little blood on the outside of her stool from what looked to be a fissure. Her stools do not seem hard. She is not potty trained yet and still has bm's in her diaper. She pushes and pushes and doesn't suceed, but it seems that she isn't doing it right. She tightens up her body and legs and then seems to push and is in pain. She usually gets some out after holding it and/or trying for 3 or 4 days, but she never seems to get it all. She doesn't seem to feel fine until after she has had a decent bowel movement - then she is a totally different and happy little girl. Her Pediatrician had an abdom x-ray done and it just showed a lot of stool to come out. They have her on a Tablespoon of Mineral Oil for the past 2 months and the Nurse Pract said to slowly decrease when I see some improvement.
I read Dr. Stolls article on Stool Withholding and Constipation and it sounds like her situation except she doesn't seem to be constipated as far as what I know constipation to be - hard dry stools.
Here are some questions I would like any info on:
1. Is the Mineral Oil or Metamucil internally harmful to a
3 yr old?
2. Can Mineral Oil and Metamucil be used for a prolonged
time?
The labels do not indicate usage for that age. When I asked a Pharmacist about Mineral Oil, he acted like one dose might be O.K. but not to keep giving it to her. As far as Metamucil, I never asked her peditrician yet since I just read the article and I tried to call her Dr. for the past two days, but still cannot get a call back or an appt. My main concern is the safety of both Mineral Oil and Metamucil at that age.
3. Should we let her keep trying to have a bowel movement
on her own, even when she really is in pain or give her
a glycerin suppository or fleet enema?
4. How should we react to her when she hasn't gone and is
in pain? We try to explain how she should stand
and push and also tell her it will be O.K., but she
doesn't seem to want to pay attention and just wants us
to go away. She says her poo poo doesn't want to come
out.
5. Is there any reason to have her situation further
evaluated by a specialist to rule out anything else and
put her through any testing?
They way I see her trying to push and tightening up her
legs and arching backward, It just seems like she
isn't doing it right.
Any info on these question would be greatly appreciated. I feel so bad for her that when I put her to bed at night I just have tears that she is going through this and a lot of times doesn't want to do anything because she gets a belly ache when she is so backed up.
Michele
In Reply to: Stool Withholding posted by Michele on March 03, 2001 at 03:20:47:
I can offer you this comfort. My son is 3 1/2 now and back in November he was doing fine with potty training, as long as he could stand to go. He would not sit to poop and therefore was choosing to hold it. He said he was a big boy and didn't want to go in his pull-up, but at the same time I think he was afraid he was going to fall in the toilet. Just about when I was at my wits end (he had withheld for 7 days!) I found this website.
No, the metamucil and mineral oil are NOT laxatives and therefore NOT harmful for your child.
You need to use BOTH the metamucil and mineral oil. Believe me, no matter how hard she tries, she will have to go. I give my son 1 tsp of metamucil in his first cup of juice in the morning. It has an orange flavor, so he has never even suspected. I just shake it up real good. Then in another drink, I add a tsp of mineral oil. He did ABSOLUTELY WONDERFUL on this regimen that Dr. Stoll advises to use.
As far as my son, we still are working on sitting on the toilet. He's doing really good though. We just sit backward and play the shell game on the back of the toilet. He has had a few accidents when he thinks he doesn't want to sit on the toilet, but who cares....at least its coming out of him now!
Good luck - I guarantee this will work for you.
In Reply to: Stool Withholding posted by Michele on March 03, 2001 at 03:20:47:
Pam,
Please do not fret. I was in the same situation with my 3 1/2 year old daughter who was potty trained. After a bout of a viral infection she had a hard painful movement and decided she would no longer go. She became very uncomfortable and irritable and actually held it for a week at that point I brought her to her doctor. I was totally unsatified with what he had to say so I started investigating the internet and read up on Dr. Stolls articules on the subject. I was amazed at how common this problem is. And even though I am not following the same course (mineral oil and Metamucil) I have with my doctors okay been administering Senikot nightly. And will do so to insure soft stool movements for the next 5 months.
Please remember to remain calm and understanding. To encourage her calmly that its okay to poop. ANd you will hold her hand or whatever it takes to help her through it WHEN SHE IS READY (don't ever force her...be "matter of fact" about it.. how Once the movements are soft they will quite often come out on there own and you can tell her proud you are of her. Good luck
In Reply to: Stool Withholding posted by Michele on March 03, 2001 at 03:20:47:
Michele,
My son is almost 4 and I have been going thru the same thing for about a year...it is the saddest thing when they can't go.. I tried the mineral oil and all he did was stain which in turn ate up his poor little butt.. If your daughter is having results from the mineral oil thats great!!! the thing about the mineral oil is to SLOWLY decrease it when she starts to have normal stools. If it is withdrawn abruptly she will get backed up again...I tried my son on senacot...no the childrens..it tastes awfull..You can find senacot in chocolate squares (like exlax) and my son ate that gladly! Unfortuatly that didn't help him either...he now takes a presribed laxative called "Miralax" and it works like a charm...it takes the liquid from the stool and turns it into bulk...He has had no prblems since he's been taking it and we have started to decrease it with hopes this problem is behind us....I wish you well..
In Reply to: Stool Withholding posted by Michele on March 03, 2001 at 03:20:47:
Hi, Michele.
First of all, children this age do not have to be constipated to have this problem. It is totally resolvable by giving her more bulk to work with and THAT is what the protocol is describing. There is no possible harm with the length of time you will need to do this to get past this stage.
Remember, every parent who has come to this board, has already been to at least several docs without resolution and ALL who follow the protocol resolve the problem. More "specialists" are more of the same.
When she wants you to ignore her and go away, she is wiser than you are. This is exactly what you need to do.
Until you have her having 2 bowel movements a day, you might have to use a suppository IF she is very constipated. Since you say she is not, there certainly is no need for ANY anal manipulation. Actually this kind of attention really makes the problem worse.
Hope this helps.
Let us know how she does.
Walt
In Reply to: Re: Stool Withholding posted by Pam on March 03, 2001 at 09:44:41:
Thanks, Pam.
This problem is so easy to resolve just with a little education that I despair of my profession.
It seems to matter little that the word "doctor" means "teacher" when the profession does precious little teaching.
Walt
In Reply to: Re: Stool Withholding (Testimonial) posted by Walt Stoll on March 05, 2001 at 11:40:40:
Thank you all for your advice. I will start the Mineral Oil & Metamucil combo.
Walt, I especially thank you for being there to help. The pediatrician and his office staff is of very little help. I still haven't got a phone call back and I have tried 3 times since last Thursday, prior to contacting you.
Pam indicated that she uses 1 tsp Mineral Oil & 1 tsp metamucil per day. I know every child differs, but do you have an approx amnt and number of times per day of each that you recommond as an approx starting point. I have only been using Mineral Oil - I have been giving her 1 Tablesoon before bedtime as her Dr. suggested back in December. She is really finicky and I hope she doesn't notice the Metamucil. I put the MO in apple juice and she does not notice.
Also, do you know why the Mineral Oil & Metamucil indicate not to use under a certain age, unless directed by a doctor?
Could a lot of my daughters problem stem from not eating any vegetables and the only fruit is strained prunes, dry prunes and I am lucky if she its a little apple.
Thank you again!!!
Michele
In Reply to: Re: Stool Withholding (Testimonial) posted by Michele on March 05, 2001 at 12:46:12:
Hi! The mineral oil warning is because it can be very dangerous to give this to a child who is RESISTING swallowing it. If it is not swallowed willingly, then you must never give it (I think this is covered in the archives). You might want to try sugar free orange flavored Citrucel instead of the Metamucil, just a suggestion, as it works for my son and Walt says it's just as good. Just a different type of fiber. You can mix it in all her drinks and she probably won't even notice. Mineral oil alone won't work! Sometimes fiber alone works, but it's best to combine with the MO.
A good way to get a kid to start eating vegetables is to give her nothing else except veggies and whole foods for awhile. She may not eat for a few days but she'll get hungry and eat the veggies and even realize she likes them in no time.
In Reply to: Re: Stool Withholding (Testimonial) posted by Michele on March 05, 2001 at 12:46:12:
I gave my 3 yr old daughter her first dose of Metamucil mixed in Orange Juice and I only gave her a 1/4 tsp and she said "Yuck, what is this kind of Orange Juice". I got her to drink most of it, but she is not pleased with the taste or consistency, I am not sure.
Any suggestions?
Michele
In Reply to: Re: Stool Withholding (Testimonial) posted by Michele on March 05, 2001 at 12:46:12:
Hi, Michele.
Listen to kmd (Thanks, kmd!)
Part of this (especially the fruits and vegetables part) is your child doing what is natural at this age: controlling the family in about the only way available to her. Stooling is the only OTHER way!
You are fortunate that she is not resisting the MO and the dose you are describing should be enough (in combination with the fiber). If you just resolved the dietary problem, the condition would probably resolve itself.
How did this culture ever get to the place where children could dictate what they ate?? How do THEY have any idea what is good for them? The food advertizers influence our children and their parents to their profit and care nothing about the health effects they are producing.
If you cannot establish control at THIS age, how will you handle a teenager??
Good luck. The tools are now in your hands.
Namaste`
Walt
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Walt Stoll on March 07, 2001 at 08:50:14:
Walt,
Thanks again for your response and kmd too!!!
Is there a big taste difference and/or texture difference comparing Citrucel to Metamucil? I tried Metamucil again yesterday, and she refused.
In the past couple of weeks I have been mixing water in her milk, giving whole wheat bread all the time, she eats a small jar of Gerber Prunes every morning and has now requested to have dry prunes. She has 5 at dinner each night. She also has the 1 tbl MO at bedtime in apple juice. Just in the past three days, I have seen lots of improvement. She has gone 3 days in a row!. We'll see what happens today.
I also made All Bran muffin mix w/Blueberry's which I tried before and she did not like. This time I did not put the small can of blueberrys in, I substituted some mini choc chips. Each muffin is 5 grams fiber. She ate it all up.
I always try to do different things like putting Gerber Oatmeal in pancakes, etc. Peanut butter on toast. Also, I just recently started with snacks like pretzels and popcorn.
If I do not succeed with her drinking a fiber supplement, do you think the increased fiber in foods will work?
Also, should I go ahead and try withholding certain foods and only give her vegetables and whole foods now?
Psychologically, one thing we've been doing that she thinks is funny, and it seems to help is a little type of role play between my daughter and her "poop" and she seems to have a better understanding of the situation. When she has to go, her poop says: I want out. She says: No I don't want you to come out. Her poop says: I am going to give you a belly ache if you don't let me out and throw me away in the trash or potty. She says: No. Poop says: Alright, here comes a belly ache, then she says: O.K., I'll let you out. She and her poop are both happy and she can go play without a belly ache and is happy again.
Thanks again.
Michele
P.S. A co-worker told me this morning when I told her I have to drop my mom off at the hospital for a breast biopsy Friday, to take the kids, 20 month old and the 3 yr old to McDonalds while I'm waiting. She laughed at me and acted like I was depriving my children when I told her they have never been to a McDonalds or any place like that before. I still don't have any plan on taking them in the next few years.
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Michele on March 07, 2001 at 12:48:26:
Hi, Michele.
Increased fiber in foods IS the best approach although difficult to get enough fiber that way. My the way, pretzels are bad (practically NO fiber) and popcorn is good!
To be successful with resolving this with fiber in foods, you really need to withold nearly all foods that have little fiber and focus on foods that have a lot of fiber. You will not have to do this forever but any foods eaten without fiber will provide calories that reduce the amount of fiber foods she will eat.
Congratulations on resisting the MCDonald's lure!
Walt
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Michele on March 07, 2001 at 12:48:26:
were not laughing ! WE ARE CHEERING ! we are laughing about the coworker;s future
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Walt Stoll on March 07, 2001 at 08:50:14:
Hi, Dr. Stoll - I wrote before about my granddaughter's withholding stool because of fear of pain. She is two and a half. She has a BM every 5 days. My daughter has been giving her Metamucil in everything she eats, which isn't much. Then we added the Fiber choice tablets (l/2 tablet), and the stool came out easily but was very rubbery--why is that?.
Now my daughter is mixing in a teaspoonful of Mineral Oil with Metamucil in orange juice. My question is, is it safe to mix the Metamucil with the Mineral Oil? She hasn't had a BM yet, but it's only been 4 days. She can't put too much Metamucil in the juice because it gels. She plans to increase the MIneral Oil if you feel it's safe to take both together. (she is still in diapers, so that she takes it throughout the day whenever she has juice. Thank you.
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Raisa on March 11, 2001 at 14:01:39:
Raisa,
I am having the same situation with my 3 years old daughter.
I have not yet succeeded on her accepting Metamucil in orange juice, but she has been doing extremely well on 1 Tablespoon MO before bedtime in apple juice and I have increased her fiber with the following items:
All Bran muffin mix (believe it is Bettye Crocker)- apple or blueberry (I substiture a little less than 1/2 cup mini choc chips for the apple or blueberry. (5 grams fiber for reg size muffin - qty 12 per batch)
5 dried prunes after dinner (3 grams)
1 small jar Gerber prunes with breakfast (2 grams)
popcorn snack sometimes
Orowheat light Wheat Bread (3.5 grams fiber per slice)
Orowheat Butter Top Wheat Bread (2 grams per slice)
Van De Kamps Deli Wheat Bread (3 grams per slice)
I give her different wheat bread - ex butter top for sandwiches and the other two with a Clearmans cheese spread broiled say with dinner or lunch.
Overall, getting her to eat the bran muffin and prunes as made the most difference.
She also doesn't want to drink much water in the winter, she will in the summer, so now I mix about a 1/4 of her cup with water, sometimes a little more and the rest lowfat milk.
I hope this helps.
Michele
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Michele on March 12, 2001 at 07:48:25:
Thanks for your help, Michelle. I will have my daughter try the pureed prunes--she has given prunes but my granddaughter tired of them. Also, I will tell her about the all-bran muffins with chocolate chips.
My granddaughter takes the Metamucil in juice three times a day with no problem. The problem is that the stools are still hard after 5 days, except for one time when we gave her a Fiber Choice tablet for two days--but then the stool was very rubbery, although soft.
Now my daughter is giving her 1 tsp. of mineral oil ALONG WITH 1 tsp. of Metamucil. It's only been 3 days since she started that--before that my daughter had been afraid to give the mineral oil because of all the warnings on the bottle.
My 2 questions to Dr. Stoll are: 1. Can the mineral oil and Metamucil be mixed together in juice safely, or should she stop doing this. 2. Do you approve of using Fiber Choice tablets instead of/or with the Metamucil?
She watches her little friends and can't believe that they finish so quickly and painlessly either on the potty or in the diaper. She has never had her stool impacted, and we surely want to avoid that!!
Thanks for your help.
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Raisa on March 12, 2001 at 15:23:22:
Raisa,
My 3 year old does better with 1 tablespoon MO. Yes, I was afraid to give to her also because of the warnings, but the Peditrician and Dr. Stoll say it is fine. I still feel somewhat uneasy, but a lot of doctors say to use it. I also give it to her only at bedtime. It is not good to give during her regular day. It interferes with the nutrients she recieves. I also give her her vitamins in the afternoon and will start switching to morning so they have some time to work before giving her MO.
By the way, the All Bran muffin mix is Duncan Hines and is made from Kellogs All Bran Cereal. You can also have her try other dried fruit - even dried cherries, although my daughter only seems to like prunes.
In Reply to: Re: Stool Withholding (Testimonial) Archive in constipation. posted by Raisa on March 11, 2001 at 14:01:39:
Hi, Raisa.
No problem with mixing the MO and fiber.
The success of this is dependent upon your getting enough fiber into her. SHE should not be the one who decides what she will eat. Since when is a child educated enough to know? So long as she is getting no refined foods in her diet, she will eat enough fiber filled foods to resolve this. The metamcil (or any other fiber supplement) is only a way to resolve the problem quicker. You need to aim for at least 2 movements a day. It is easier (less messy) to do it while the child is in diapers.
Hope this helps.
Walt
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