At her two-year check-up, our pediatrician told my wife and me that our daughter, who at 8 months was in the 90th percentile in weight, was now in the second percentile. This change was due to constipation and picky eating issues. We watched as our lively baby turned into a cranky and lethargic toddler who would spend days lying on the ground in pain.  The last two years have been a very difficult journey for us, but I'm happy to see that it seems like we're in the clear.

First Step: Find a Pedatric GI and Speech Language Pathologist

If your child is struggling with something similar, the first thing you should do is see a pediatric gastroenterologist. Our pediatric GI referred us to an amazing feeding therapist.  Speech-language pathologists are generally known for their work treating speech, language, and communication issues.  However, many are also trained in feeding and swallowing.  

Part of our daughter’s issue was her preference for dry and crunchy food, as well as dairy products. The feeding therapist got her to start eating many more fruits and vegetables, which is crucial. This is where the SLP came into play — shifting her diet towards foods that help with constipation while ensuring she got enough calories and nutrients.

Food Tips for Curing Toddler Constipation

These were the most useful foods we found for mitigating our toddler’s constipation.

  • Fruits and vegetables: Any and all.
  • Frozen blueberries: Kids love them and think they’re a treat. They deliver tons of fluid, but you’ll need lots of wipes and paper towels with them!
  • Barlean’s Omega-3 Flax Swirls: Another food our daughter happily takes. The flax oil seems to have a positive impact, and it is known to have a mild laxative effect.
  • Coconut oil: It seems to help with constipation, softened up things like bread that my daughter wanted, and provided necessary calories for our picky eater.
  • Candy: Whatever your kid loves, because you really, really need them to go and sit on the potty.  
  • Senna chocolate: Early on, we needed this, as it stimulates the bowels. As she sat on the potty more, she no longer needed it and we phased it out.
  • Canned mandarin oranges: They were easy to get in and very helpful in softening the stool up.

Why Fluids are Key for Treating a Constipated Toddler

My wife and I spent the better part of the year chasing our daughter around with water and juice bottles. Anything you can do is worthwhile. I've tried to eliminate sugar from my diet entirely, but if a juice box is what you need to get fluids in that day, so be it. You can definitely see differences in bowel movement frequency, as well as texture and consistency depending on liquid intake. If it hurts, consuming a lot of fluids makes it hurt significantly less.

These were the most helpful fluids for helping our daughter relieve her blocked bowels:

  • Black mulberry juice: It tastes a lot like grape juice but has many more nutrients, including iron and calcium, which we desperately needed in our daughter’s diet. She liked it, and fluids are essential. It even has some protein. The Smart Juice brand is excellent.
  • Prune juice: It may be a challenge to get your child to drink prune juice, but if you can manage it, it is extremely helpful.
  • Pedialyte Pops: They were easy to get in our daughter, and especially useful when we were struggling to get enough electrolytes in. If bowel movements seemed close (less than 30 minutes away), this often helped put her over the top.
  • Nut milk and yogurt: We try to limit dairy, and found hazelnut, hemp, and flax milk all useful at times. Kite Hill almond milk yogurt was a good substitute for the dairy yogurt smoothies. When we did give dairy yogurt, we would use a bottle or a cup with a straw and mix it 50/50.  
  • Water, water, water: Asobu drink boxes were very helpful for us.

Supplements that Relieve Toddler Constipation

  • Renew Life Buddy Bears Gentle Move Kids Colon Support: This was the only way we could get our daughter to consume magnesium, which draws water into the bowels. My daughter likes these, while any other product containing magnesium felt like pure torture to get in.  Other parents wear by Natural Calm magnesium, but we could never get our daugther to drink it.
  • Probiotics: We tried a whole bunch of probiotics, and the Culturelle ones seemed to work the best for us, as they have a good balance of taste and effectiveness. UP4 vanilla cubes and Nature's Way Primadophilus also helped.
  • Ready Set Go: A homeopathic mix with prune extract and other anti-constipation ingredients that’s a heck of a lot more child-friendly than getting your kid to drink a can of prune juice. We found using Ready Set Go several hours before an anticipated bowel movement helped, as well as almost immediately after the act.  
  • Harvest Moon ClearFiber with SunFiber and Rainbow Light Fiber Garden Gummies: These helped add some fiber to the diet. The direct correlation to bowel movements wasn't as obvious.
  • Smartypants Kids Multivitamins: A solid multi supplement with fish oil and tasty enough to use as a post-potty candy reward!

The Potty is Key

Because of the constipation, you might find potty training extra hard. Our GI advised us that the diaper was causing our daughter to hold it in. In general, kids don't like the feeling of a soiled diaper, and it makes them want to hold it. So we would get either blocked up, or small poops when she couldn't hold it any more. Sometimes we would get a half dozen or more of those a day. Transitioning a child in this state makes using the potty super hard — I actually went in late to work a few days to help with it, and bless my wife's soul with the patience she showed. We spent hours reading books next to the potty, and we even bought one for the car that we still carry around in the trunk.  

Why Miralax May Be The Lesser of Two Evils

I will warn you now that either your pediatrician or pediatric GI will probably prescribe a combination of Miralax and Senna, and you will face a decision on Miralax, depending on how severe your child’s constipation is. We tried like heck not to do it. But without it, our daughter would lie on the floor for a week in pain.

There are a lot of studies that show that Miralax has an impact on health and behavior, but we weighed the cost/benefit here after trying every other solution. Do what you think is best for your child, and don’t think twice about it. We’re the most hippie-dippie, organic, avoid-prescription-medicine-people ever, but we ran out of ideas. If you want to research ways to avoid Miralax, there is a remarkable Parents Against Miralax Facebook group.  You will find kindred spirits and many ideas to try. Depending on the severity of the constipation, you may be able to find ways to avoid Miralax. It's an agonizing decision — just remember that you are doing what you think is best for child given your situation.  

Why You Can and Should Get Your Child off Laxatives

Our pediatric GI explained that when a child has severe constipation, the large amount of stool causes the bowels to become misshapen and lose their shape and tone. After an extended period of regular pooping, this reverses. The bowels regain their tone and motility.

We experimented pulling Miralax by reducing dosage. We finally got off it after our daughter started having daily bowel movements. It was seriously one of the happiest days of my life! It’s difficult to understand unless you’ve been through it.

Other Tips for Parents of Constipated Toddlers:

  • Notice when they are holding it in: You will become an expert at knowing when they are holding it in. You can sometimes tell from the smell or behavior. Whatever it takes — cajoling, candy — to sit on the potty, getting it out is the most important thing.
  • Tubby time: Bath time helped a lot. Sometimes it even seemed to help too much (I’m happy to share some funny stories). The warm water helps relax the muscles.
  • Travel: Travel is stressful enough as it is, but with a constipated toddler, it can be a nightmare. Make sure you stay on track diet-wise. It can be harder to get fruits and vegetables eating in restaurants or on the fly, especially with a picky eater. Stick with whatever supplements are working for you.
  • Support, love, and patience: It is hard. You will lose your patience. You want your kid to eat the right things. You will spend many hours coaching potty sessions. You will cry when large bowel movements hurt your child. If you’re facing a similar struggle, I empathize with you, and I can tell you that when you are through it, every second will have been worth it.

There are no words for how relieved I am that, at 4 years old, our daughter is healthy, happy, and no longer constipated. She is now in the 30th percentile in weight with no developmental issues. Everyone’s journey will be different on this front – if you have any questions or want to talk about it at all, please comment below.