Toddler constipation

Something usually starts this off, and a worm infestation, the treatment and subsequent infection is all that it takes to disturb the regular cycle. Diet is important, as is extra fluid. The main aim now is to re-establish a different bowel habit.

Once dietary waste has hardened in the lower bowel (constipation) nothing taken by mouth will allow it to become soft and easily passed once more. All that medicines are likely to do is make liquid of the waste that follows this constipated stool - and encourage its leaking from the bowel around the block, thus increasing any soreness.

This sometimes creates the illusion that the child has diarrhoea, with liquid staining the underclothes but this is actually constipation with leaking stool. The aim is to keep the waste soft and bulky from the beginning; lots of fluids and bulking/fibrous foods help - as she already seems to have in her diet with the addition, perhaps, of the medical bulking agent that you have already used (lactulose), at least twice a day - even increasing the amount for a while.

To this can be added a small dose of daily Senokot - which is available in liquid form, and is only a vegetable laxative, in order to stimulate the bowel gently.