I haven't been doing a lot of running these past months. Partly due to injury, but more so due to all of my attention being diverted to W's potty issues.
I mentioned previously that we have had a couple of Dr's appointment due to withholding and functional constipation. I have been reading everything from peer reviewed medical articles, naturopathic articles and mommy blogs to try to help him work through it.
While our Dr. initially prescribed Miralax, I have reservations for a couple of reasons. For one, it didn't help us. His blockages remained but watery poop passed around them, leaking into his diaper up to nine times a day. I also found evidence that Miralax has many adverse side effects. Most concerning is the fact that it has never been approved on label for pediatric use. You can read more about that here if you are interested.
I am sharing a short listing here of potential remedies for other parents who might need help navigating this tricky issue.
More water: If you are going to add fibre you need to increase water. In an attempt to get more fluids in W we also give him juice once a day. This is something I hadn't done before but there is a water content and many juices have a laxative effect (papaya and pear if you can find it). We have also tried to make it more fun with ice cubes and new water bottles.
Lansoyl or mineral oil: At our last appointment our Dr. was very receptive to our concerns and suggested we try Lansoyl - a fruit flavoured mineral oil jelly that can easily be mixed with jam at breakfast time. *mineral oil should not be given to infants.
Flax meal: I try to ensure W has a high fibre and nutritious diet. That said, I have been making a concerted effort to sneak in additional fibre where possible. Flax meal in peanut butter is one solution. While peanut butter can be a binding food (= leads to constipation), we do give him it once a day mixed with flax meal and topped with the Lansoly/jam mixture mentioned above. I also made these muffins on the weekend and they were a quick family favorite.
Reducing binding foods: through research on naturopath and health food focused sources I have read that there are a number of foods that can contribute to constipation in children. Frequent offenders in our house include bananas, too much dairy, and apple sauce. In retrospect, I realized things used to replace eggs as binding agents often make the list.
Increase beneficial foods: We have all been eating more pears, prunes, coconut oil, figs etc. in an attempt to model healthy gut behaviours. There is some great information on this site and some pin-able reminders too.
Calm Magnesium Supplement: This powder is easily mixed in water or juice and has a lemonade taste.
Magnesium, a gentle laxative, helps to prevent constipation by relaxing the walls of the colon. This role of magnesium is very relevant when you are under stress, have anxiety, or have too many worries. Magnesium, normalizes tension on colon walls allowing for a normal peristaltic action. Also magnesium attracts water and allows you to bring in more water into your colon.
Additional remedies: Aloe vera gel apparently works quite well but I have yet to find a way to disguise it enough for W to take it. Ex-lax will work in a pinch (I have used it past the 7 day mark) but it is habit forming.
I also suggest keeping track of all bowel movements using a calendar. There are some really good resources online (see here).
We have had small victories. We went from 7-8 days to a 4 day gap. Still too big, but I am hoping with time things will improve. As always, advice would be great!