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Getting to the Bowel of It

by |  January 6th, 2014
Recently, a reader of the 411 book series I co-author emailed a question on the topic of constipation. It’s an issue that I address frequently with parents at 411 Pediatrics—no one wants to see their baby or toddler cry in pain. I thought I’d share the question and response here in hopes that it might address some of your issues.

My 20 month old screams in pain every time she has a bowel movement. This has been happening for a while. Her doctor hasn’t told me anything that I haven’t tried. I heard that goat milk may help her problem. I’m not familiar with goat milk as I grew up with Cow’s milk.

It breaks my heart to see my daughter scream and cry in pain.

Thank you in advance.

The goal is to make her poop nice and soft so it never hurts for it to come out—that way she will not be fearful of pooping and toilet training later on.

The key points here are:

  1. Increase fiber in the diet. You can adjust to the amount she needs to make the stool soft.
  2. Make sure she drinks at least 8 ounces of water a day and limit milk intake (cow’s milk is fine) to 2 cups a day. Excessive milk intake sometimes is constipating.
  3. Consider a short time laxative. The one I advise is MiraLAX which is over the counter. But you should discuss this with your doctor. I usually do a larger dose initially and then a maintenance dose until the poop is soft.

Check out the Toddler 411 book for a list of high fiber food choices. A ballpark for her is around 5-7 grams of fiber a day. Go slowly and see how much it takes to get her poop soft.

Dr. B


411 Pediatrics


Dr. Ari Brown founded 411 Pediatrics and After Hours Care in Austin after two decades of education and experience in child development, behavioral pediatrics and pediatric healthcare. Our pediatric associates, consisting of pediatricians, pediatric nurse practitioners, physician assistants, and lactation consultants, share a common goal. We partner with parents to help children grow up healthy, happy, and resilient!

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