Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Constipation Question: My daughter is 20 months old. She is having severe problems with constipation. She is unable to have a bowel movement on her own. I have been using the fleet babylax every five to seven days. That is the only way for her to have a bowel movement. She pushes off and on for several days in pain but nothing moves. I have seen her pediatrician about this several times but all he says is it is normal for her age. When she passes one it is so big her little bottom bleeds. I have increased her fluids and increased her vegetable intake nothing helps. I hate to see her suffer like this. Do you have any suggestions? - Michele Answer: Dear Michele, Constipation is not pleasant at any age, no less a 20 month old! There are some questions that I would need to know. First, when did this problem start? Has it been ongoing or recent? Has potty training started? Withholding BM's during potty training is not unusual. Many times a child will only use the diaper for having a BM. They will NOT have one in the potty. This is a very common issue. Withholding BM's is a form of control used by the toddler during potty training! New foods introduced? Started vitamins with iron? New environment (started day care or new sibling at home)? Is there a family history of constipation? Children (anyone, really), will tend to withhold having a BM when they associate pain and discomfort with it. Bleeding episodes signify tearing of the tissues from straining, usually with hard stools. Suppositories and laxatives will be a temporary fix, but will not get at the cause. This leads to just what you said. The inability to have a bowel movement without the babylax (mineral oil suppository). Try and go through all the foods and fluids that your daughter consumes. Make a diary and see what days seem to be better with regard to her BM's. You may find that too much milk (for example) may make it worse. ASK YOUR PEDIATRICIAN for a list of foods that are known to be constipating. If the problem cannot be pinpointed with all these things, perhaps you might ask your daughter's pediatrician to refer you to a specialist so this can be remedied. He or she may be able to pinpoint the problem with a more objective view. Good bowel habits should be started early in life. They may last a lifetime. Dr. Betti Also see: What is the cause of ITP and is there anything that can prevent it from recurring? Can a pediatrician comfortably prescribe and manage ADHD medication or is it better suited to a psychiatrist? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.