problems with 3 year old

I have a concern about my 3 y/o granddaughter, who has been in my care for about 6 mos. She refuses to have BM's. When she feels the need to go she will hold it in anyway she can. I have been feeding her a high fibre diet and a daily dose of mineral oil but she still holds it for about 7-10 days at a time. She often complains of tummy aches and holds her belly as if she's in pain. I explain to her that if she went to the toilet more often her tummy wouldn't hurt, but she just keeps doing it. The other day at preschool she had to lie down in the nurses office because she had such a bad belly ache, although she was ok again in about 30 mins. Could you tell me why she does this and what I can do?

[Kevin Kennedy, Ph.D.]

Children usually do this because they expect that having bowel movements will be uncomfortable. This occurs when they have become constipated and actually experienced pain and discomfort. Be sure to work in cooperation with her pediatrician. It's possible she'll need to be cleaned out, if her bowels have become impacted. Check with the doctor about the regimen you're employing. Also, reward your granddaughter when she does use the toilet. After some experiences of comfortably moving her bowels she will improve.