This is the poops.
October 7, 2017 12:02 PM   Subscribe

We're at our wits' end with potty training. Our son turned four in August. He's great at going pee on the potty but we can't seem to get him to poop and we're at the point where we're all just way past frustrated at changing dirty underwear. Help.

He used to poop on the potty just fine but then had a number of intermittent bouts of bad constipation followed by large, hard stools. After that, I think he was a bit scared of pooping in general. On the advice of our doctor we started giving him Restoralax. That solved the constipation fine, but he wouldn't go on the potty. Basically, he just sits down on his knees and says "I pooped." If we see him assume that position, we start to try to get him to the potty but he gets upset when we get close to him. We try to be positive—"Let's go! You can do it!"—but to no avail. If we rush over and try to physically move him ourselves he either resists our picking him up or has pooped by the time we get there. He'll have several smaller movements or sometimes one or two large ones a day like this.

We tried a few behavioural interventions to make him more relaxed on the toilet—giving him something to play with, blowing bubbles, et cetera. He's fine to sit on there, but won't poop. Sometimes he'll sit on there for 15 minutes, happy as a clam, and then get off and poop in his pants a few minutes later.

It was suggested to us we consult with a physio who evaluated him and confirmed that he had some tightness in that general region. We did some stretches for a while and made a little bit of progress (that is, he pooped on the potty twice). But then it stopped again. We then tried another behavioural tactic—he hates getting messy, so we started making him take the initiative on cleaning things up (of course we help but he has to take the lead on wiping his bump, putting the poop in the toilet, et cetera). That seemed to work and we had a few good days, but then he went back to pooping in his pants again.

He understands that he's not supposed to poop in his pants and will even promise us that next time he will do it in the potty but never does. We've tried bribing him with toys, with sticker charts, even with cash (ha), but he's apparently not motivated by these kinds of external rewards.

He is in junior kindergarten now in the mornings, but seems to be able to hold it until he gets home. He hasn't had an accident there. He's never had an accident when we're out an about either—only at home.

I'm not totally sure he always understands when he is going to poop, or if he does and just ignores it. We don't generally see any signs that a poop is imminent until he drops to his knees and by then it's too late.

Please, please help us.
posted by synecdoche to Grab Bag (21 answers total) 1 user marked this as a favorite
 
How do you feel about putting diapers on him when you come home from kindergarten, and keeping them there until he poops?
I understand concerns at this being a step back. But.
At the moment, frustration and pressure (yours and probably his) are a way bigger problem than a delay in potty training would be.
posted by Omnomnom at 12:31 PM on October 7 [2 favorites]


I wonder if the Restoralax is making the time from ‘I feel something’ to ‘pooping NOW’ so short that it makes him freeze up? Have you talked with him about what he’s feeling in his body right before he poops? Have you asked HIM why he doesn’t use the loo? Hell, sometimes kids get splashed and it makes them uncomfortable and refuse the toilet- will he go in a potty chair or can you teach him the TP trick? What about having a child sized toilet installed, assuming you have more than one bathroom (I had one installed for my kids and it was great- no teetering on a stool, no hanging, dangly legs, just an appropriately sized facility)?

This sounds stressful for everyone. I think it’s good that he’s cleaning himself, but I think you need to step waaay back on helping him at all and just do a final ‘inspection/check’ with ZERO stress about it. Make him a kit that’s kept under the sink so he can clean up and bag his dirty undies and put new ones on. Have him call you for a clean up check once he’s done.

Quit tying to chase him down to move him to the toilet. He’s four and while that is young, as long as there’s not a diability at play here, he’s plenty old enough to grasp the need to go poo in the toilet. Drop all the stress around it, he deals with the consequences until he’s ready to make the switch. (Obviously you’re dealing with clean up consequences too, but you don’t need to share that stress with him.)
posted by PorcineWithMe at 12:51 PM on October 7


I'd just put him back in nappies (diapers). Don't make a big deal of it, avoid psychological trauma and it will probably just sort itself out (frustrating though it is).
posted by KateViolet at 12:52 PM on October 7 [2 favorites]


Oh, and assuming it’s not medication related (though “several” bowel movements a day sounds like a lot), these aren’t accidents. Your son kneels down to go and is CHOOSING to go in that manner. I’m also hoping that you don’t end up in a circle where he holds it at school, gets constipated, it hurts/splashes/whatever and then his behavior becomes more entrenched. If you can, maybe get pooping down before continuing pre-Kinder.
posted by PorcineWithMe at 1:00 PM on October 7 [1 favorite]


The term you're looking for is "encopresis." If left untreated, it can cause long-term problems such as enlargement of the intestine, so it might be a good idea to ask your pediatrician about specialist referrals for GI and behavioral intervention.
posted by timeo danaos at 1:36 PM on October 7 [3 favorites]


We used the "Oh Crap Potty-Training book" for guidance regarding p-t our kiddos. We didn't have the issues your son is experiencing but I am given to understand that this lady does good work with kids that have challenging issues. You might spend some time perusing her website or maybe even email her to see if she has suggestions for you.
posted by vignettist at 1:45 PM on October 7 [1 favorite]


When my son was newly 4 it seemed like he soiled his pants every day at the same time at preschool, just before I picked him up. I could never understand how he couldn't make the connection but that was the way it was. I started trying to pick him up 30 minutes earlier so I could get there before he had an accident, and sometimes I would put him in diapers. We eventually moved past that but it seemed like it was never going to end. 4 seems pretty young to be forcing him to clean up after himself, or punishing him for this. He may not have the gross motor skills to fully clean himself (and frankly I wouldn't want to have to clean up after a 4 year old trying to clean themselves and put their dirty underwear in a bag, that sounds like a poop being spread all over the bathroom). He may not have the sense of awareness to go to the potty when it's time until he's actually going. And can't articulate to you what the issue is. Potty training is really frustrating and it's full of forward progress followed by regressions.

If he's pooping at home after school, then there's somewhat of a routine, and I suspect, a window of time during which he always poops. Maybe 15 minutes just wasn't enough or he wasn't relaxed enough. I'd focus on getting him some more experiences of successfully using the potty more than punishing him. Make sure the set up is comfortable for him, if it's an adult size toilet make sure he's got support for his legs, etc. An hour on the potty with a tablet and his favorite show. Is he always in a particular room when he soils his pants? Put a kids potty in there, that's why they are portable. We would put the potty in front of the tv, take it outside. There was something about the novelty of it not being in the bathroom that helped both of my children. They were much more inclined to try and get themselves on it when the time was 'NOW' than they were when it was hidden in the bathroom. And they found it hilarious to have it someplace else. It's gross, but less gross than dealing with soiled pants and it's only a temporary situation. They only really ever used it outside of a the bathroom a couple of times.
posted by littlerockgetaway at 2:07 PM on October 7


Just a thought- could it be that the squatting position is more comfortable? Have you tried him with something lower than a toilet, like a potty?
posted by KateViolet at 2:13 PM on October 7 [4 favorites]


This was us 19 years ago. Never had accidents outside the house or at school so able to wait until he was home. No real medical issue. Pretty much did all the things you have done. Then we kind of just stop pushing it. He still wore his underwear (did not want to go back to pull ups or diapers). We didn't make a big deal out of trying anymore and just cleaned up the mess (with his help). We didn't talk about it. Maybe a month or two without any "pressure", he just started going on the toilet. If you have tried everything, maybe trying nothing is better. (Our kid was (and is) strong willed, spirited and persistent. He could outlast any battle of wills, just in case yours is like that)
posted by maxg94 at 2:20 PM on October 7 [3 favorites]


Another vote for encopresis here. It often starts with some poop related trauma, but if left untreated can continue for years. I had a friend in high school with encopresis who still had to follow the protocol of scheduled toilet time at various intervals throughout the day because she'd lost the ability to physically sense the need to poop until it was too late.
posted by xyzzy at 3:08 PM on October 7 [2 favorites]


Thanks for the advice so far. Just to follow up on a couple of things.

1) Re encopresis, we're aware of that and that's why he started taking Restoralax (I think it is called Miralax in the US) at the suggestion of the doctor; the physio also gave us a stretching routine that was supposed to help (and him doing the stretches did coincide with one of the all-too-brief periods where he was getting on the potty) and is monitoring the Restoralax dose. He hasn't had any issues with the large hard stools for months now. When I say several small, I don't mean just staining or anything like that. There are definite (soft) stools--just not overly large.

2) Re: cleaning himself, this is not a punishment, nor is it expected that he do it all himself. He doesn't object to doing it in the least. Usually he makes an attempt at wiping and then we finish up whatever he can't do (and he can't do a lot at this age), or else we start it and let him finish it off (so he gets a feel for what it's like when he is done). He does prefer things to be clean (and expressed I guess satisfaction during one of the successful movements about how much neater it was to go on the potty one of those times).

3) He's mentioned worry about getting splashed before but won't sit on a little potty. He only brought it up after being asked if he was worried about getting splashed, so sometimes I wonder if it was just him latching on to the suggestion. We tried the paper towel trick but he has never actually pooped on the toilet when we have done it. He also has noted during one of the good weeks that he didn't actually get splashed.

4) We've thought about getting the squatty potty but he often kicks the little footstool we do have at the front of the potty away so I am not sure how kindly he'll take to it. But we'll try nearly anything at this point.
posted by synecdoche at 4:46 PM on October 7


Rewards, and reduced attention to the issue. Is there a favored toy? For my son, it was matchbox cars. Every time he voluntarily sat on the potty, he got a few M&Ms. Success got a matchbox car and a well done.
posted by theora55 at 4:58 PM on October 7


It's been a few years, but we were successful using rewards: one chocolate chip for pee in the toilet, two for poop. It worked great!
posted by summerstorm at 8:03 PM on October 7


Go read the book It’s no Accident by Dr. Steve Hodges.

I too was at my wits end with potty training, did not know encopresis even existed. This book changed our lives. It’s on kindle too.

Then go to bedwettingAndAccidents.com and read The MOP Book. You can get it ln PdF. We have been doing MOP for a while with my five year old and our lives have gotten much much better. No more cleaning pooped undies every day. PLEASE memail me! I can help. (I’m almost in bed now or I’d memail you myself)
posted by CrazyLemonade at 9:17 PM on October 7


But then it stopped again. We then tried another behavioural tactic—he hates getting messy, so we started making him take the initiative on cleaning things up (of course we help but he has to take the lead on wiping his bump, putting the poop in the toilet, et cetera). That seemed to work and we had a few good days, but then he went back to pooping in his pants again.

It’s not behavioral. Your kid’s colon and rectum are stretched with poop, making them loose correct nerve and muscle function. No amount of psychological strategies will work until the underlying physiological issues are solved.
posted by CrazyLemonade at 9:21 PM on October 7


Rewards worked on our kid. We had an M&M jar and she got an M&M and praise each time she used the potty.
posted by w0mbat at 10:00 PM on October 7


Poor guy! This is so so common in little kids and esp when there have been constipation issues.

Some kids, esp, when the poo has been a while coming out, or seems bigger than normal, think (I think) that more than the poo is coming out - hence the need to do it in a nappy, so it's contained, rather than in a big bad empty toilet.

This sounds crazy, but lots of parents (and me!) had success reading Poo Goes to Pooland which kind of covers it a bit. There's an app too!
posted by low_horrible_immoral at 3:58 AM on October 8


Go read the book It’s no Accident by Dr. Steve Hodges.

I too was at my wits end with potty training, did not know encopresis even existed. This book changed our lives. It’s on kindle too.

Then go to bedwettingAndAccidents.com and read The MOP Book. You can get it ln PdF. We have been doing MOP for a while with my five year old and our lives have gotten much much better. No more cleaning pooped undies every day. PLEASE memail me! I can help. (I’m almost in bed now or I’d memail you myself)


I agree with this. My daughter has constipation problems and it was Hodges' advice--to use nightly enemas, basically--that made a huge difference. People are really scared to use enemas but it is not that big of a deal for a kid (they might be scared before hand but it really makes a huge difference). His book for kids "Jane and the Giant Poop" helps too. It's really ridiculous, but my daughter likes talking about what kind of poop she's going to have and it has really helped to normalize it for her.
posted by PhoBWanKenobi at 4:55 AM on October 8 [1 favorite]


Also he can still be constipated and pooping regularly.
posted by PhoBWanKenobi at 4:56 AM on October 8


Sent you MeMail.
posted by CrazyLemonade at 10:14 AM on October 8 [1 favorite]


If you've ruled out medical issues and he can feel when he needs to go, just stop worrying about it as much as possible. He will grow out of it. Many of us did. Some of us were delayed even longer by shaming, intentional or otherwise. The more of a thing you make it now, the longer it will persist and the longer it will be before your offspring stops having weird poop hangups even after using the toilet.

Also, be glad he's not pooping in closets and other hidden places. It could be much much worse.
posted by wierdo at 12:26 PM on October 8


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