Helping the little one do number two.
August 4, 2011 6:31 AM   Subscribe

My two-and-a-half-year-old boy is making his pooping an ordeal. What to do (if anything)?

The basics: he's two and a half, we're getting him off diapers and he more or less only wears them at night. If he has to pee, he'll announce it and my wife or I will take him to his potty--which sits over the toilet in the bathroom.

When it comes to pooping, though...he doesn't want to poop in his diaper and he's scared to poop in the potty, so he holds it in. For HOURS. And when his bowels are obviously telling him "Hey, kid, time to poop!", he just clenches and writhes on the floor until the feeling passes. Sometimes it lasts a long time, like 15 minutes per "push". Eventually we hold the little plastic poop bucket as he squats on the floor and does his business in that manner.

But this holding out goes on for days. We thought he would poop tonight, but he went to bed not having done so, which makes day 3. And the boy eats, he eats a lot. I marvel how he can keep so much food in that little body and not poop it out for so long...

SO. I'm not exactly worried, but wonder if there's anything I could do to speed this latest phase along. Slipping him a little prune juice to expedite things doesn't seem very sporting, but if that's good for him, I'll try it. Or should I just sit back and do nothing?
posted by zardoz to Health & Fitness (24 answers total) 4 users marked this as a favorite
I'd do whatever you can to keep him from holding things in, the gentler the better.

If you can convince him it's okay to go in a diaper, even if it seems like going backwards, that's what I would suggest.

This kind of thing can lead to a bad cycle of constipation and once you get there, then you get liquid fecal matter leaking everywhere, pain and discomfort...basically you really don't want this to continue.
posted by the young rope-rider at 6:36 AM on August 4, 2011 [1 favorite]

zardoz: which sits over the toilet in the bathroom.

It may be this. Toilets are scary. Is there some reason you're not using a more traditional training potty? Smaller, no flushing, under his control, etc.
posted by DarlingBri at 6:36 AM on August 4, 2011 [5 favorites]

Oh, and prune juice is fine. Any juice will probably work, actually, if he's not into the prune juice. Make sure if he's eating lots of fiber that he's drinking plenty of fluids.
posted by the young rope-rider at 6:37 AM on August 4, 2011

Similar previously.

I am learning with you. The only thing I can offer is my comment in the above thread. My sister did something similar. My mother took to bribery. She placed a new Ken doll (to her barbie) up on her dresser and would not give it to her until she went poopy in the potty. To the point she would say to my Dad - "I am not getting that Ken doll today Dad." It worked! She has been using the potty successfully for 24 years now!
posted by BuffaloChickenWing at 6:41 AM on August 4, 2011 [3 favorites]

Second DarlingBri. We went through a transitional phase where we used the training potty for quite a while (maybe 9 months) and eventually he was ready to use the potty seat with the regular toilet. We also put a small footstool under the toilet so his feet wouldn't dangle and to make it easier to get up and down.
posted by chickenmagazine at 6:47 AM on August 4, 2011

I'd recommend visiting the pediatrician. We fought this with one of our kids, and if you don't get it fixed it can become a life long problem as his body essentially learns to ignore the urge to go. Our doc told us that if that it becomes virtually impossible to reverse as they get older.

As I remember it, we put mineral oil in his juice to help soften things up, we spent a small fortune on Thomas the Tank Engine trains as rewards, and it took at least a year until #2 was just a normal thing and no longer a struggle.
posted by COD at 6:58 AM on August 4, 2011 [1 favorite]

My niece went through this, and a combination of things worked for her.
1) She was constipated and pooping hurt, so she dreaded it and held it in as long as possible. Giving her fiber stool softener helped with that aspect.
2) Having her own little potty, NOT in tbe bathroom but out in the middle of everything where she would not feel deserted and apart from the goings-on in the house was also crucial.
3) Flat out bribery. Every time she pooped, she got a potty quarter. We lined them up on the fireplace mantel where she could see the line of shiny quarters (all of which could be hers someday!) from her seat on the livingroom potty. When she pooped, we gave her the quarter - she had this whole hilarious interpretive dance ritual about putting it in the piggybank. After a couple of weeks, we cleaned out the piggybank and bought her some kind of stuffed animal from the zoo shop that she wanted. (It cost way more than the amassed quarters, but monetary specifics weren't the point.)
Good luck.
posted by 8dot3 at 7:02 AM on August 4, 2011

Not sure if prune juice is such a good idea. It's hard on the bowels.

Encouraging the diaper at this point seems like a good plan. The biological and psychological collateral damage here seems too great.

I'm speaking as the father of an 8-year-old who wore diapers until the first day of kindergarten. Our 2-year-old right now shows no signs of wanting to ditch diapers, either.

Boys take longer.
posted by KokuRyu at 7:22 AM on August 4, 2011

Children are natural imitators and little boys want to be just like daddy; therefore, the answer is to have daddy use the toilet in front of sonny and impress him with how awesome it is. No need for toy bribes, the best reward is time being spent together. Best of luck!
posted by Renoroc at 7:29 AM on August 4, 2011 [1 favorite]

I have friends who were having this problem with their 3 year old, but it was more of a "not ready to leave fun play time to poop" then fear. They did something very similar to Renoroc's suggestion:

The boy received a very important grown up watch that had an alarm that would be set for specific times (just like Dad's!). When the alarm would go off, he would stop what he was doing and take stock of what his body was telling him. Was he hungry/thirsty? Did he have to pee or poop? He would tell Mom or Dad, and they would treat it as very normal, and a very grown-up thing to do.
posted by lootie777 at 7:38 AM on August 4, 2011 [3 favorites]

Perhaps create an environment that does what the young rope-rider is suggesting. How about a private potty corner where he can linger as long as he wants, like, with a few books or toys or what, you know, with items of interest and really in private, without any are-you-done-already type of feeling.
We used one of Ali Mitgutsch's great fold-up books for our son; made a closed circle with the book, potty inside, son on top. A quarter of a hour silence, then he was fine.

It's not only that the toilet may be scary, it just may be a totally uninspiring environment, where he doesn't want to be for long. At the very least it's grown-up turf.

Reverting to diapers - well, I actually remember they did that to me after some or other accident when I was 2 (memory as an iron kettle...): it was utterly humiliating; that trick might turn out counter-productive.
posted by Namlit at 7:51 AM on August 4, 2011

Another vote for a little standalone potty. Toilets are screwed up, your poop plops into a big pot of water and then then make this loud noise and it all gets sucked into this vortex to God knows where. Hanging out in the potty while grown-ups do their business (and I absolutely HATED this myself, do not want company while I poop) is good also and he can sit on his little potty while you sit on the big one. Per a number of no-nonsense books we encouraged sitting on the little potty sans diaper when he didn't need to go, just hanging out, no emphasis on getting the job done, distracted with a book or movie or whatever works. Getting used to it, making it a no-pressure place to hang out.

A 2.5 year old does not have the cognitive equipment to understand what is going on with their poop. He doesn't know that when the momentary discomfort of holding it in "goes away" the poop goes away, or that the longer he waits the more accumulates - and he is not capable of processing these ideas. 3-4 seems to be the generic age range for declaring normal transition issues to be actual problems. On the other hand 3 days is a long time to hold it and I agree with a trip to his doctor. One term for this excessive avoidance is "stool holding" (scroll down a bit) and it should be medically addressed. I would particularly not want to give a toddler a laxative (even a natural one like prune juice) to address an ongoing problem without some medical oversight.

Anecdotally I started out as an over-involved potty trainer (as a parent with a child, I mean, I have next to no recollection of my own potty training and God willing my kid won't either), trying all this different stuff and I think I projected a lot of my stress onto the kid and just slowed the whole process down. Potty training is messed up - I mean imagine "the authorities" all the sudden showing up and trying to get you to sign up to radically alter your toilet habits for incomprehensible and seemingly arbitrary reasons. Little kids can't really process what is going on but it's not hard to see how they would want to opt out of the whole thing. To whatever extent you can take the pressure off and avoid stressing about it yourself, it helps. They all get it eventually.
posted by nanojath at 8:08 AM on August 4, 2011 [1 favorite]

My kiddo was like this when kiddo came to us at 2 1/2 having never been potty trained. Kiddo was the victim of some pretty serious abuse and control of the body was one of the things kiddo could control.

When we started potty training, kiddo completely freaked out the first time a poop ended up in the potty chair. For the next several months, kiddo would sneak off to hide when pooping needed to happen. If we could catch kiddo, we'd relocate to the potty chair and quietly wait. Having kiddo's pants off during those urges made it easier to "let it go." If I noticed that kiddo had held it for a day or two, I'd make the bath warm instead of cool as kiddo liked it. When the bath tub squirming started, onto the potty chair we'd go.

We saw the doctor who put him on a laxative for a while. We were also advised to give kiddo pear juice. Lots and lots of pear. We found that the pear worked well and got off the laxative as quickly as possible. We still buy pear juice but that's because kiddo likes it.

If you want to try the pear juice/nectar route and are having a hard time finding it, check in the groceries or section of the groceries which caters to the Latin community. We buy it in 32 oz tetra packs which cost under 2 dollars each.

So, see the doc, use pear juice, use a potty chair and have LOTS and LOTS of patience. Don't get frustrated with your child. Just calmly sit the child on the potty chair and encourage the child to just let it go. To keep from getting frustrated, I made sure I had a book to read. When the poop happens, be sure to praise lavishly. Know that bribery doesn't work for all kids. It didn't with my kiddo. Good luck.
posted by onhazier at 8:12 AM on August 4, 2011

Make sitting on the potty fun. Sit with him and read books, play games, sing songs. That's what my SIL did with my niece who had all sorts of toilet training issues.

Along those lines I would get a potty that sits on the floor, sitting way up on an potty on a toilet isn't too stable and their feet hang and they feel insecure and get the poor guy some prune juice or something all I can think is if he's able to hold it in so long it must be pretty damn firm and maybe it hurts coming out that'd put me off wanting to go.

Also taking someone for a walk can help make them want to go poop as well. My SIL used to go for a walk with the kids and dog so my niece didn't get suspicious then when they got back she got to sit on the potty for a while, while that sang and read books, if she went she got lots of "OH good girl you went potty." if not she got no pressure and just tried again later.
posted by wwax at 8:26 AM on August 4, 2011

When I was in high school I babysat a little boy who was fully trained (4-5 years old) but for whom #2 was a huge ordeal because of an ongoing pain/hold it/constipation/big hard poop/pain cycle. As far as I know, it wasn't a power thing, although he was an incredibly anxious and fretful kid.

I used to stuff him full of apple or pear slices, coax him into drinking a bunch of water, and then get his little brother to help me chase him around the house until we had some movement.
posted by clerestory at 8:28 AM on August 4, 2011

Apple juice is a laxative because it contains sugar. Applesauce or raw apples are constipating because they contain pectin.
posted by bq at 8:38 AM on August 4, 2011

Is it possible that she's already constipated? Behavioral stuff led to my 4 year old becoming quite badly constipated, and we were starting down the Road of No Return in that arena. My doctor suggested Miralax every single day for a year. a YEAR. And sure enough, it's helping the problem.
posted by KathrynT at 8:56 AM on August 4, 2011

2 things I did with my son. Peeing: place a square of tp in the water, and tell him to sink it. Fun for everyone. Pooping. Every time you sit on the toilet seat (we had a potty chair) you get a couple M&Ms or similar tiny treat. Every time you are productive you get a Matchbox car, the favored item at the time. It took about 12 - 15 cars. No lengthy commenting, discussion or negotiating about it. Just, Peeing and Pooping in the bathroom is what big kids do, and when you're ready, you will too. It's so nice to have a clean bottom. He wasn't ready till 3 or 3 and a half or so.
posted by theora55 at 9:54 AM on August 4, 2011 [2 favorites]

plus, A diet that includes raisins, apricots and other fiber is helpful, and plenty of water.
posted by theora55 at 9:54 AM on August 4, 2011

Lots of people swear by Poo Goes to Pooland

It sounds stupid and the illustrations are infantile, but it really worked with my daughter, who had a similar problem for a little while.

(Now she is a little obsessed with where various waste products go - poo goes to Pooland, wee goes to weeland, farts go to fartland - and I confess I am indulging it a little - 'that was a great big poo! Do you think it was a daddy poo? What's he going to do when he gets to Pooland?' but hey anything to make the whole process a little more fun :-))
posted by low_horrible_immoral at 11:35 AM on August 4, 2011

As the mom of a kid with pretty much ongoing poo issues (which is not to make you worry, he has autism and this all ties in with sensory issues as well), I definitely second the mineral oil. It only takes a tablespoon or so. A bath to help relax is another fantastic idea. A nice solid potty chair that rests on the ground, and a postive but matter of fact attitude. Maybe even set a schedule or use a timer ("We go poop every single day.") and do stuff like when the timer beeps, we'll go try to go poo. He sits, stays a minute or two, then oh well, we'll try again later. A lot of talk about listening to your body - even now I remind my boy, "When you fart, it means you probably need to poop!" lots and lots and LOTS of praise for trying and for succeeding both.
posted by lemniskate at 12:51 PM on August 4, 2011

I'm also writing to recommend talking to your pediatrician. My oldest withheld his bowel movements when we started potty training, and eventually had reduced sensation and extreme constipation. Had it gone on indefinitely, we're told that he could have done permanent damage to his colon. We spent about a year giving him daily doses of Miralax, and we taught him a routine that his doctor gave us to help him relax his muscles when going to the bathroom.
posted by GeekDad at 9:07 PM on August 4, 2011

Thanks everyone, for the answers. Seems like there's more than one route to try. And to clarify a few things: we started with a stand-alone potty that we set in the living room. This was about 6 months ago, when he was around two. He never liked sitting in it, but a few times he would relax enough to pee in the plastic bowl. I only recall him sitting and pooping once in it. Now either he'll poop in a diaper (rare these days) or my wife or I will hold just the little plastic bowl under his bottom as he stands in a half squat.

So after a while the thing just sat there--he eventually stopped using it altogether. It adapts to a potty you put on top of the toilet, so we've done that, and it hasn't been a success, either, but as a stand-alone the kid didn't like that at all.

My son, I suppose, is very stubborn and when we want him to potty--during the times he's holding it in--absolutely NOTHING will convince him to sit and poop. Nothing could convince him to do it when the potty was stand-alone, either, which is why we're scratching our heads. Nothing seems to work. We've got half a dozen books on the subject of pooping, which he always seems to like, but in the end he'll still hold it in.

I like the dietary suggestions. Pear or apple juice seem a simple idea, that would be great if they work.
posted by zardoz at 11:45 PM on August 4, 2011

Another thing to consider, if you have an elongated (oval) toilet it something like this Kohler toilet seat:

We have them on our toilets and it greatly aids in getting 3yo to use them.

That and an EZ-Foldz brand step stool. They're great in that they come in a bunch of different colors and fold up very neatly when you don't need them. Sturdy to stand on too.
posted by wkearney99 at 2:18 PM on August 5, 2011

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