Kindergartener skid marks, should I worry/act or leave alone?
September 9, 2016 7:28 AM   Subscribe

For at least a year, my 5.5-year-old has been having "poop accidents" which are not major poop events in his underwear but rather incidents that, at most, leave skid marks. To my eyes, they SEEM to be more frequent around stressful times (starting school etc.) but I wonder if there's a nutritional/health component that I need to address.

My son is 5 and a half and has been fully potty-independent (wiping his own butt etc.) for about a year, maybe a year and a half. He sometimes comes to whisper to me that he's had a poop accident, which is usually just a little bit of poop that has escaped no farther than his cheeks and at most leaves a bit of a skid mark. This has been happening since before he started wiping his own butt, so probably about two years.

When it first started happening, he was drinking a lot of milk so we thought maybe that was the problem... when we switched to lactose-free milk there seemed to be less of a problem but it might be a false correlation because we are still on the LF milk and the "poop accidents" are happening daily lately. They've been happening daily since he started kindergarten 3 weeks ago.

Prior to that, the last time they happened with noticeable frequency was when he started a new daycare in early July. I remember thinking a few months back that stress seems to be a factor, so there are probably other correlations with changes in his daily routine. The past two years HAVE seen a lot of changes in our lives, two moves (one of them cross-country) and four new schools/care providers.

My husband thinks there might also be a component of not wanting to go poop at school, and then being so distracted by playing once he gets home that he doesn't want to stop and poop.

He ALSO could use some diet improvement, though, as he's one of those kids that gravitates to simple carbs and sometimes we're so busy that we just give in to it, so for instance breakfast is a bowl of cereal, snacks are granola bars and crackers and fruit, and he's not a terrific dinner eater, so in general we feel he doesn't get enough protein or fiber.

Since they've been happening daily lately, we've started talking about how we should really address this, but don't know where to begin. Elimination diet? Diary of stress/poop accident correlation? Behavioral training? Or should be just ignore it and assume it will work itself out eventually? He's a healthy kid overall and this really has a minimal impact on our lives, outside of extra laundry.

Have you been through this or do you have any insight?
posted by rabbitrabbit to Health & Fitness (21 answers total) 1 user marked this as a favorite
Not to state the obvious, since you've probably considered this, but if he's only 5 and a half, maybe he just needs to refine his butt wiping skills?
posted by cakelite at 7:50 AM on September 9, 2016 [25 favorites]

Without going into too much detail, my son had plenty of accidents and years of lazy butt wiping long after he was potty trained.

My husband thinks there might also be a component of not wanting to go poop at school, and then being so distracted by playing once he gets home that he doesn't want to stop and poop.

Also, this.

It pretty much worked itself out. We helped, we advised, we even wiped and cleaned up, but eventually it worked itself out.
posted by bondcliff at 7:55 AM on September 9, 2016 [3 favorites]

Just so we don't go further down that road... his butt wiping skills are really good when I spot-check. Between that and him telling me when he has had a "poop accident" I think there is a legit thing happening when he is away from the toilet and not poor wiping after toilet usage.
posted by rabbitrabbit at 8:05 AM on September 9, 2016 [1 favorite]

Counter-intuitively, that kind of thing can sometimes be related to constipation: "The soiling and smearing of stool is caused by liquid stool finding its way around the retained hard stool and eventually leaking to the underwear."
posted by needs more cowbell at 8:11 AM on September 9, 2016 [6 favorites]

Can you get him to use the bathroom at home before heading to school? Maybe with a little enticement (e.g. 5-10 minutes of a game on a tablet)?
posted by xo at 8:30 AM on September 9, 2016

At 5.5 he should be able to give you a little bit of insight into what's going on, even if he can't be super precise about it. Have you tried asking him how he feels right before he has a poop accident? Like, he may be able to tell you whether the issue is that he's aware he needs to poop but isn't going to the bathroom right away, or whether it's catching him by surprise. You should also ask him whether there are any times when he feels like he needs to poop at school, but decides not to go to the bathroom then.

If he can't remember, try asking him those questions right after he's come to tell you that he just had a poop accident. Keep it in a neutral tone - it's not a big deal, you're just wondering if you can help him troubleshoot a bit.
posted by telepanda at 8:36 AM on September 9, 2016 [1 favorite]

My guess is also constipation - our pediatrician calls it "grade 1 belly" as the kids won't poop at school unless it's an emergency and it messes them up. She prescribed a mild remedy and it cleared up. My child was complaining of tummy pain on and off too.
posted by warriorqueen at 8:46 AM on September 9, 2016 [1 favorite]

Adults talk to kids about how dirty poop is, they get nervous about wiping at all. So, they need help learning how to wash hands well, after; and how not to worry. Sometimes kids who need some time on the toilet, feel rushed and get cut off somewhere in the process. Yeah. Nothing like having a long talk and take time to makes sure the kid knows you have the time, to find out if there is anything else going on, bullying in the bathroom, or a broken thought process, about the basic process. Then there is the younger sibling and the attention they get, if he has one of those.
posted by Oyéah at 8:59 AM on September 9, 2016

Is he gassy? This could also be a shart situation where he thinks he's just farting, but more is happening.
posted by quince at 9:02 AM on September 9, 2016 [8 favorites]

One more vote for constipation. When my daughter was about that age, she was having really liquid poop and poop accidents (not only if the poop-squirt kind), and we took her to her pediatrician, who also described constipation as a likely cause. There's a big old blob of hard poop somewhere in the system, and the only stuff that can escape around it is really squishy.

She prescribed miralax, I forget how much (probably half a capful) for a week or so and that seemed to clear things up.

(Daughter in question is 8 now, and...whadda ya know, we're on another round of miralax for probable constipation.)

tl;dr, talk to your pediatrician, it's not too trivial modulo $, but my bet is constipation.
posted by leahwrenn at 9:04 AM on September 9, 2016


Happened regularly since he started school, eh? Is there milk or cheese at school?
posted by corb at 9:10 AM on September 9, 2016 [1 favorite]

Suspecting that in the excitement of being at Kindy he's not noticing he needs to poop until the last minute & maybe it's started coming out. Both my niece & nephews toilet training relapsed slightly under the added excitement of starting kindy, there is so many distractions that it's easy for them to miss the signals.

Maybe add some fibre to his diet, soften up the stools & make them bulkier so he feels the need to go poop earlier, & it will gently help if he's constipated. Oatmeal for breakfast would work great here, or pumpkin or sweet potato. If he's Ok with wheat then maybe try metamucil or fibre gummies if he's a fussy eater.
posted by wwax at 9:18 AM on September 9, 2016

Therapist who frequently works with kids who have poop in their pants.

I always recommend first thing to get kiddo checked by the pediatrician -- just to rule out that there isn't any medical issue that's contributing to it. As others have said, this happens commonly when kiddos are constipated. The constipation itself can then lead to a cycle where we can't poop, so we don't like to try because maybe it doesn't feel good or it hurts, and the more we don't poop, the worse we feel, and on and on. Then because we're backed up, a little lump of hardened poop can develop in our colon, which the squishy poop leaks around and comes out.

Sometimes a short course of Miralax from PCP can really help with that.

Also in agreement with the distraction theory - I frequently have kiddos who only realize that they have to go at the very last moment, so by the time they get up to go potty, it's already in their pants. I do a lot of work with kids about learning to check in with their bodies, like, how does our tummy/abdomen feel when we have to poop? What else happens in our bodies? (We might feel pressure or tightness, our bodies might be more wiggly than usual, we might fart, etc.)

Hope this helps, good luck to you and your lil buddy!
posted by fairlynearlyready at 9:20 AM on September 9, 2016 [1 favorite]

I think your husband's right and this is a stress thing. When I was around 5-7 or so, I refused to use the restroom anywhere but home. I was afraid to use it at school, wouldn't even use it at friends' houses, and even made my poor dad leave a football game to take me home so I could go. I outgrew it, and have no longstanding issues from those days. I suspect once he gets used to school things will calm down.
posted by jhope71 at 9:24 AM on September 9, 2016

Addressing only consistency issues here -- fibre is a wonderful stool normalizer (though it should be taken with a good amount of liquid) -- Metamucil and the generic versions are not things most people swill down with pleasure, but, Benefibre dissolves into nothing; it's tasteless and doesn't thicken. I might try Benefibre-ing up his breakfast drink with a spoonful to help with, ah, 'sharting' bothers. Apparently you can also mix it in to soft foods, including hot dishes.

(I take opioid pain medicines so deal with 'bowel management' schemes, and you really do have better poo all around with extra fibre. If I was an adult with a shart hassle the first thing I would do is up my fibre intake. Go slow; don't give him a full dose on the first day, but slowly ramp up. Obviously I am just a person who poos and not a physician; ignore me if you get different professional advice.)
posted by kmennie at 11:21 AM on September 9, 2016

My son, who just turned 5, had this issue on and off the last year. My kid was having these accidents at school, and almost got kicked out because of it. He ended up being afraid of the toilet at school because he said it had a fire alarm in it and he's HATES loud noises. I ended up having to send a set of headphones and telling him the headphones would protect him and his teacher worked with me on it by giving him a sticker everytime he went, etc - and he worse those stupid headphones for months before he got over it.

Is there something keeping him from going at school?

Also, this sometimes happen at home too. Not often, but sometimes. I have always attributed that to just not wanting to stop playing. (I've seen it with my own eyes, where I can SEE him rocking back and forth while playing hot wheels, etc, and then he jumps up last minute crying)

No real "insight" here, but wanted you to know you're not alone.
posted by Sara_NOT_Sarah at 11:25 AM on September 9, 2016

My 5yo just started Kindergarten too, and we had a long talk about the restroom procedures because it was going to be totally new - at preschool there was a restroom in the classroom and kids could pretty much get up and go as needed (I think they did need to practice raising their had to leave the table if it was lesson time, but lessons were only for about an hour in the morning, the rest of the day was art and play time). Plus in the last year he's had a few (pee) accidents specifically because he didn't want to stop playing, or stop watching if there was a show on.

So we talked about not being afraid to raise his hand to ask to go, about what he should do if the teacher's back was turned and she didn't see his raised hand, etc, or what he should do if he was out in the yard at lunch or recess times.

So the most basic thing to rule out is just to make sure he feels empowered about how he can take care of his personal needs, and to know that a restroom is a restroom is a restroom, and there's no reason to wait until he gets home.

As for dietary issues, we find that it's easiest to stick to good choices if we have food pre-made. Like, for breakfasts we make a big pot of oatmeal and keep it in the fridge and have some of that each day, with some granola and raisins mixed in (added fiber, less simple carbs and refined sugar). We cook two or three proteins in big batches (say eight chicken breasts, or a whole side of salmon) and two or three steamed veg. Then dinner time is a simple choice "do you want chicken or salmon? Broccoli or carrots?" He feels like he got to make a choice, we feel like he got something good and we didn't have to resort to freezer waffels. It's easier to stick to good choices if the food is already there and we're not dead tired and looking for the easiest thing.

I agree with the advice above to ask him very neutrally about it when an accident occurs.
posted by vignettist at 2:21 PM on September 9, 2016 [1 favorite]

I have never liked going #2 with other people in the room, even with stall doors. As a result, when I was ages 6-7 I had similar skid mark issues because I refused to go at school. My mom ended up talking to my teacher and asking if I could go to the bathroom during class when nobody else was there. The teacher agreed to this.

I was hugely embarrassed, and I don't think I ever actually went during class, even though the teacher would sometimes ask me if I needed to.

I am not your kid, but this could definitely be a possibility.
posted by tacodave at 2:30 PM on September 9, 2016

I haven't parented a five-year-old, but I HAVE read How To Talk So Your Kids Will Listen and How To Listen So Your Kids Will Talk, so with my expert pedigree established, I'll ask, have you tried just finding an opportune time and then asking him in a respectful, no-big-deal, hey-I-happened-to-notice, do-you-have-any-idea-what's-going-on sort of way? I feel like he might be old enough to have that conversation.
posted by salvia at 9:20 PM on September 9, 2016

I added some Triscuits to his school lunchbox to get some more fiber into him and the skid marks have stopped. So I guess it was a fiber/constipation issue. Or maybe he just got used to school and wasn't stressed out anymore. Either way, yay! (at least for now -- it's been known to recur before so we'll see)

Favorited kmennie as much (or maybe more) for the phrase "shart hassle" as for the fiber rec.
posted by rabbitrabbit at 10:32 AM on September 22, 2016 [1 favorite]

Sigh. Skid marks are back, and occurring daily -- TWICE yesterday (so an at-home day, not an at-school day). Moving on to benefiber before I make a ped appointment.
posted by rabbitrabbit at 11:22 AM on December 5, 2016

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