Why is my 8 year old still having bathroom accidents?
November 21, 2019 9:33 AM   Subscribe

My son is 8, and still having bathroom accidents. It honestly doesn't even look like he is TRYING to wipe his bottom at all, and there have even been times that it is bad enough that it looks like he didn't even go to the restroom. What could be the issue?

You are not a doctor. I get it.

My son is an extremely bright 8 year old. He took a long time to potty train and wasn't fully trained until he was almost 4 years old. Even then, he had frequent accidents in preschool.

He is now 8, and we are at our wits end about why we are having major issues. He even sometimes smells badly because of it, and when I question him, he gets upset. He told me on some occasions the following:

1. My teacher said I can't go to the bathroom during the lesson
2. I didn't feel it until it was too late
3. I have to poop like every 2 hours
4. I forgot to wipe

Either way, this is embarrassing for him and embarrassing for us, though he doesn't seem nearly as embarrassed as we do. In fact, my husband is getting really angry at this point.

Things we have tried:
1. Taking all of his favorite things away and letting him earn them back with good underwear one thing at a time
2. Traditional punishments like extra cleaning/chores/going to bed early etc
3. We even bought a bidet attachment for our toilet

What am I missing? I have addressed his teachers a few times, who ensure me they are on board and will remind him as well as talking with him and telling him he is welcome to use the restroom anytime he needs.

Wondering if a doctors appointment may be next resort?
posted by Sara_NOT_Sarah to Human Relations (29 answers total) 1 user marked this as a favorite
 
This isn't uncommon, actually, but it's long past doctor time. The poop accidents are probably caused by constipation, but only a doctor can tell you for sure. In good news, treatment is likely to be noninvasive (Miralax, probably, to start with.) But if it's something worse than that -- I don't know what that would be -- the doctor can help you figure that out too.
posted by chesty_a_arthur at 9:43 AM on November 21, 2019 [11 favorites]


Yes, absolutely see a doctor - it could be encopresis caused by chronic constipation or another cause.

If medical causes get ruled out, make an appointment to see an occupational therapist, especially one who sees older kids with ASD, etc. It sounds like your kid is fine from a developmental perspective, but OTs are geniuses about working on things like toileting and paying attention to what your body needs.
posted by bananacabana at 9:45 AM on November 21, 2019 [10 favorites]


Absolutely a doctor's appointment is in order, and gently, as gently as I can, punishing him for this is probably doing more harm than good. He doesn't need to be shamed, he needs help. What that help ends up being is hard to say. Could be you need to speak with the teacher (is he really not allowed to use the restroom on demand?) AND the doctor (why isn't he feeling it until it's too late - does he have sensory issues? and does he really need to poop every 2 hours?). I get why the adults are frustrated, but punishing him and getting angry are counter-productive reactions.

On review, I see that the teachers have been addressed. Does your son know this, that he can go to the bathroom whenever he needs to? Have you spoken to him about this in a calm, non-confrontational way? The best time to have difficult conversations (and let's face it, this is really difficult for him; he's probably really really ashamed of himself) is in the car so you're not face to face.
posted by cooker girl at 9:48 AM on November 21, 2019 [63 favorites]


Anecdata again, and I do suggest a visit to the pediatrician, but it could be a food intolerance. Lactose intolerance is a prime candidate.
posted by SereneStorm at 9:50 AM on November 21, 2019 [1 favorite]


I agree that you should go to a doctor and address whatever medical issue he might have. He could have IBS or something else that is causing these issues, and then anxiety from being embarrassed in front of his classmates for needing to use the bathroom so frequently - which leads to him just not going and then pooping his pants. I think bathroom anxiety is definitely a thing with kids. I used to be terrified of getting up during class to use the bathroom when I was a kid. Needing to do it a lot makes it a lot scarier.

But anyway, addressing a potential medical issue with a doctor would probably be the most important thing, and then fixing it would help his anxiety about it.
posted by koolaidnovel at 9:52 AM on November 21, 2019


Please try to acknowledge the fact that he's not showing a lot of embarrassment does not mean he's not feeling a lot of embarrassment and anxiety over this. Stop all punishments immediately, and ramp down your anger and your husband's.

Separate from whatever's going on with your kid's bowels, sensory issues, etc. the anger and punishments are only teaching him that he should hide his problems from you, which will carry on into bigger and more important topics as he gets older.
posted by BlahLaLa at 10:11 AM on November 21, 2019 [95 favorites]


This isn't his fault and not really in his control the way other behavior might be. He's getting lots of judgement from you and his peers, he knows exactly what a toliet is and he knows exactly what he is supposed to do.

Some kids have have medical issues that make it harder to know or pressure to go more often than normal. A doctor can figure it out, it's worth the appointment(s).

Some kids do have underlying psychological issues that create behavioral responses around tolieting, but usually you see a regression in the ability to use the restroom, not sustained difficulty. But one would always always always rule out medical causes before evaluating for psychological ones.

Either way there is something unknown that's causing this to happen and there are professional tools to manage the problem . Get an evaluation and find out what they are, so the problem can be solved.

In the meantime teaching good hygiene as if accidents are inevitable for him may be a good step. This means stuff like having an extra pair of clothes on hand, maybe keeping wetwipes in his backpack, encouraging him to address the issue as soon as he notices and not waiting. Then a bag to store the dirty clothes in. These clothes shouldn't be any different than his regular clothes, you want him to feel comfortable changing into them. The key is that he gains the independence to just handle the accident, as if he were simply asking to go to the bathroom. When he does this, reward him. Praise him for noticing and cleaning up and for handling his problem maturely.
posted by AlexiaSky at 10:17 AM on November 21, 2019 [31 favorites]


We had similar issues with my child, however my child is not your child. For my child, the root of the problem was executive processing delays and sensory issues. Again, though, my child is not your child.

You should talk to his pediatrician about this as soon as you can.

You should also stop punishing him, stop being angry with him, and overall start thinking of this as a medical issue he a) cannot help, and b) needs help with. Reframe your own thoughts first, so you find ways to set your anger and frustration and embarassment about this aside. Make sure you and your spouse or on the same page about this.

All the steps you've listed to address this (except the bidet, which is a good idea) are punitive. Your job is to help him and teach him, not punish him. I also note that you don't talk about steps you've taken in coaching him how to clean up. Have you done this? (Again, not while angry, but in a true spirit of teaching.) Have you sat with him in the bathroom while he wipes? Had him use moist wipes? Helped him figure out the body mechanics involved in wiping that works for him. (Mefi knows all about stand vs. sit while wiping, there is more variation in body mechanics around this than you ever dreamed.) Keep doing that, and really listen to him - you'll learn so much about what is going on by really attentively listening to him about what is going on with his body.

So: tell him that you're sorry you've been so angry about this. Just flat out apologize to him. Tell him that it has become clear to you this isn't his fault, but that your family is going to get him help to figure out why this is a problem. Don't make going to the doctor seem like an additional punishment. Accept that you'll need to wipe for him (or check his work) for a while. Pack him extra undies in a ziplock bag, so he can use them at school if he needs them. (then praise him for using them, rather than being angry that he did)

Good luck to you.
posted by anastasiav at 10:18 AM on November 21, 2019 [37 favorites]


Aside from agreeing about talking to a doctor, is it possible he has any issues with using the toilet at school? My son reeeeallly prefers to poop at home, and has gotten good about setting aside toileting time before we leave for school. If your son has any issues with public/institutional pooping, or with other students, it's possible he prefers accidents in his pants and your negative reactions over his whatever the other options are.
posted by cocoagirl at 10:20 AM on November 21, 2019 [3 favorites]


Nth-ing that this is definitely something you should take him to his doctor to talk about - I would assume that at age 8, if he could (easily) be using the toilet correctly like other kids, he would. I'd back off the rewards/consequences that are aimed at making him want to do better, because it sounds like desire to do the right thing is not the root issue.

My kid has had issues with chronic constipation and when it gets bad, we see some of these behaviors. In particular, the comment about not wanting to go because he has to go every two hours sounds like something my kid might say - he stops trusting his body's signals about needing to poop because he goes to the toilet, poops a little, gets up, and still feels like he needs to go (incomplete elimination, super common symptom with constipation). Kid logic means that if this happens a couple of times, it's easy to stop bothering using the toilet at all because it feels pointless - then you end up having an accident when all of a sudden it's urgent and you don't have time to make it to the toilet. The incomplete wiping is also something we've seen and it can definitely be connected to how hard/soft the stool is, and a kid getting tired of wiping and wiping and wiping and not getting clean.

Good luck, this is a hard thing to deal with as parents (you probably rightfully feel like you should be beyond cleaning poop up!). It was actually helpful for me to realize that it wasn't a matter of my kid just being defiant or not caring enough--having it be a medical issue really took a lot of the emotion and frustration out of it on our end. I hope the same happens for you.
posted by iminurmefi at 10:21 AM on November 21, 2019 [6 favorites]


He gets upset when you ask him about it because you're treating it like a deliberate naughty behavior he's choosing to do. Of course he doesn't want to talk about it with you - because it makes you angry. But 8-year-olds don't regularly shit themselves just for fun and games. If he could physically control this, he would be doing so.

Doctor time, definitely.
posted by showbiz_liz at 10:30 AM on November 21, 2019 [36 favorites]


I doubt this is deliberate, and the punishments you instituted may have made him feel worse about continually disappointing you. I had a similar long-running battle about a different issue with my son that did not improve until, thoroughly frustrated, I made a drastic change in my thinking and my approach to the issue and my son. I realized I was not going to be able to "fix" things, and sought novel approaches I had dismissed as impossible. I had convinced myself that it was up to my son to change, rather than admitting that the environment could be contributing to the problem. I turned things completely around and put my faith in what my son was telling me. In truth, I had tried every other approach I could think of, and this seemed the only approach I hadn't tried. In his case he transferred to a more appropriate school, but it took my really acknowledging how miserably unhappy he was before I genuinely listened to him and and trusted him as he described his experience. After that the tension, punishments, bribes and tears (on both sides) gradually melted away and the issue resolved, more rapidly than I had imagined. We also saved our relationship which was heading in a pretty confrontational direction, and are now a close family.

It would be supportive of your son to thoroughly investigate any possible medical or food-related cause. Even suggesting he keep a small diary where he can record the circumstances of his poops might enlighten you and the doctor about possible contributing factors, and give him a sense of control, if he is willing to try it. I don't think forcing him into keeping a diary would be helpful, though. Can you enlist him, and the doctor into a brainstorming session about how he can participate in the search for the answers? If the pediatrician doesn't help or suggests testing, he or she will probably refer you to a pediatric gastroenterologist.

The fact that he had some earlier toilet training delays also suggests a more nuanced and deductive approach. Good luck to both you and your son.
posted by citygirl at 10:30 AM on November 21, 2019 [6 favorites]


Nth-ing possible encopresis/chronic constipation. My daughter went through this around the time she was potty training and at 7 years old, we still have daily reminders about pooping because if given the opportunity she'll avoid it for whatever Reasons 7 year olds have about these things.

For us, we worked with her ped on diet/nutrition issues and then saw a GI specialist and a therapist to work out a plan, which included a couple weekend colon cleanses accomplished largely through an Ex-Lax/Miralax combo, and a period of daily low-doses of Miralax.

One thing that was important for us to understand is that the encopresis often isn't something they are doing on purpose and may not be something they realize is happening until after it happens.

Good luck to you--I hope this gets sorted soon. I know how frustrating it can be as a parent.
posted by cheese at 10:30 AM on November 21, 2019


When my daughter was younger and we were dealing with lots of squishy poop accidents, her pediatrician explained that when kids are very constipated, sometimes all that can squish out around the constipation blob is squishy poop---so it looked like her issue to us was squishy poop but really it was pretty substantial constipation. For us, giving her Miralax every day for a while fixed it. (She was significantly younger than 8, so I can't help you with that aspect, but it would never have occurred to me that constipation could show up as squishy poop/poop accidents.)
posted by leahwrenn at 10:33 AM on November 21, 2019 [3 favorites]


In case you haven't seen this on your internet searches yet, check out the Modified O'Regan Protocol. I'm joining the chorus of "it's probably constipation"; parents underestimate just how much and often kids are constipated. Definitely take him to a doctor (although you may want a new one, pediatricians can feel feces and will do a check on this during his yearly wellness so if they aren't catching it...).
posted by emkelley at 10:49 AM on November 21, 2019


I was this child. I can't explain it. It felt like a combination of having a hard time anticipating when I needed to poop, or if I knew I needed to, delaying as long as possible. I also just... and this sounds weird, but ... as a kid I enjoyed the feeling of needing to poop, so would I drag it out. Sometimes until it was too late.

Then when I would poop, I was so scared of getting my hands dirty because I wasn't very good at wiping and sometimes a little poop would get under my fingernail and then my fingers would smell like poop all day to me, no matter how much I washed my hands. And I would worry other people could smell it.

My mom would find my dirty underpants in the laundry basket and would ask me over and over about it, what was wrong with me, did I feel sick, don't I know how to wipe like a big girl, etc. This had an extra layer of shame to it because it took me so long to be able to make it through the night without wetting the bed. I would even have to go to slumber parties wearing pull-ups instead of normal underwear like the other girls and I would need to think about it all the time so no one would discover my shameful secret.

I started hiding my dirty underwear. Sometimes I would take it off and throw it away at school, but mostly I would just hide it under my bed in the far back corner. And I would get scared whenever my mom or sister or friend would need to look for something under my bed. Sometimes my mom would find it and get frustrated with me and the shame would start all over again.

I grew out of it, not sure when exactly but probably around age 10. I am 31 years old and every once in a while I still have nightmares about the dirty underwear under the bed. I was an otherwise bright, carefree child. I don't have children of my own so I don't have any advice for you, but I can promise you that if your son felt fully able emotionally and physically to stop this behavior, he would do it immediately.
posted by BusyBusyBusy at 10:53 AM on November 21, 2019 [32 favorites]


Another possibility beside constipation: Is he feeling stressed about something? We had a similar issue with our (unconstipated) eight year old last year. Our kid was also very slow to potty train, but had been fully in control of things for years when this started. After some frustration and shaming -- which I agree with posters above is counterproductive, but is also REALLY hard to control, ESPECIALLY if potty training took forever -- we got on top of our own emotions around it and focused on reducing embarrassment. It was impossible for the kid to articulate what was going on, probably due to shame etc, so we just gave them clean underwear in a plastic bag to take to school, encouraged the wearing of easy to remove, dark-colored pants, provided wet wipes, etc.

We felt despairing and as if we were back to square one, but once the stressful thing was past (an international move, new school, new living situation) the problem vanished, and has not returned. In hindsight I'm really glad I pulled back on the shaming and anger, though it was not easy to do, and I wish you strength in doing that.
posted by ogorki at 11:06 AM on November 21, 2019 [5 favorites]


I can almost guarantee this is constipation. (I know, it's been said a zillion times already.) One of my sons (who is almost 12 now) dealt with this off an on for a few years. When he's this badly constipated, he just can't feel when it's time to go, something about the nerve being pressed on by some massive boulder of poop in his intestines (or something more scientific than that.) This book helped me understand it immensely, and also solved the problem. And it helped me to be less emotional about it, and less upset with him.
posted by pyjammy at 11:20 AM on November 21, 2019


(And I should add - he wasn't urinating on himself, just pooping. While the book I recommended talks a lot about bedwetting and the like, it also addresses the pooping issues. Like a previous commenter said, the squishy poop can get around the stuck poop.)
posted by pyjammy at 11:23 AM on November 21, 2019


Constipation can make it difficult to recognize the need to poop. More fruit. Cut up an apple, scoop some peanut butter into a dish for dipping, or spread on theapple slices. OJ, strawberries. I'd shoot for an apple a day, plus some other fruit. More vegetables - baked sweet potatoes are easy and tasty. I make super-muffins - for ages I made pumpkin, bran, apricot, walnut, whole wheat muffins, got tired of them, now I make blueberry, corn, bran, walnut muffins. In the short term, laxatives help get things moving, but a healthy diet with fruit, veg and other fiber is a major health component.
posted by theora55 at 11:32 AM on November 21, 2019 [1 favorite]


Please stop treating this as your kid being “bad” and start treating it like a medical issue. Why on earth would you think your kid would be doing this if he could avoid it?? Treat him with kindness and understanding. Most of all, the idea that this is “embarrassing for us”—that somehow his medical problem, an issue he is struggling with, is shameful for his parents—is unempathetic and unkind in the extreme. How would you feel if your spouse told you the way you smelled or something else outside of your control embarrassed him? If I were your kid I wouldn’t feel comfortable sharing anything vulnerable with you. Some kids are naturally very shy about bodily functions and easily shamed. Instead of reaching out to your kid with love you’re punishing him for something he can’t fix by himself. For gods sake, he’s only eight years old!
posted by sallybrown at 12:10 PM on November 21, 2019 [8 favorites]


Response by poster: My natural emotion and initial response was anger and irritation - and I already know and feel guilty about that response, so thats not what I am looking for. I am looking for ideas, insight, similar situations and advice on how to move forward now that I am taking next steps and have scheduled a doctors appointment. Between now and then, I'm trying to understand him better so that we can change our response and hopefully help the situation. Thank you to all of those who read my post and saw that specific need I was looking for without judgement on the mistakes I have already made trying to deal with and understand it.
posted by Sara_NOT_Sarah at 12:28 PM on November 21, 2019 [1 favorite]


Between now and then, I'm trying to understand him better so that we can change our response and hopefully help the situation.

I think the key is to embrace the idea that, even if he is not acting like it, he does not want this to be happening and would not be going this way if he was able to stop it. He is a bright kid—it’s not that he doesn’t know what you want. And no kid wants to have this issue at school with a bunch of peers or to be the “smelly” kid. That means he doesn’t need to be convinced (or chastised) about it, he needs help solving the puzzle of why it’s happening. Treat it as something that you and his dad are going to help him solve. It’s not you vs. him, but you and him and his dad vs. the poop. Have as open a conversation with him as possible, that sometimes our bodies do things other than what we want and we need a doctor to help us figure it out.
posted by sallybrown at 12:36 PM on November 21, 2019 [2 favorites]


The one thing that I can suggest you do right now is to talk to the school/teacher about making using the bathroom non-negotiable. I work in a school, and we have plenty of kids whose parents had to advocate for this (and in reality it is the policy of the district to allow children to use the bathroom when they need to.)
posted by momochan at 1:43 PM on November 21, 2019 [1 favorite]


My son had (still has a little, at 15) serious anxiety about pooping. We took him to a therapist, put a little Miralax in his juice, and gave him a poopy cow (rubber cow that "pooped" when you squeezed it). The doctor taught us the "what's the worst that could happen" trick. You ask what the worst thing that can happen when he poops and then make the scenarios crazier and crazier to relax him. He got over his major anxiety after therapy, but for years after would flush the toilet and run away because of his fear that the toilet might overflow.

My recommendation is doctor first, then a therapist if needed. The Miralax just softened things up to make it easier when he tried.
posted by ceejaytee at 2:15 PM on November 21, 2019


Best answer: Here's some insight that might or might not apply: they say some children are orally-fixated and some are anally-fixated. Your description reminds me of when I was a kid and was anally-fixated. When I was around the same age - 1st and 2nd grade - I wasn't having poop "accidents." I just enjoyed the feeling of *almost* pooping and then "sucking it back in." I would intentionally force myself to almost poop on a regular basis. And sometimes I pushed a little bit too much and ended up with soiled underwear. I would usually do this in a kneeling position while playing with toys or watching TV.

When my mom asked me about it, I was too embarrassed to tell her the truth, so I told her I didn't always know when I needed to go and that I was too shy to ask for a bathroom pass during school. She spoke to my teacher and they set up a special phrase I could say to go to the restroom when needed, but that wasn't the problem and I knew it. Their attempts to help me didn't help at all because they didn't know the real issue. I never spoke about it to anyone.

I was later diagnosed with OCD and a bit of Tourrette's, and I think those were aggravating factors. And now I have a child who exhibits the same behavior and her siblings will tease her about "smelling like poop," but I am able to discuss it with her much more kindly because I get it. I know what's happening.

You might want to consider that your kid isn't facing a medical condition, but a psychological one instead.
posted by tacodave at 4:37 PM on November 21, 2019 [2 favorites]


+cocoagirl: I have shy bowel (also known as parcopresis), so that might be worth something checking into for your kid. It's definitely a psychological condition.

Echoing others that anger, IMHO, has no place here. This isn't your son's fault, and he shouldn't face anger for something he can't control.
posted by dubious_dude at 6:50 PM on November 21, 2019 [1 favorite]


SereneStorm: Anecdata again, and I do suggest a visit to the pediatrician, but it could be a food intolerance. Lactose intolerance is a prime candidate.

Came here to say this. I had these issues too, though they were mostly under control by age 8, and I was later diagnosed with lactose intolerance severe enough that the doctor I saw said they'd never seen a faster result on the breath test. I also have some problems with air swallowing that can cause sudden and severe GI distress if I eat a large meal too quickly.

It was/is 100% medical and in no way whatsoever a psychological, behavioral, or an obedience/boundary-testing issue.
posted by capricorn at 7:13 PM on November 21, 2019


I’m not sure if this was recommended already but we found this book The Ins and Outs of Poop: A Guide to Treating Childhood Constipation to be useful, and it’s less intense than the MOP protocol. Sorry you’re going through this.
posted by hungrytiger at 10:05 PM on November 23, 2019


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