3.4yr old DD holding poos and really suffering. Any help please!!

[Elmosong]

If anyone has any advice I'd be so grateful. I'm starting to feel quite desperate.

My DD 3.4yrs never took very easily to potty training (started at 2.8yrs). It was on/off success for a while, often resorting to smarties to bribe her to potty or loo for a wee. The problem she always had was holding on for hours on end and only going with myself or DH. She rarely wet her pants.

Throughout all this she has refused to do poos in the loo or potty - it HAS to be in a nappy. I've been careful not to pressurise too much on this but have tried gentle encouragement at various intervals.... to no avail.

5 days ago she had an upset tummy and did a runny poo in her nappy which was a bit messy. She was quite upset by it and has refused to do a poo ever since. She really really needs to go and spends all day every day holding it in, crossing her legs, grinding on a chair etc. She has become quite withdrawn and the concentration and effort of all this is exhausting her. She's waking up at night, presumably as she's so uncomfortable but still refuses to go.

I'm at a loss as to what to do. I'm trying not to pressurise or bang on about it as I know that will backfire, but I am occasionally trying to encourage her to put a nappy on and give it a go. She'll put the nappy on but then can't make herself try. She's getting really upset about it.

Her diet is healthy, lots of fruit and fibre. I bought prune juice but she won't drink it.

Do I resort to laxatives which might result in tummy aches and more explosive poo (which could compound the problem as it was a runny poo that started it) or do I just sit it out and hope she will eventually give it a go and risk more days of misery? (for her)

Spoke to Doc who basically said at this stage it was my decision.

Sorry, bit of a long one but if any replies appreciated.

[girlscout]

Love the doc, who can see mum and child distress and still bats the responsibility
It does seem that this is psych, not physical (impaction), so giving her anything might not help.
You say that she goes with you in the room? Can you revert to that for a while and make it very low stress but a happy experience?
My dd hada problem with retention when she was the same age, she was given lactulose which was useless nad would hold on for 6-7 days between empting hwer bowel. We tried everything, to make it anice experience (books,songs chat etc).and in the end ,after she had emptied her bowel, introduced the idea of a star chart,after every poo, she got a star on her chart,and after 20 poos she got a barbie!

Remember, retraining bowel habbits take about double the amount of time tosort out than they did to set up,so be ready for lots of patience. I get that you want the quickfix (we all do)but your dd is not odd, and lots of people on these boards have had the same problem.

[Elmosong]

Thanks for your advice - glad things got sorted for your daughter. I'll revisit the chart idea.

[juneau]

I've been battling this very same issue with my DS lately. We've had some success with Lactulose, which is a sugar suspension used as a gentle laxative. We went to the doctor on Tues who recommended 10ml morning and evening and although he's still witholding, the Lactulose forces him to poo every 2-3 days. It's neither painful, nor explosive, although because he's holding on until he's actually in pain he's still got tummy pains. It's a work in progress I guess. Anyway, you can buy Lactulose at any chemist if you want to give it a try.

[juneau]

Ha - just read post above which said Lactulose is useless! The other thing you could try is Movicol, which is available on prescription and I didn't find DS's poos explosive after that either - but I'd take her to the doc and force the issue if you're worried. I've found it very stressful if I'm honest.

[Elmosong]

Thanks for replying. It certainly is stressful and unbelievably frustrating. So much more difficult when it's a mental block, not physical. And a really difficult one to balance as a parent....I hope your son gets there soon.

[razors]

You need Movicol - it sorted my youngest dd - she would hold on to hers for days - Movicol isn't a laxative - it helps the bowel retain water to keep stools soft so it doesn't hurt when your dd eventually goes. It's a vicious circle it hurts to go so they hold it in then hurts even more to go! Poor little mite - get her some Movicol - add it to her favourite drink - I used to put 2 sachets in her warm milk with some honey to disguise the taste. Hope your lo gets some relief soon.

[OddBoots]

We've had a couple of children at work with this issue, it's not perfect and it certainly caused a double-take but the PDF book Poo Goes Home To Pooland has been a help.

[Elmosong]

Thank you everybody for your replies and tips. I'll give them all a go. She's now holding wees too as she's so worried that a poo will appear. I know homeopathy is a hotly debated theory but has anyone had any success with it for this problem?

[HanFran]

We had a very similar problem with our daughter withholding when she was around two (this time last year) and I can truly sympathise because it was a miserable 6 months for the whole family. She would hold onto a poo for around 5 days, during which time she'd be a totally different child from her usual happy self. Whilst withholding a poo which was quite clearly pressing down and wanting to come out, she would be grumpy, utterly miserable, completely unable to concentrate or play with any of her toys, and she spent the whole time pacing around on tiptoe with her buttocks clenched, trying to hold it in, and wimpering with pain. I can't describe how terrible it was - I felt really sorry for her distress, and yet was so frustrated beyond belief that I had a terribly hard time not shouting at her, "JUST DO A POO!!! YOU'LL FEEL SO MUCH BETTER!!".

Basically, withholding took over our lives because it changed my daughter's character for days at a time. When she did finally do a poo, it was like having a different child; my happy, playful, loving, intelligent daughter came back for a few days. And then it would all start again.

When she did eventually do a poo, she screamed and screamed, tears rolling down her face, dreadfully upset, fighting it coming out every second. It was incredibly traumatising for both of us. But it would always come out in the end; I think that her body eventually just over-ruled her and it got pushed out whether she liked it or not. Thankfully she never got very constipated, so although it was more upsetting than I can describe, she was never impacted or had anal tears or any other horrific side-effect like that.

I did a lot of research, and spent several hours talking to a clinical psychologist (it being a psychological issue rather than physical). Here's what we did:

1. Spent a lot of time talking to her about how we all need to do poos, and repeatedly read and then talked about a children's book called, 'Everybody Poos' by Taro Gomi.
   
   
2. Gave poo a personality/character and talked about 'Mr Poo', who is inside our bottoms but really wants to come out and go into the toilet so he can join all his friends in Pooland. (Yes, this sounds absolutely bonkers, but it was suggested by two clinical psychologists, independently of each other.)
   
   
3. Bought and read another children's book called 'It Hurts When I Poop!' by Howard J. Bennett. This book was really too old for her, but we used to pictures to make up a much simpler (and less American!) version that she could relate to more easily.
   
   
4. Read 'Constipation, Withholding and Your Child: A Family Guide to Soiling and Wetting' by Anthony Cohn. This was quite a reassuring book in that it explained a few things about the psychology of it all, and made us feel that we weren't the only people in the world going through this awful situation.
   
   
5. Found a pdf copy of 'Mr Poo Goes to Poo Land', which was written by Tamsin Black (another clinical psychologist) for the NHS. We coloured in the pictures together, read the story over and over, and talked about it.
   
   
6. Showered her with ridiculous amounts of praise when she did a poo.
   
   She has not been withholding for about 6 months now. It just gradually changed, maybe it was as a result of all the above, maybe she would have grown out of it anyway. It's hard to say. But I hope that it's useful to you to see what we did, and maybe it will give you some ideas. Good luck.
   
   (Incidentally, we now have a different problem with her and her toiletting, which I'm going to post a request for help about now - just as one thing gets sorted, something else crops up. Such are the joys of motherhood!)