Toileting

[Nel81]

Hi, after some advice please. My son is 4, came home 4months ago and has settled in really well. There are some ups and downs, of course, but on the whole we're doing OK. The main issue we're having at the moment is that he keeps soiling himself. He's done it every so often since he's been here but it seems to be escalating in its regularity. I know that it's stage not age but don't know whether to speak to the health visitor or wait to see if it's a stage that passes. Creche says he laughs when he has to be changed there but I think that's a shame reaction.

My son and daughter both had toiletting issues and he too came home aged 4 and she was 6. I’d get your GP to check him over as an initial step - turns out my DD had chronic constipation which was causing most of her issues, and wasn’t picked up because everyone assumed it was something psychological.

It may also be you’re seeing an increase due to regression following his move to you - not all regression happens immediately, sometimes it shows up later when the initial shock of change has passed.

I’d also talk to your health visitor about toilet training - I know it’s not strictly a “training” issue but there are strategies and techniques that can help both the physical and physical and psychological sides of things.

You have my sympathy, no matter how much you understand what might be driving it, it’s hard to cope with.

Boys can be more prone to constipation because they pee standing up so don't notice the urge in the same way that girls do. Apparently NASA had to alter the whole way the toilets work in space because once women get to a certain age they automatically wee and poo during a visit to the toilet whereas boys don't.

As a traumatised child he could be experiencing sensory issues and/or fear that have led to him withholding and constipation.

There's a great children's charity with a website called ERIC, they offer advice on all areas of continence in children

My first thought was also constipation. Or withholding until he can't any more, which will lead to constipation anyway.

And the laugh is almost definitely a red herring, probably just hiding his embarrassment.

I would take a two-pronged approach with both GP and health visitor.

I'd agree with comments on constipation - persistent soiling happens becauseof constipation and LOs often have ni awareness it happens. Have you looked at the ERIC website. Also if on facebook an incredibly supportive and knowledgeable private group is, "movicol mummies," (terrible name but wonderful support.) Feel free to PM - we have been through this extensively.

My son went through a stage of toileting issues too and it wasn’t linked to constipation (we got checked after the first few accidents and suggest it is better to rule it out). For my son, it was trauma related and when he felt scared and overwhelmed he would go. The only thing that helped was time and patience and recognising the triggers and helping my son become aware of his body. It’s a slow process but with time, he will be able to manage it. He has had a huge transition to yourself and will be overwhelmed so it could be that. Lots of children who start nursery or other transitions often regress after a few months and what he has gone through has been a much more overwhelming experience. Keep an eye on it, make note of when it happens and make sure there is nothing medical going on. Also happy to pm if you think it will help.