To want to ignore this advice...

[stilltiredinthemorning]

Even though I know I probably shouldn't!

So, my daughter will be 4 in December. We didn't have the easiest ride with potty training and didn't start till quite late (just after 3rd birthday). She cracked peeing in the toilet/potty pretty quickly but pooed in her pants most days for at least a couple of months. The HV came to see my younger son one day and I had a massive teary rant about it... She was lovely and basically said I needed to relax, be neutral when it happened and she would get the hang of it in time. Like magic she pretty much nailed it from the following day... Since then we've had the odd wee accident, but she has been pretty much completely reliable with poo (so for around 6 months).

She started a new pre-school 6 weeks ago (2 days a week) and has had a few accidents including 2 poos there. I've tried to be super relaxed about it and just assumed it was the new setting (no problems in nursery or at home etc.)

Then on Saturday she wet herself 3 times and then 5 times yesterday plus a poo!

I can see from a photo on Tapestry that she had also been changed into her spare trousers at nursery by 09.30 this morning...

So, I rang the ERIC helpline to get advice because I was so anxious about it last time and I really just wanted to check the right things, to say etc. I thought they would say it's just a blip, nothing to worry about..., but the lady I spoke to advised my daughter probably has chronic constipation and will need treatment. This apparently means prescribed medication and a week off childcare during which time she is likely to have 'explosive diarrhoea' and need to poo several times a day...

This is my idea of a nightmare. My husband works in retail and can't take any time off work at this time of year. I've just started a new job and a week off would be a REALLY big deal. My daughter is also extremely active and there is literally no way we can stay in for a day, let alone a week.

I know this sounds horribly selfish and of course I'll do it if it's needed, but it will be no small task...

AIBU to think this seems quite extreme or ridiculous to doubt the advice if an expert? Has anyone had any experience of similar?

I wouldn’t take advice about constipation for a child over the phone. I would book a gps appointment and in the meantime keep a diary. Include a brief description about what happened (highlights any issues you may overlook), what she eats/drinks and her toilet habits for that day.

I know children are different, but I haven’t come across a child who needed a week off because of the meds. If that was the case there would be children, and adults who would be at home for most, of not all of the year.

Also, to add (sorry for the TMI!) my daughter poos every day and shows no signs of straining etc. Her poos look normal, but she does often have quite a big tummy after eating (always has).

ffs I will definitely take her to the GP, though the lady I spoke to said that I should specifically ask for this treatment in line with the NICE guidelines. What she is suggesting is not just laxatives it is a 'de-impacting' programme, which from what she has said would certainly not be able to be carried out by pre-school.

I agree that constipation advice over the phone is always suspect. In your situation I would talk to her about it, make it clear that she’s a big girl now, and that these accidents in school and at home are worrying you. Talk to her about why she feels she can’t go to the toilet in time and try and bribe her to use the toilet regularly even if she doesn’t need it (get her nursery’s support too by tracking her). If it still doesn’t resolve in 2 or 3 weeks then take her to the GP

This is what the website says: `Because of all the pooing and the possible discomfort, your child won’t really be able to go to nursery or school during disimpaction'.

My daughter will also be 4 in December and has just come out of a six week phase of having many many accidents a day at preschool and at home.
We went to the Dr and got her checked out and the Dr said that she was physically fine and it's just a phase. And try to relax about it and she will grow out of it.
Ever since that day she's not had an accident.
So I would definitely advise you to see your Gp and if all is ok just try and wait it out.
It's really not a fun stage though.

It sounds like your dd is just anxious about her new pre-school. It's not unusual to have accidents surrounding new and unfamiliar things. Maybe just make sure that your dd is happy at her new pre-school and double check that she knows the routine for asking to go to the toilet and is comfortable with it and is allowed to go whenever she needs. My dd had accidents for the first few weeks of each new preschool and elementary school teacher until she was 7 or 8. Also, I discovered that my dd was having accidents because the teacher wasn't letting them go to the toilets as needed (dd needed to far more frequently than the others).

Thanks all, what you're suggesting is much more along the lines of what I was expecting... I was more wondering if there was any specific language I should use etc.

But now I've got that advice I feel like I can't unhear it! She was very lovely and seemed knowledgable - we talked for a long time.

I wasn't really worried at all when it was just at pre-school, just more concerned when it was at home and included a poo accident.

She LOVES preschool and is always keen to go, but they do have to ask to go to the toilet whereas there's a loo in their room at nursery. I think there she probably just starts making her way to the toilet and they follow her lead. She can ask to go to the toilet but isn't very good at doing it, so when we go out I always check she knows where the loo is and keep an eye on her.

This is a process that is used with children but it is after other avenues have been explored thoroughly. I’m surprised that ERIC have jumped straight to this method. It’s not uncommon at her age and a trip to the GP or HV would be an appropriate place to start.

She said that the Dr. may examine her/feel her tummy, but that even if there were no indications of constipation I should still ask for the medication to be prescribed as my daughter has at least two of the diagnostic indicators of constipation (wetting and soiling).

Tbh I find with the GP that they just seem to go with whatever I say... For example, I was concerned about her hearing as a baby, the GP 'had a look' in her ears and said they were fine. However, because I am a paediatric HCP myself and that was closer to my area of specialism, I pushed for a referral to audiology (she had stonking glue ear, moderate hearing loss in both ears).

So, now I've had this advice I don't know if I'll feel that reassured if the GP says she's fine...

It says something that I'm much more interested in the opinion of the MN hive mind....

How does she know she has chronic constipation without assessing the child physically? Thats involves an abdo exam.

If thats what your concerned about take your daughter to your GP. DO NOT start your child on medication without actual medical advice and a diagnoses

path I was surprised too... Now I'm wondering if I misunderstood, but I don't think so.

Well whatever you do, don't tell her it's OK and it's just an accident. I see too many parents doing this. It's basically giving them permission.
Make sure she knows you are not happy, and that's not where she should be doing the toilet.
Don't let yourself get overly anxious about it.

She's still very young and accidents are not uncommon at that age and in new situations.

The treatment that's been suggested to you sounds quite extreme and I can't believe that such a confident diagnosis is something that someone could, or should, be making over the phone.

Agree with pps the place to start is with the GP who will have a better idea of what's going on with your little girl once he or she has had a chance to actually examine her.

I read your post and did think constipation or UTI. Either way you need to take her to the GP.

Ignore the advice and give your health visitor a call.

Definitely ignore that advice. Sounds like crap to me

Things I learnt about potty training:

1. When you thing they’ve got it, they probably haven’t.
2. It takes a looooooooonng time.
3. You go forwards with it and backwards and forwards and backwards and....
4. If there’s a big change in their little lives (like changing to a new preschool), expect a regression.
5. The GP won’t even consider a problem until they’re around the age of 7.

Sounds like to me you’re doing all the right things. Keep on, keeping on. You’re doing a great job!

Oh dear drogo I'm afraid that's exactly what I say to her . I should add, on the advice of the HV and then again by the ERIC advisor today...

I have booked a GP appointment, but (and perhaps I should have more faith) I am at least 90% sure they'll have a look and say 'she seems fine, give it a couple of weeks and see'. I am equally sure that if I say, 'well ERIC advised bla bla as per the NICE guidelines' they'll say 'OK let's do that'.

My husband will do basically the same if I discuss it with him.

Grrrr this parenting lark is tricky. The buck always stops with me and I will doubtless feel guilty whatever I do!

As a preschool teacher, I’d say it’s worth asking if the ‘ask to go to the toilet’ rule can be relaxed for a month or two at preschool. Explain your daughter had the hang of it but is probably adjusting to the new routine. I can’t imagine them saying no, I’m sure they’d much rather let her go than change her every time!

Does she ever complain about a tummy ache? You say she never strains.
Does her face ever show signs of her tummy being uncomfortable? Does her body language indicate anything to you?

A child I know of went to a neurologist for ‘strange’ facial expressions investigation but nothing ever came of it. Eventually she was diagnosed with significant constipation despite pooing daily. The parents had NO idea.

Under the paediatric consultant she underwent the disimpaction process you speak of, using Paediatric Laxido.

Yes it was messy. Yes, it meant time off work for the parents. Yes it meant staying house bound.

You need to get to the GP who should feel her tummy first and foremost. If you have any concerns or the GP does, a referral to Paeds should be offered, hopefully for an x-ray although they don’t like to do these unless they feel they have to for confirmation.

Victoria we did ask but it was a hard no. Tbf I think it's more that it's quite a big setting and the children will need help going through doors etc., rather than them having to ask for 'permission'.

line no never complains of tummy ache, very happy, active child. She has a good appetite and eats plenty of fruit and a reasonable amount of veg. She isn't great at drinking though and will only have water/milk if REALLY thirsty. I periodically relax my juice rules if I think it's needed .

As it turns out she'd only been put in clean trousers as she'd got soaked at the water table and has done both a poo and a wee on the potty since we got home... [shrug]

Probably a 2 or a 3 on the Bristol Stool Chart if anyone's interested

It doesn’t sound anything like constipation, what odd advice. She is most likely anxious in her new pre-school.

What qualifies the woman on the phone to make this diagnosis and treatment plan? All without seeing your Dr. I'd be very sceptical about following any advice given in this way. Especially for a child.

OK, I feel I may be unintentionally misrepresenting the ERIC advisor here. I'm sure they do a great job and give lots of help and support to families.

I was a bit surprised by what she seemed to be suggesting, which was to go to the GP and ask for this treatment. She seemed to be saying that my daughter's sudden difficulties with wetting/soiling already met the diagnostic criteria for constipation and this type of treatment. She did make it quite clear however that she couldn't give me medical advice per se and that I should go to my GP.

She definitely was advocating this treatment plan however, even when I clarified saying it would be very disruptive for us all for something that seemed fairly minor to me. I suggested perhaps waiting until the new year and she said that was a 'long time' to wait.