To ask for your top tips re constipated 4yo?

[Draineddraineddrained]

I have gone about this all wrong and am keen to get it absolutely right from now on so want experienced advice! I swear I'm not a poo troll.

My 4yo was beautifully potty trained (wees and poos) from about 2.5/3. Hardly ever had an accident. We graduated her to the toilet a bit late and in a bit of a disorganised way; and also at the same time I was pregnant and have recently had a second baby (now 3 months old).

Around that time daughter has begun soiling herself. Usually just a little smear, very rarely a full motion in her pants (this usually only happens at night, in the day it's just smears on her pants).

At first I thought it was just nerves about the new baby, classic regression, tried to be calm and encourage her to try regularly. After a while of this going on and not resolving as all the health advice promised it would, and as she got more and more resistant to going, even when showing obvious signs of needing to go, I have become more frustrated with her and let my temper show on occasion. I feel terrible about this btw.

I'm now coming round to the idea (as this has been going on for months now) that she has a real physical problem (possibly developed from anxiety witholding initially but now it's beyond her control?). And I want to deal with it in the best way possible, as well as try to undo the damage to her emotionally and psychologically from all these months of stress and conflict around going to the loo 😔

I'd rather not go to the GP as I don't really get on with her - nothing I could put my finger on, I just feel like she doesn't respect me and she makes me nervous.

Has anyone successfully dealt with this - both the physical issue and undoing any emotional harm/psychological issues that will prolong the vicious cycle?

I'm thinking trying to up her fluid intake (I will finally yield to squash to get her to drink more, she never really drinks enough). Maybe trying to get her to eat prunes, or of that's a step too far for her then drinking fruit juice every day to try and add fibre/soften stools. Encouraging her to sit on the loo for a bit on waking, before meals and before bed, but being far more relaxed than I've been about whether she actually goes or not while she's there. And totally revising my approach to accidents, no more recriminations or constant "checking" whether she needs to go (even if she clearly does!) - just try to release my anxiety about it and if it happens it happens, deal with the mess quickly and move on, no biggy. Does this sound like a sensible approach?

I had similar with one of mine. What happens is the feces compact in the colon and the smears are from the body’s own lubrication leaking out. It can’t be helped until she’s had a good clear out.

What worked for us was to realise our DC had shy poo and needed privacy to poo. Also let them eat as many raisins as they wanted (natural mild laxative). Had read a book on potty after a morning walk and read a book on the potty every evening after a nice warms bath. DC would usually go one of these times. Over time they got better. But work with body’s naturally rythm. We are more likely to need to go after exercise, eating or a bath, not before.

Thank you! Raisins a great idea. She could probably use more exercise as well - she's not one of those kids who dash around a lot, more into imaginative play so I could try and encourage a bit more activity to help things along a bit!

If she's constipated enough to be soiling, I'm afraid diet just about never works to sort it back out. Usually need a decent dose of laxido.movicol to make progress. Basically, when they've been constipated for a while the rocks of old hard poo sitting waiting to come out stretch up the last part of the gut, which is meant to sit empty like a stretchy hose pipe. To improve things you have to get rid of all the hard rocks, which tends to me quite a lot of the best laxative (laxido/movicol), usually getting them pooing loads of liquid poos for days. And then for months have to have them pooing easily soft squidgy poo every day, so the gut can shrink back down and heal up. The soiling is softer poo from higher up the gut sneaking past the hard rocks. I'm afraid you do need to see the GP.

I'd really recommend www.eric.org.uk for information.

Worked for my DC. I’d give it a go before resorting to harsh laxatives. They can lead to humiliating accidents and misery on the loo.

Thank you! Argh GP. But I thought that might be the case.

To be honest if this has been ongoing for a long time she is likely to need some help to fully clear her out, the smearing is likely to be due to fairly severe constipation. If she is impacted then diet changes alone may well not be enough.

If you don't like your GP can you see someone else at the practice? Or move to a different practice? When my DS was constipated the only thing that worked was movicol prescribed by the GP.

There is a website called ERIC that are brilliant with advice on toileting issues (including withholding) they also have a helpline you can call.

@nocoolnamesleft cross post!

@PlanDeRaccordement

Worked for my DC. I’d give it a go before resorting to harsh laxatives. They can lead to humiliating accidents and misery on the loo.

This is a point - certainly if i go down laxative route will have to wait until half term, I won't make things worse for her by her having obvious accidents at preschool. She'd be mortified.

Go to the GP

Movicol is not a harsh laxative (it doesn't force the bowel to contract) it keeps water in the bowel to soften the stools.

Dried apricots taste nice and also definitely helps with constipation, 4 or 5 a day helps

@PassMeTheWotsits she actually already eats loads of dried apricots, she loves them! Although she has been off them recently in favour of fresh strawberries... Time to reintroduce!

She's impacted. Get her movicol from the doctors it's the only thing that ever worked for us. It's gentle and just softens it to stop it hurting.

I'm pre potty training but my lb was on Laxido as he was constantly constipated. Now he has a tesco prune puree with lunch and he loves it. Avoided medication and doesn't hold them until they are bullets now! It might be worth a try!

Not the exact situation but im 29 weeks pregnant and due to being on iron tablets have found myself very constipated to the point I feel I’m giving birth and having to sit it out for 30 minutes on the toilet. This last week I have been drinking at least a glass of fresh orange each day and since I haven’t had any problems so maybe worth a try.
Hope things gets better soon xx

I had this with my child around the same age. I take laxatives long term due to bowel issues and was very reluctant to go down that route. Spoke to dietician friend who agreed to try diet first despite the obvious signs of long term impaction. She recommended the Ella's kitchen (or equivalent) pouches of prunes. I gave a pouch for breakfast for a few days and soon was cleared out and for a while gave 2/3 times a week until it was easier to poop and they weren't scared to go anymore. Now at first sign of anything amiss she has a wee pouch and it's sorted.
Good luck

My daughter had alot of problems with constipation around 3/4. The problem with laxatives is often it's too compacted and they cause more leaking and smearing without properly clearing the blockage. We had to get in a real routine of lots of fluids, warm bath after dinner then on the loo for 1/2 hr. Thankfully from around 5 it became much less of a problem.

We've had ongoing issues with ds over this. I can share what works for us at the moment-once she is cleared out it may help you? I have every sympathy- it's stressful all round, especially when there's a psychological element too.

Ds has to sit on the loo after breakfast and after tea every day. He gets reward marbles for each try, more marbles if he pushes a poo out( he hates the sensation so would wait till it falls out otherwise which makes him prone to constipation).

He hates going and toilets etc in general so we let him choose to watch a ten minute program on the loo in the morning and evening. He has limited screen time so this is a big incentive.

We also encourage lots of raisins, veg, fruit, water and innocent smoothies which helps too.

Hope you manage to sort things.

Also recommend the gp and movicol route. Our gp had us gradually increase the dose till it achieved the required effect with no unexpected explosions. It is really really common at this age. By all means try dried fruit etc, fruit juice, exercise etc but if it doesn't help fairly soon do go to the gp. Don't punish an accident (we did that at first thinking it was deliberate, stopped quickly when telling off didn't help, but I understand your frustration), and do instigate a regular fairly lengthy sit on the toilet. Every day, ideally at a time they would usually go, with no pressure to poo but insistence they sit and try. A book may help.

And agree with the prune pouches too :-).

DS is on low dose lactulose as movicol didn’t help.
Request a phone consultation with GP and ask for help.
Please don’t shout at your DD.

My DS is 7 ,he has ASD and I wiped poo from everywhere when he leaked. He had faecal compaction and actively withholds poo.

Thank you all so much. Taking all on board and will call GP on Monday. Poor lass, she's going through it emotionally with new sibling etc and I wish I'd just jumped on it when it first started instead of believing it would resolve itself. I even wormed her (and us!) last week in case that was the problem (she had them when she was 2 and there was bed wetting and terrible mood that vanished after worming so I'd hoped this could have a simple solution too).

Just read ERIC website and the laxative route sounds terrifying, protracted and potentially traumatic for her 😭

I haven't shouted at her but I've been very accusatory at times - usually when I've been telling her for ages she needs to go (dancing around, scratching her bottom etc) and she's been refusing vehemently, denying she needs to go, and then I smell it on her pants and it's smeared everywhere - just so frustrated as it was so obviously inevitable. But it really isn't her fault, it can't possibly be her fault however it's happening, she's 4 😭 I feel so terrible that I've not been more patient with her.

Please update OP after your GP appt as this sounds identical to my DC, down to the new baby. Thanks.

Once the initial difficulties are resolved a carrot to nibble on after school and plenty of water usually helps. I’d avoid raisins they absolutely wreck kids teeth.