To think this poo situation is just ridiculous now?

[Alittlebitwary]

Posting here for traffic to see if anyone else has any experience of the same, as I'm at the end of my tether with this and literally don't know what else I can do.

My 4yo just will do anything to avoid doing a poo.
Potty training was fine, this started sometime between age 2 and 3. She holds it to the point it starts to come out, so gets poo in her knickers, but won't go to the toilet. She will cross her legs, crouch on the floor, and though clearly desperately holding it in she flatly denies needing a poo.
We sit her on the toilet and she screams her head off saying she doesn't need one, despite the repeated pooey knickers. She'll then go off and play, then repeat. More pooey knickers and toilet refusal. I'm absolutely sick to death of it now.

We've tried everything.
Poo apps recommended by HV.
Ignoring and letting her lead (she then holds so long - days - that it's eventually painful when she finally does do one then is even more avoidant).
Forcing her to the loo (she refuses)
putting games and toys in the loo to keep her there / make it relaxed (she just plays and no poo comes out)
Positive reinforcement, sticker charts, rewards. Huge praise for every poo.
Also tried not making a fuss so she didn't stop doing it just because she wasn't getting a fuss.
Increased fluids and fruit.
We make doing a poo part of bedtime routine and sit her on the toilet every night before bed.
We often have to spend 15 mins making her laugh to get her to relax enough to poo.
She ALWAYS denies needing to go, even while she's doing one!
However, occasionally she takes herself off to do one, and gets on with it no problem. I have no idea why sometimes she can and sometimes she can't.

We saw GP when she was 2 or 3 and she's been on laxido daily ever since and the poos are always soft now. It's possible she was constipated at one point and had a painful poo.

The thing is, we'll go round in circles having a period where she's going on her own no problem, every day with no issues!! and then suddenly there'll be another period where she is constantly holding and it's a constant battle to get her to be regular.

I am absolutely sick to death of the pooey knickers and her little sister is starting to copy this behaviour and I just can't!

She's at school now and comes home with poo knickers on the regular and she gets a sore bum.

Help me Mumsnet!!

Have a look on the Eric website, and maybe speak with their helpline. Lots of tips for withholders

oh look thread about poo

It's frustrating, I get, but you have to remember that withholding is a psychological difficulty, not her being badly behaved. I have a dc with this issue after an earlier problem with chronic constipation and painful anal fissures. I have to be honest and say it didn't get better quickly, but getting cross about it won't help.

We found this book helpful.
Constipation, Withholding and Your Child: A Family Guide to Soiling and Wetting https://amzn.eu/d/4A3Zrjd

But, making pooing any more stressful or distressing won't help. Diet/fluid changes to keep stools soft (we also used movicol for years) so poo can't do easily be withheld is helpful. Making absolutely no fuss about pooy pants (they can't help it) and helping to reduce shame, and giving them the things they need to clean themselves up when at school was helpful.

It's possibly a mix of behavioural but also physiological.
She's possibly still constipated on occasion and if sore will then be reluctant to poo again.
Try increasing Laxido (or move to Movicol - worked much better for us) Also consider reducing dairy as an OP suggested as could be an intolerance.
She'll get there!

I'm not sure it does. The reason I don't think this is because she's usually doing a poo every day, it's usually a big soft log - but this tends to happen on an evening as part of her routine and with us having to intervene with enforcing she at least sit on the toilet and making her laugh or whatever to get it to come out.

The problem is if she needs the toilet in the middle of the day, before her regular nightly poo.
She is withholding it for whatever reason. I see it happening in front of my eyes. She'll be mid play with something, and I'll see her face change - she flushes and frowns, clearly knows she needs to poo, as she then crouches down to the floor while she tries to hold it in. She can't seem to stand up while doing this - assuming she's desperately sucking it back up. It's at this point she gets some poo in her knickers - when it has started to come out but she's managed to suck it back in.

It's always sticky and soft, rather than loose or watery such as you might expect with overflow.

I have wondered if she has some sensory processing issues as the HV mentioned this can mean she can't sense the need to go until the last minute. Then maybe she's too embarrassed to go, as she's already soiled by that point. I don't know. But she didn't say there was anything you could do about this 🤷

For those suggesting ERIC I've tried all their website tips but can never get through on their phone line as it's always engaged!

My youngest was like this and it was such a difficult time. This little story is the only thing that worked.

https://www.cntw.nhs.uk/wp-content/uploads/2016/08/Poo-Goes-To-Pooland.pdf

Poo goes to Pooland worked with my DS when he was reluctant to let his poos go. Plus he got a chocolate button for every poo in the loo!

You can find it as a PDF online

Have you tried getting her to eat kiwi fruit, my DD recommended it for DH (shed been told it helped constipation in children). - it works very well.

If she’s getting sore, this may contribute to her withholding.

Please apply a nappy cream after every cleanup, and explain that it will help her to not be sore next time.

My son has special needs and I went through this for years . It's horrendous so I feel your pain .

I tried absolutely everything and he was dry but poo was a problem. I think the fact she can and will do it means she will eventually but it is painful wanting them to just stop !

My son would only poo in a nappy despite trying everything he just randomly got on the toilet one day and did it . We never looked back so I'm sure this will happen but when you are knee deep in it you cannot see it every ending ..

I know it's hard but I imagine she is getting alot of attention for messing about so I would just completely ignore it and I'm sure she will come to the realisation eventually it's for the best .

she's 4 years old. That's awful and humiliating.

Thank you.
It's so hard to not get frustrated, we do unfortunately end up just losing our shit at times because it is just so ridiculously frustrating!

But yes, it generally always makes the situation worse so we just feel like total failures. Tonight was another episode of about 4 smears in a row and still toilet refusal despite us picking her up off the floor during her crouching down so she ended up with us basically telling her she clearly needs to go, cannot leave the toilet until she does, her screaming her head off crying in there for 10 mins, and quite obviously this did not result in her doing a poo.

Parents of the year aren't we.

Hence my post tonight because I'm at a loss!

Could it be an anal fissure ? Then she’s terrified to go because even with a soft pooh it’s painful for her, bless her.
Increased fluids and strategies to help, a friends child did this and she used to do some dancing about to music when she spotted the holding on phase as you say you can see it, she could do so music on let’s dance approach usually resulted in a rush to loo with storytelling to help distract especially funny books or made up funny stories. In time the fissure healed and her daughter was fine. Good luck

My advice is to get a referral to paeds. One appointment there and she was sorted after 6 months of issues.
My daughter was a withholder. She could hold in the max dose of movicol until you could hear her sloshing when she walked!
In the end, it was recommended she was put onto picosulphate which is a stimulant laxative, as chronic withholding can stretch the bowel and cause problems later down the line. Dose was low, made her poo every day until she got used to it, and she was slowly weaned off. No issues since. It's recommended to make sure they aren't impacted by doing a movicol disimpaction first as hard poo and stimulant laxatives together hurt.

I feel for you - my whole life centred around poo it felt like at the time. Good luck

Sorry if this has been mentioned as I didn't have time to read all the responses but could privacy help? My 2 year old won't poo unless she's on her own on the toilet or potty. She calls me back when she's done so I can wipe her bum

Has anyone mentinoed encompresis? My friend's daughter had this. They got help from pediatrician and psycholgist I believe.

A friend of mine had a similar problem with her son. He wouldn't poo, then everything in the house revolved about his poo, they would talk about the poo problem in front of him, they will pressure him to go to the toilet, different methods discussed to help him poo...EVERYTHING revolved about the poo. He also had laxatives prescribed, but they didn't work, the GP couldn't understand this and referred them to a psychologist.

The psychologist saw my friends son first and then the parents and told them that clearly the kid had not a problem at all and the problem was them (the parents). They had made such a fuss and continue to do so every day that the problem was a psychological one created by them obviousluy, unintentional). The pychologist told them to stop making a fuss and to not talk about the problem with him or in front of him and act as nothing happened, if they had anything to discuss about poo, it would have to be when their kid could not listen to them. That was the end of the problem for them.
Consider this. The solution was to do nothing at all and relax. Sometimes we overcomplicate things, I think your daughter can see you are over invested on this.

She is toilet trained - and at school already. She's been out of nappies since she was 2.5, I'm not sure how nappies would be any different to being in knickers for this issue though? She's not more likely to poo in a nappy than she would be in the toilet (I don't think). X

Get her to clean her own knickers
May help

Why are people suggesting getting a 4 year old to help clean her pants by hand to try and prevent her soiling herself? What a horrible way to handle it

Also, I forgot to mention...the ignoring went for everything. First time he did a poo after this approach, they were advised not to make a fuss or a 'party' either, but behave as if it was the most normal thing.

I don’t have any great ideas but when my son was struggling to toilet train and it was all rather messy, i was finding it very hard not to lose my cool and transfer the stress to him. I stocked up on secondhand non stained (sorry!) pants that people offered on our local free kids stuff site and from friends, and bought any discount packs I saw in the shops, and gave myself permission to just throw any pooey dirty pants away rather than soak / bleach etc. I felt awful because I usually try to be environmentally friendly but this saved my sanity and stopped me losing my temper with him at yet another dirty pair when it really wasn’t his fault. Maybe just an idea to try and help you keep a cheerful face on with it all.

Stop with the cleaning her own knickers messages., this is a wee girl we are talking about, a 4 year old child.
Piscis message worth reading.

You have my sympathy. I could have wrote this post back when my DD was your age.
It is a long journey- as other have said I would bet she I constipated with overflow and that is why you are seeing the soiling.
Things I wish I had known....she had stretched her muscles and caused herself damage so she couldn't feel the 'urge' to go any more!
The muscles around the bottom are slack and she was full of loose stool. This meant that each time she relaxed-she would leak. It wasn't her fault. If she jumped around or ran she would also leak. When she was backed up was worse. She needed professional medical advice and monitoring as well as medication. It wasn't a case of bribing her or telling her off
Be careful with movicol / miralax- it can sometimes make the situation worse.

Try not to stress about the pants- just have a good supply of cheap ones!
I found that she needed regular 'clear outs' once she got backed up to help her regulate bowel movements again. We would plan this on a weekend and stay home to let her have a big 'empty'.