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!!

Not if you do it the right way.

With DS, I just said "oh look, you've missed the loo there love and there's a bit of wee on the floor. Go and grab a j-cloth and wipe it up and then I'll go over it afterwards to give it a good clean up.....You're so helpful, thanks darling"

I'm not talking about saying "oh my God...you and these pooey knickers are driving me mental!!! Get me a bucket this minute cos you're cleaning these knickers, I think you're taking the mick with this now"

There is a difference.

We gave my DC a nappy to do a poo in before bedtime until age 5.
Then suddenly one day she decided to use the loo and that was that!

She didn’t wear the nappy at day time - literally just put it on before bed, she did a poo, then went back into pants / PJs

A stimulant laxative can work to break the cycle of withholding - like senna.

Withholding is not taken seriously enough by HV and GPs - probably because they only have general knowledge and aren't aware of the awful consequences - encopresis caused by long-term withholding can take years to resolve when the bowel has been stretched out.

I suggest joining movicol mummies on Facebook, getting a load of laxido in and doing a clear out for her in half term.

How many sachets is she on? My constipated DC goes from needing half a sachet every other day to at the moment being on two sachets a day just for maintenance. Once she's past the idea of "going to do a poo" towards "a poo is happening now" things will improve and a much higher dose of laxative will help that.

You can control the dose so they poo at home and you can check it on the Bristol scale etc. I keep my DC on the too soft side as any soreness is upsetting.

Shes only 4!

We are just coming out the other side of this. Solidarity, it’s so so stressful.

Two things have helped us; one is that we sit my daughter on the loo with my phone after a meal. And second has been the phrase ‘you don’t have to do a poo’. When I tell how stressful I found the accidents, it honestly was affecting my relationship with my daughter and I couldn’t get her to just say ‘I need a poo’ and go to the loo.

Tend to get a natural urge to poo after eating, so an episode or two of Bluey she’ll sit and watch and is pooing much more easily now it’s a habit. And even if she doesn’t poo, that’s okay, we’ll try again later.

Forgot to say Eric website/ helpline is good. School nurse helped with explaining importance of drinking to her.

She ended up with mega-colon and a long time under Paediatric gastro consultants. She is so much better now and doesn't need meds but occasionally suffers from IBS.

i would speak to your school nurse

I am invested in this story. We have had periods where we've not needed to mention it at all, because she's not had any accidents and has managed herself fine. But then it's started again. We definitely don't make a big fuss or issue out of it, but do we remind her every time she comes home with pooey knickers that she needs to change them / wipe properly otherwise she'll get sore. Would you ignore completely and just help her clean up and crack on? Obviously I can't ignore sore skin but I can sort her out and not actually mention it verbally.

I also worry about the vicious cycle as if she goes regularly every day, she's generally fine. But if we stop encouraging her to go and just leave her to it, and she doesn't go for a few days, it's then sore tummy and a huge poo and it's worse, so I don't want to stop encouraging her to go daily as I don't want the problem to get worse again.

But I do feel like she's a lot better at going herself when we are ignoring it / letting her take the lead.

It's getting a balance between making sure she's regular to stop the problem escalating, and not giving it too much attention.

It’s so weird why this is such a common thing. Not to this degree at all but my, at the time 4yr old, suddenly developed a fear of pooing and refused for about 36 hours until he was pacing in pain and panic. It was really stressful. He was almost hysterical. Then it pretty much fell out, he couldn’t control it. Then he laughed and was immediately over it. Said he had no idea why he was so worked up. So bizarre.

If you are getting stressed then look after yourself first. We had issues with our child and went back to nappies for 6 months, as I was getting annoyed having dirty underwear to deal with constantly and I knew that wasn't right.
6 months later we tried again, and things went a lot better. Even a year later I have to enforce a toilet time regardless of whether they claim to need it, but I've put up a book shelf with their choice of books.
At first when he was holding it, I noticed he would always do a poo in his pants when he was playing the keyboard, so I ended up making the keyboard into a toilet only toy, which worked great but was a massive hassle! Then I gradually weaned him onto books.
I definitely second the things about sensory issues, having a poo is quite an ordeal if you are sensitive, so it's easy to understand kids wouldn't want to be diverted somewhere they don't like in order to have an experience that's not nice. Especially if your carers seem really stressed about it, as a small child that's a big danger sign.
Definitely see the GP repeatedly, they are there to rule out physical issues and also help with mental issues, our GP suggested books and resources and was very helpful.
Good luck!

You can get senna prescribed by GP if you push for it - they are reluctant to prescribe to children (understandably - there is really a need for more funding for paeds continence clinics so GPs don't have to deal with this)

We had the same. She was a bit younger but we returned to nappies for a while and then to potty rather than toilet. We worked out that she didn’t like the sensation of it coming out of her body and the drop into the toilet made her anxious. So actually the potty worked a treat as it was less distance to drop. Worth a try?

Between 2-3 we had similar problems with our DD.

she is 4 now and will deny needing one if not desperate - though you know she needs one (telltale signs like shuddering/squirming/the smells! Etc). and she’ll still get angry if you try and make her sit on the loo. But luckily she’s better than she was with it and will tell you if she is desperate and feels she can’t hold it in. On the whole though, she won’t stop what she’s doing to use the loo unless desperate.

some things that I feel worked for us/made the situation easier:

I downloaded a “social story” book about doing poo. Aimed at autistic children but I just liked how clear and simple it was. How everyone poos. Holding it in makes you poorly. That some food/drink makes it easier to come out. Etc

If I am pretty sure she needs one (Eg telltale signs) we race up to the toilet (even if she says she doesn’t need one) i don’t even ask, I just shout “I bet I can get to the toilet before you and do a poo first” in a teasing way, and run towards the bathroom. she doesn’t like not winning, so will at least sit n try just to try and win. Then I make a big fuss of her for trying.

high ticket reward. “Try a poo when mummy asks and if you get 7 stars on your chart you will get the diabolically expensive piece of plastic from the tv show you love”. Again I just ask her to “try”.

chocolate. “Try a poo and We’ll see if there’s some chocolate in the cupboard when you’re finished”

low pressure. It really gets her back up if I ask too much.

probably psychologically damaging her in all kinds of ways to do with rewards, praise, competition etc 👍 but she’s not on the laxido anymore from withholding so it must be working 😆

Could it be a control issue? I note you say she is mid play when you see her face change and wonder if she doesn't want to stop what she is doing. Does she find it hard to transition between activities generally? I know with my DS he has occasionally soiled himself when absorbed by the television and DD refused to poo in the toilet for nearly a year (had to put a nappy on) and it was all about control. It wasn't a physical cause for either one.

I hope this sorts itself out soon and your other dc doesn’t start the same

Youve said you’ve increased fruit but can I suggest green leafy veg too
Also can you cut down on carbs, I know a friends son ( he was much older) had the same issue and when they dropped carbs he was fine.
Carbs make poo more solid

So more fruit and veg and less carbs. Meat also makes poo more solid so swapping some for lentils, beans etc would help.

Oh yeah, we also did tablet on the potty with her favourite show on for a while.

@Alittlebitwary Has she been frightened by a lavatory at any time? Kids can be funny like that.. they can get phobias.

Maybe try a potty to see if she's more willing, or a baby seat for the adult loo.

A child I knew ''fell down'' an adult loo and developed a terrible loo phobia, at a not dissimilar age.

They too had constipation, and ''having a poo'' became a massive deal.

Email ERIC - they get back to you really quickly and call you honestly they'll give you the best advice
With-holding is really tricky it's a fear response - you said she's had a painful poo in the past so in her little head she will do everything in her power to not poo because it might hurt. I know how frustrating it is as been through it with my DS
The only way we got round this was laxido making the poo so soft it cannot be held and we got over the fear response eg basically over lots of time of doing super soft poos. It wasn't a quick fix.
Good luck

We went through this with my daughter at around the same age. She's now 5 and although she does occasionally have a little bit of poo in her underwear, the weeks on end of this behaviour are behind us.
What finally seemed to crack it for her was following the disimpaction routine advised by ERIC (someone has already linked above). We thought that it was probably linked to her being constipated on and off, and we just couldn't get past it with natural methods of stool softening.
Putting her on the toilet at regular intervals helped sometimes but not always, as she's a stubborn little mite so if she didn't want to be there, would go into meltdown. But alongside the disimpaction routine, seemed to help her.
Good luck. I know exactly how frustrating and hopeless it can feel so I hope can all get it sorted soon.

A magnesium salts bath on an evening and she won't be able to withhold.
That stuff just makes you go.
My autistic children who could withhold for days on end we're using the toilet for poops within a couple of days using these bath salts

We had similiar. What worked was completely ignoring it. So, never asking if she needs one. Never telling her to go when we could see she needed it. Never forced her to sit. Never asked before we left the house or got in the car.

The only thing we did do, was make her get fresh pants and put the dirty ones in the wash every time. We did this with as few words as possible, just stating facts, and without standing over her. That sounded like, 'your knickers are wet from wee. You need to change them before you come back into the lounge'. Then walk away.

Of course this strategy meant more accidents at first. But the stress evaporated quickly once we accepted she would have tonnes of accidents. Once the stress was gone, she was able/willing (?) to just take care of it herself. It took a few weeks.

My daughter is 2.5 and potty trained early and easily and actually started doing poos on the toilet well before she was ready to do wees. However, after a period of constipation she started holding her poo in. She is still in nappies at night time and she finds it a lot easier to go in a nappy for now as she can get into any position she likes to poo, which clearly helps as she gets nervous it’s going to hurt. So we have just rolled with that. We give her lactulose if she goes two days without pooing and just offer lots of water and fruit. We just talk to her casually but honestly that the more water she has and fruit etc. the softer and easier her poo will be. I was worried initially that she was going back to do it in nappies but think it’s more
important just to let her do what she needs to, and will try and encourage her back to the toilet in time.

We also had issues with DSS where he wasn’t wiping his bum properly and was getting it on the sides of the toilet etc. and we really didn’t get it as he was quite a bit older. It turned out he wasn’t washing his bum in the bath/shower because he felt like it was dirty. So we had to explain that it’s totally normal to touch your bum in the shower to wash it, how to clean yourself after and that as yucky as it is, there will be times when you get poo on yourself and it’s totally fine you just need to wash after. We also had to show him that he needed to keep wiping his bum until the toilet paper came back clean, no matter how many times that was.

It seems he’d grossed himself out and felt shameful about it and then it became a cycle of not washing himself properly which made it worse. Obviously I assume you still help DD to clean herself but it’s really important that there’s no shame, but just enforcing that we all have to be careful when it comes to poo as it can make us poorly.

She will get there. Just tell her if she has poo in her pants at the end of the day to put them straight in the wash and not
worry about it. See her do it and deliberately don’t comment. Let her stop worrying about it completely.

Yes she 100% hates stopping what she's doing. Similar with eating, she never eats anything at after school club because she's too busy playing and doesn't have anyone to sit her down at the table and take away distractions. So she comes home hungry. She does struggle to transition. Gets very upset if she has to turn something off before it's finished or without a 2 minute warning of some sort. This could definitely be part of it.

She also hates being told what to do, which is definitely part of the problem.
I did a lot of googling of autism /PDA when she was younger. HV came out and did say she seems to have a few sensory issues but that is all. We've kept an eye on it but it was just the odd trait so unsure if it's anything more than that.

As someone who has also been in this situation I really sympathise. It's so challenging and frustrating! I would recommend returning to the GP for stronger laxatives. Over half term, give them daily (and plan to stay in if possible!) to get into the habit again and it not being painful. We have had to do this on and off a few times. A doctor explained to me it is a phobia - almost like she's afraid of heights and being asked to skydive daily. Since they said that it helped with my frustration a bit as I know it really isn't stubbornness. It is still really sad to see though.