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!!

We went through something similar with my son when he was 4, including the crouching jn corner. At the tjme what worked was making sure he ate tons of pears (which are a natural laxative). The more pear he ate, the softer and easier it was for him to poo, so that after a couple of weeks the fear of going eased. I feel for you - our GP said this was such a common problem at this age

I think I would ask her to help clean the knickers (just putting them in a bucket etc) and I think I might be inclined to go two or three days without mentioning poo at all. See if she will go with zero pressure. I would explain to her that it’s the body’s way of getting rid of waste and germs etc and that everyone does it. If she hadn’t gone by herself after a few days I would be back at the gp. If you ask her why she won’t go or doesn’t like going what does she say?? I might try Netflix on the iPad or something in the loo with her and I’d leave her completely alone. I deffo don’t think hanging outside the door will help at all. I can feel your frustration… I am about to potty train soon and am dreading it!!! Seems it’s much more complex than I thought!!

Was just thinking of this book. We got a copy of it when my then 4 year old son had problems and it helped massively.

I see @Alittlebitwary that there are queries over possible ASD. Health visitors are not qualified to assess and girls are typically less easy to spot than boys at a younger age.

Have a look at this clip on interoception - I know it leads with the "new topic in autism" but it's not exclusive to autism and is common with children with sensory issues.

At 4 you can also ask for a referral to your local bladder and bowel team. Ours were absolutely brilliant.

have you ruled out an intolerance? Might be painful/ associating pains with going to the toilet?

i am no help. I could have written this post. My DD is 7 and has just come out of a holding cycle. She is exactly the same as your DD, will hold it for weeks on end, soiling and letting out small bits, then she’ll finally poop properly and will keep going almost daily and all seems well again, then bang back to holding and soiling and insisting she doesn’t need to go. She’s been like this since she potty trained. Movicol keeps it soft but she still manages to retain the stool for long periods of time. School nurse has been no help, nothing helps her, it just seems endless . Sorry you and your DD are going through this too. Makes me sick with worry that’s she’ll have a bowel rupture or impaction. I am at a loss.

Potty Monkey is good too, my DC prefered this too Poo goes to Pooland

My 3 year old holds his too, he does get a sore tummy and when he does go his poos are absolutely massive!
The best way I have of making him poo is I force him on to the toilet and then I have to pretend to be a poo and I jump around as his poo plops in to the loo and then he flushes me away. It sounds ridiculous but it really does work (for us).

To be fair she's not bothered about privacy. When she does a poo on her own, she is usually pretty proud of herself and shouts to us then gets us to come look at it 😂

I sympathise OP. Went through this with my now 10 yr old DS. It was horrendous.

I agree with your instinct that it isn't physical - you can see when she needs to go (I remember the "trying not to poop" face and the crouching so well) and you know her stool is soft.

For DS, his "trigger" for avoiding going was pain from a bout of constipation. Unfortunately this became a vicious cycle as the more they withhold, the higher the chance it'll hurt. We did movicol for years and whilst it did soften things up, it didn't change DS's fear that it was going to hurt. He'd often be surprised when he eventually went and it didn't hurt.

I don't have a miracle solution for you - DS is much better now but it's been gradual. He still gets constipated sometimes and spends way too long on the toilet to do a poo. It's almost as though he's made his bowel lazy.

For what's it's worth, I'm certain DS has ASD (but no diagnosis or interventions as he's "accessing the curriculum appropriately" and "isn't disruptive in class"). Bowel issues and poop avoidance definitely seem to be a bigger issue in ND kids than NT kids.

The one thing I would say is, literally, don't take any shit from her on this issue - excuse the terrible pun. But genuinely, we found some low grade poop shaming to be helpful. I tried not to get shouty but frequently failed after multiple underwear changes in a day.

Good luck - bear in mind most adults don't soil their underwear on a daily basis (I hope) and she will grow out of it.

The HV specialised in additional needs and did a specific checklist for autism in girls so seemed to be fairly on it to be fair. She did mention interoception, I vaguely remember googling it but I don't remember there being much practical info on how to help / what do do about it, but I will look into this again thank you x

We’ve been there OP! It’s sooo frustrating! I know you said she’s taking Laxido but what worked for us was Lactulose because it’s quite instantaneous so she literally couldn’t hold back. So we’d use it say every other day until she was regular again. Then she would be great a few weeks and when the pooey knickers started again we’d restart the lactulose. I initially hadn’t considered a laxative because I thought the dirty underwear indicated that she could go if she wanted too but, I think she was constipated and scared of the pain of going so was putting it off. The key was making her have to go! Good luck OP x

I have no top tips, but can only say that you have to fix this now.

We adopted our DD when she was two years old, but by then the damage was done. She had refused to poo so much that even at that age her bowel was distended to the extent that her body was no longer sending signals to her brain that she needed to go to the toilet until the stools were too big for her to pass without considerable pain.

It was awful. Literally for years we sat on the bathroom floor with her while she sobbed in pain, There were many, many trips to the doctor and A&E.

Now she is 14 and things are improving, but she is still taking 4-5 sachets of Laxido every day. However, she has extreme mood swings which I genuinely think are linked to when she is still struggling to go to the toilet, but she will rarely admit to that. My hope is that as she grows, and Laxido keeps her regular, her bowel will recover its strength, but I don't know if this will ever be the case.

There might be some helpful information on the children’s bowel and bladder charity website. https://eric.org.uk/ I found their potty training advice the best.

It was my HV who picked up my son's autism and organised the referral. She specialised in SEN and was trained to recognise it so it's entirely possible.

Thank you to everyone who has taken the time to post wonderful solidarity and some really useful advice! I'm going to probably re-read the thread tomorrow, but it's been so helpful to see things that have worked for others and possible causes etc.

I think in the first instance we will try the completely ignore approach and leave her to her own devices, especially given she is better when not "told" to do things.

If that doesn't help I will try emailing ERIC for advice rather than phoning and see what they say. May also try playing around with the laxido and diet. I'm possibly swaying more towards stopping it being more of a help (as suggested by a PP) rather than increasing due to the specific circumstances.

But also do want to look into the stretched colon etc more to make sure it's nothing like that. Though the fact she can poo unprompted at times makes me think it's hopefully not that, and more of a control / not wanting to stop playing kind of issue. I may try putting toys in the toilet again... Though in the past she has just messed about too much with the toys and been better when left to concentrate on pooing!

As for cleaning pants, I don't care about that - we used to do cloth nappies so washing pants isn't the frustration. We still use cloth wipes at home so she puts her pooey knickers in the bucket. Maybe I'll get her more involved in that again, focusing on changing her knickers and making sure her bum is clean, rather than drawing attention to doing a poo.

Glad I posted as this thread has been so so helpful, so sorry I haven't replied as much as I'd like to I will definitely be reading through again tomorrow xx

It strikes me that you say she’s on laxitives and then also say she’s having loose bowel movements that come on suddenly, could reducing the laxative dose help in making them less sudden? Beyond that, could you try introducing a midday poo attempt as well as the evening one?

I could have written your post myself! We tried everything. In the end, it was a phase that was grown out of just like everything else. It was stressful and infuriating and upsetting. Then gradually stopped. Now 5y6m and my only regret is being so active to try to get our child to change it. In the end it was only they who could decide to get to the loo. I hope at least reading some of these posts knowing it is not as unusual as you may think helps you feel less alone

Sounds so frustrating! Does she take a daily probiotic? You can get chewy ones like the vitamins. Found that much more effective than laxido!! Upping green veggies too, perhaps in a smoothie?

Also have you taken her to an osteopath? Ones that specialise in children can be quite effective at helping resolve bowel issues.

Anything is worth a try!

If you think it could be a control issue, as it was with my DD, is there any part of her day to day where you could give her more perceived or real control to refocus that (very human) need? What we put into us and when we let things out is the control we have as children. I would say to DD what do you want to wear today x or y, what snack x,y or z, what shall we have for tea x or y, etc. You may already do this, as did I to a degree, but I found ways to increase her contributions and it worked. She is still a very strong minded girl and I'm really happy that she is! Very annoying at times but reassuring as well! Finally, if your DD is going regularly and is not constipated, and there is a chance there are sensory needs, would making her poo softer somewhat diminish the sensation and actually be unhelpful would be something I'd consider.

Sorry, wrong thread! I've reported it.

I can't believe people are suggesting you get her to clean her knickers, shaming is not a great parenting tactic.

I’m in Ireland but @ pooandtheloo on Instagram is a bowel nurse in a children’s hospital here. She gives loads of advice for free on her page but you can also book in for a 1:1 to make a personalised plan for your daughter. Her free tips have helped us hugely and we’ve just had our first successful week of poos on the toilet, no bother. Can’t get over how many children seem to have this issue though?

Agreed. Having been the child in this scenario, I would warn that shame can have long-lasting impacts on the developing mind, which can manifest in surprising ways in adulthood.

And while withholding might be a ‘choice’ of sorts, the subsequent soiling is not. The soiling occurs because the child has got used to ignoring or avoiding the urge to go, so they become desensitised from signals from the bowel that they need to go. Making the child wash the pants or shaming them for the soiling is wrong- they actually can’t help it.