AIBU to not want to put DD back in nappies?

[Poostorm]

Have NC'd so I can share with DH...

DD is 3.5. We successfully potty trained her last June, however she regressed when she started nursery in September and ended up back in nappies for a while. She has been back in pants since December, although still having quite frequent accidents (both pee and poo). I suspected she might be constipated and that was behind some of the accidents; this week she became incredibly constipated and was prescribed lactulose, which helped.

She's having so many accidents now though. Today she's done four poos in her pants already. We are putting her on the potty and toilet regularly, she just doesn't go and then does it in her pants. I'm conscious that the lactulose may be a factor, so I'm going to stop that now.

DH wants to put her back in nappies again. I really don't want to take that step backwards once again. I'm going to phone the health visitor tomorrow for some advice, but in the meantime I thought I'd seek some options on here!

So - AIBU to not put DD in nappies again and to just ride this poo storm out? Or is DH right and should we protect our sanity/our floor?

Why are you stopping the prescribed medication?

It’s 10.25am she’s had 4 poo accidents already, I’d be putting her back in nappies. It’s so much easier to clean and the lactulose is not letting her control her bowels.

you can still encourage her to pee and poo in the potty but the nappy will help contain the mess.

Put her in pull-ups for a week whilst she’s on the lactulose, it’ll be softening her stools and making it harder for her to hold/ recognise the urge. Sort out the constipation and then go back to underwear in a week or so.

We weren't given any instructions as to how long she needed to be on it. I will contact the doctor this week to find out whether she needs to stay on it but given the current situation I think it's safe to assume it's done its job.

I'd stick with the lactulose.
If that means using pull ups for a bit, do it.
Or, buy the cheapest pants available, and bin the ones where an accident has happened.

Argh I'm sure you're right. I just REALLY don't want to regress again 😫

I suspect she's just really constipated. When you have a big hard lump.of poo in your rectum, one of two things can happen. You can squeeze out a little lump from the end (hard pellet) or as softer stuff comes down your gut it squelches down the sides and just comes out without the child realizing and so they soil. You are under treating the constipation with lactulose meaning more squishy stuff coming through and increasing the soiling. She's probably been constipated for a while, meaning her rectum (which should be empty most of the time) has got stretched and she probably can no longer feel when she needs a poo.

Having a big lump.of poo in your bowel means less room in your pelvis for the bladder, hence more wee accidents too.

If it were me, I would suggest moving over to a macrogol laxative (like movicol) and cleaning her out completely with a disimpaction regime. I would have a look at the Eric website (www.eric.org.uk) and have a look about childhood constipation and disimpaction regimes. They also have a helpline you can ring.

Good luck

Put her back in nappies whilst she’s using the lactulose and when you sort out the constipation, you can then deal with potty training again

This is what I would do. I'd go back to the GP and ask their opinion first though

I'd be happy to just bin the pants, that doesn't bother me at all. It's when it's not being contained by said pants that it becomes more of and issue 😬

Can you not just wash the pants? Soak them in a spot of vanish or biotex or napisan and wash them?

Oh gosh absolutely. OP would need to go to gp for a prescription of movicol.... Not suggesting she free style it because of a random on the Internet 😁

It could be overflow constipation. Where you’re still constipated but poo leaks out around the blockage. This is a good website for all things to do with toilet training https://eric.org.uk/childrens-bowels/constipation-in-children/
I think the most important thing to consider is what will be less distressing for your child. Will they be embarrassed using a pull up? Or are they embarrassed about the accidents?

I think you need to try and look at it differently OP. The regression has already happened, she’s had 4 poo’s in her knickers already this morning. Putting her back in nappies just means keeping her more comfortable when those things happen, the nappies don’t = the regression.

If an adult had shit themselves 4 times before 11am you wouldn’t see it as a regression for them to start wearing adult nappy’s rather than keep soiling their underwear & shitting on the floor.

In which case you definitely need to stick with the lactulose. She's not cleared out, and the really soft stuff is coming around the blockage.

The issue here is not the nappies. It's the constipation.

You fussing over nappies and potties, when she's probably feeling most unsettled and even in pain in anything wee and poo related will not help.

Back to pull ups and seek medical advice over the constipation if it is not resolved.

Thank you so much for this! It's really helpful. Her poos have been a mix of both small hard pellets and looser - so typical of what you have described.

She's in a pull up now, I won't stop the lactulose and I'll do an e-consult for the doctors tomorrow to get her reviewed.

Your post both makes total sense and made me laugh a lot!

How does this work at nursery? In that setting it would be really difficult to manage and a member of staff might be needed to follow your dc around and many checks for signs of needing toilet. Then your dc spending ages getting changed, sounds intense for your child to spend so much of the day with a focus on toileting. Can't imagine this being comfortable for your child. Can pull ups help while you get support for her. We are seeing more and more 5 and 6 year olds in school with nappies on so your little one isn't too old and maybe can't manage it out of the house yet.

You're all totally right. My focus was misplaced and I totally accept that. Thanks all for providing some much needed clarity. I'm off to the shop now for more nappies!

You wouldn't know that my eldest actually had chronic constipation as a toddler, so I've dealt with this before, would you?! In my defence, that was 8 years ago and he has a complex medical condition that formed part of that issue, so I often don't easily relate his/our experiences to my youngest 🤦‍♀️

@Poostorm ^ this.

@LeanIntoChaos thank you for your post, you said it so much better than I would have!!

I suspect you pushed her out of napies too soon. She's then learnt to hold in her wee/poo because of the pants, which gives rise to the accidents.

That's not a usual route from nappies to pants, the aim isn't to teach child to hold in. I think that unhelpful learnt behaviour has got you where you now are, just shy of a year later.

I'd suggest you have some un-learning and re-learning work to do.

Start with un-learning. Which means bavk to nappies, lose the expectation to hold until toilet/potty and just let her clear as the urge comes. In the nappy, without this being an issue.

Once she's un-learnt. Focus on recognising the urge and re-learn from there. This isn't regressing. It was a false-start from the outset.

Chronic constipation is shit (sorry for the bad pun). Been there with DD and it was horrendous - the movicol disimpaction week is burned in my memory.

Hope it gets better soon for her.

Another helpful perspective - thank you.

Honestly as another poster said, the nappies are a total side issue. Who does 4 poos before 11am? Even if they were in the toilet that's an issue! She's super constipated, but you could disimpact her in less than 2 weeks and get her down to a normal poo frequency. Then even if she's still soiling, at least it's only once a day.

Really pleased you are going back to your GP! But unfortunately there are mixed levels of experience with childhood constipation in general practice. So, if I were you I would be all over the ERIC website and go in armed with what you want (which in my opinion, is a shit tonne of movicol)