Will not start poo on toilet

[Louweetie]

Can anyone help. I am at my wits end. My 41/2 year old has been toilet trained (no1's) from 3, no problem. But no2's is a whole different matter. He will not ask to go to the toilet, he just starts it in his pants and then holds it in. Put him on the loo and he will either go, sometimes, or not go at all. When he has gone we make a real fuss and big it up so he knows we are proud etc. Clean pants on again and then poo in them again. Have tried everything. Sticker charts, chocolates, rewards, ignoring it, repremanding, and now have tried to leave him without pants which is not very practical when you want to go anywhere. He was not happy to go without pants and we told him he would get his pants back when he went on the toilet and not in them, again asked kept prompting him to go to toilet etc and sure enough he went in his trousers, then when I put him on the toilet he didn't do anything. He wont go fully in his pants, just the start of it, but will hold in if he wants, when put on toilet. Doctor recommended laxatives at night and sit him on loo in am, but he will sit on a toilet for hours and just not go - (until it gets to a point where he is about to explode), then when his pants are on will start it a little bit (he never does a full poo in his pants). Has anyone had similar problem and how on earth did you manage to sort it. My son is at school now and it is becoming a real problem.

Hi Louweetie, I have had similar problems with my ds1 and got hold of a book recommended here, 'Constipation, Witholding and Your Child' which is brilliant, both at explaining what is going on and ways of dealing with it.

The book suggests that they withhold and then go in pants basically because they are scared of doing a "sore poo", as my son calls it! and recommends treatment with oral laxatives.

We started with 1 tsp Lactulose night and morning (prescribed by GP), and sitting on the potty for a good while after breakfast and after dinner. It took a week or so of practicing this but he's now pretty reliable, so long as we make sure he gets a goodly amount of potty time.

I think the trick is to start with enough laxative that they can't hold on when they're on the potty, then after any blockages are cleared out and after lots of soft poos, gradually reduce the dosage till the poos are soft, but formed. We're down to 1/2 tsp Lactulose in the evenings now - but if we forget that, he starts withholding again and we have to up it. From everything I've read it's going to be a question of keeping up the lactulose for a long time, till his bowels are un-stretched from the holding on and also till he's not scared of the poos any more. If your son can still sit on the toilet for hours and not go, then perhaps the dosage of laxative should be higher.

Oh and we also sit him on the potty rather than the toilet, because crouching with knees higher than hips opens up the bowels more. You can get the same effect by putting a high step under his feet when he's on the toilet.

I hope this helps a bit. Close to my heart as we had months of despair about this, but it wasn't till he started school that we started treating it and making progress. I know how hard it can be.

Dear Systemsaddict

Thank you so much for responding. Am new to mumsnet and it was my first intro so I did waffle a bit. I think I will try the laxative again whilst he is on half term. He has movicol which is a stool softner (nice subject eh!) and put him straight on toilet. He did have sore poo's and I do think that this is the underlying physcological problem, but the movicol had "softened" things up so it's a case of perserverance, and will take on board your advice. Thank you. Also thank you for the book will look it up. Many thanks x

Good luck and you're most welcome - this is SUCH a hard thing to deal with (not to mention that people are constantly saying 'it'll sort itself out' which it doesn't!). Definitely keep on with the laxatives consistently, that's been the key thing for us.