Won't poo - holding it in - 4 1/2 yrs old

[merlin]

Hope you lovely ladies have some advice for my friend!

Her DS seems afraid to poo! He just holds it in for as long as possible, but then has 'accidents' where a little comes out. He then refuses to sit on the toilet or says there is no more to come. Continues with what he is doing and in no time at all has another 'accident '.

She is having to change hime 3/4 times some days and is at her wits end and worrying about him starting school in September.

His nursery are not being the most supportive and have appeared to not have noticed sometimes when he has had an accident - she has picked him up and he has pooed! Of course, that could have just happened as he was waiting to go home.

She doesn't know how to tackle this without making him more paranoid - and luckily I didn't experience this with my two - so hope someone can pass on some much needed advice!

Thanks in advance.

maybe a reward every time he goes to the toilet? I know some people use this when potty training, may be an idea.

Thanks Ninja - she is trying the reward method - doesn't wash with him at all!!!

Anyone else?

She is going to have a word with the GP I think.

If this carries on your child should seek medical advice. This can escalate, it is a VERY common problem and can stay with kids til their early school years. If the child is withholding poo because he likes the sensation, he may develop problems whereby the colon becomes distorted, and pooing then becomes very painful, thus making the whole situation worse - this is a worst case scenario! but sadly very common. My nephew suffered this for years, and my sister studied this topic (encopresis) for her nursing thesis as a result (I proof read the thesis, and also have a son who became encopretic despite all this prior knowledge!).

Your friend may find that the nursery are not sympathetic. I was very lucky that my son's nursery worked with me to change him when he had accidents, and to encourage him to "go" with reward charts and positive messages home. I found that the combination of persistent rewards, lavish praise, laxatives and patience worked in the end. (Maltesers were the most effective, his favourite sweetie, yes I know but it worked!)

The laxative that worked best was called Movicol Pediatric Plain. Great because it breaks up the stool, and makes it comfortable for the poor child to go. Hopefully it won't get to this point for your friend, but if it does get her to insist on the movicol. The other laxatives are either unpleasant or painful (senna - shudders! gave him terrible tummy pain poor child).

Good luck!