4 year old constantly soiling herself, please help!!!

[MrsHelenBee]

This actually refers to my brother-in-law's little girl, but he's not got internet access at the moment to get any advice. My niece is due to be starting school in the next few weeks and no amount of incentives, talking, motivational chat etc seems to help. i know my brother in law is beside himself as he feels it's his fault when his marriage broke down, and that it's a direct result of that. While this might be the case, she took a long time to be clean and dry in the first place, a lot longer than her other cousins, and being reliably clean seemed to be a relatively recent success story. Now she's gone back to square 1. She's very bright and says she doesn't like to make her daddy upset by messing herself, and I know she cries and promises she'll nevr do it again, only for her to break that promise within minutes. Has anyone else gone through this? How did it resolve itself? Any tips would be great.

Has he taken her to the doctors? It depends what kind of poo it is really. And whether there is a lot or a little each time. How long has it gone on for?

I looked after a little boy with impacted constipation which caused him to leak fresh poo around the sides of the impacted poo in his bowel. A child with that problem has no control overthrow bowel movements. If it is something like that then the gp can help. If it doesn't sound like that they shouldprobably still go and see the gp!

To the best of my knowledge, it's usually a smallish amount but enough to make her very smelly indeed, and to ruin her underwear. She goes off somewhere to hide to do it, pretending she's going to play with a toy. It doesn't seem to bother her at all. Having said that, I heard she went through a phase some months back and into last year when she wouldn't go because she was frightened it would hurt. She seemed to get past that, but at 3 she was already fairly late in being clean. I've suggested she gets taken to the doctor but I think my brother in law is too embarrassed to as he feels he's failing as a parent with her. He thinks that fact that he and his wife have been apart since early last year is the problem and that a reconciliation is what she needs.

Agree with unlurked there can be many reason for soiling most of which she would have no control over, so all the bribery in the world won't make a difference.

My dd was constipated to the point of soiling and it is a long SLOW slog to get to a place where bowel control is fully returned see the GP asap. Have a chat with the teachers at school and sxplain the problem, say you are seeking medical opinion. Make sure she has planty of spare pants in her school pE bag in case of accidents. (and maybe some nappy bags to bring the soiled clothes home).

Have a look at the ERIC website here to see if anything rings a bell. Soiling and or constipation are aurprisingly common in children but very few people talk about it.

DS started school last year at 4.5 still having poo accidents. There was nothing I could do so I told the teacher who was fine that he could start and they would clean him up. It only took 3 weeks and he stopped so maybe the embarrassment of soiling himself at school helped.

He looking for reconcillation on the basis of her soiling but doesn't want to go to the GP?

He needs to put his dd first and ignore hios own issues of embrassment. DD started soiling at 4 she has been seen by GP, poo nurse (continence specialist but her name for him) consultant etc.

He needs to stop self diagnosing and get her some help.

It seems to have been a problem for 3-4 wks now. The fact that she dd it the other day - 3 times in as many hours - would suggest that she's never totally emptying her bowels. she doesn't complain of discomfort or pain, or a tummy ache but when you sit her on the loo she insists she doesn't need to go and bursts into tears.
Perhaps I should add that she's also being beligerant overall and is defying both parents when it comes to the boundaries set for her. However, I think this issue is one that's causing considerable upset for all concerned, especially with her about to start at school.

I think all you can do then is jeep reassuring him that it is very common and it isn't something he has caused. Even if she is soiling as a reaction to her parents break up it can be dealt with. These things often take a long time to resolve but once you know what the problem is it makes the dirty pants much easier to deal with!

DorisIsWaiting - he always puts her first, from what I've seen he's a doting daddy and would do anything for her but he's battling with depression at the moment and the constant blaming of her misbehaviour on him is just another reason for him to doubt himself. He's only really talked to his brother about it in the last few days. He only has his DD for 2 nights a week so I think it's pretty difficult. He is being told that her behaviour overall (this problenm included) would be much better if he was with her mum, and I think he's been worried a GP will criticise and blame him too - difficult to take at the best of times but very hard when you're extremely low and suffering with anxiety and stress issues already.

Thanks unlurked. He doesn't know me very well as we live quite a long way apart, and I only have a 1yr old son so it's not something I've had personal experience of at home. However, he seemed to find it easier to talk when I said I'd dealt with it a lot at school (I'm a primary teacher). I assured him that I've seen a lot of cases, and the vast majority have been down to medical reasons which, as you say, makes it easier to stay sane with. I also suggested that it could have a connection to the separation, but that even if that was the case, the GP may be able to help with some support for parents and their DD in the form of advice, counselling etc.

My son had big problems with pooing when he was three, he'd hold it in for days and days, and when it had to come out he'd scream and clench his bum, saying he was scared it would hurt - of course it did hurt because it was so big. We tried everything, star chart, rewards, saying nothing when he messed his pants etc, and the only thing that worked was a little book called "Poo Goes To Pooland". It's a really sweet and completely barking little book you can download and read, and it helps the child realise that the poo has to go into the toilet etc etc.

You can download it here, I really hope it helps your niece.

Thanks everyone, good to know he's not alone by any stretch of the imagination, and thanks for the advice. I'll look on the ERIC link, and suggest my b-i-l have a look at the book CatPower. Thanks so much!!!

Sorry if I came across harshly.

It sounds like the GP would be good for both of them. If he only has her 2 days a week I can see the difficult but he and his partner need to work together (easier said than done I know).

No experience with soiling, sorry, but I just wanted to second the Pooland story, as it solved my son's fear of pooing on the potty/toilet literally overnight. I don't know how or why it works but it does! I hope it makes a difference for this little girl but it does sound as if a chat to her GP would be beneficial as well.

She needs to see the house, if only to rule constipation out. It does however sound like constipation to me though, my dd2 suffers terribly from it and the soiling is beyond her control emotional blackmail and promises, reward charts do not work in this situation. We clean up, remind her that poo goes in the toilet and move on.

*Needs to see gp (not house - stupid phone)

Thanks everyone. I've found the book, just wondering if I could use the idea to create a girl's version for her but certainly worth him trying the book out with her - not like it's going to make the situation worse! And I'm grateful so many have seconded the GP, I think they'd be able to give better advice but, perhaps more importantly, reassure him that it's not his fault.

I'm hoping my husband and I can peruade him that he could do with seeing the GP for himself too. Both of us have been worried about him (although he seems to find a way to keep it together in front of his DD).

LoonyRationalist - I did laugh (thought I was the only one who made nonsense messages, predictive text is my downfall).

DorisIsWaiting - thanks, just worried I might have painted a misleading picture of him, which would mortify me. He's a lovely Daddy, lovely with my little one too, and he'd do anything for his DD, just think he's struggling now and could do with some reassurance and positive suggestions, so the help is much appreciated.

Another one recommending gp for referral to continence clinic.

Ds1 has had issues with impaction, and the longer you leave it, the longer it takes to resolve.

Treatment is v simple - oral syrup usually (so that it both softens the impacted stool and makes it more difficult to withold) and introduction of a toileting routine.

Anxiety does sound like it could be playing a part though. He is more likely to be seen as a caring parent if he gets gp support for a medical problem, than if he ignores it and it gets worse, btw.

There are gazillions of threads on here about impaction, or encopresis, by the way. Have a search. V common, but no one talks about it in rl. Ridiculous.