Friend’s child 11, soiling themselves

[BroadbeanPesto]

My friend has a troubled child (11) who regularly soils themselves, wees and poos. There is no obvious physical issue. The child appears to be quite normal and is extremely capable in some areas - athletically and in STEM activities at school. No autism diagnosis but the child has anxiety problems. My friend has mentioned that DC is prone to self harm, but I’m not sure what type exactly. DC is also extremely picky with food. My friend recently broke up with her partner - the child’s father, moved countries and has now come back as the move didn’t work out financially. She’s a concerned mother and the younger child is very well adjusted and doesn’t seem to have sibling’s issues.

My main problem is, they have been coming around to our house and the troubled child smells terrible because of the soiling issue. It’s so bad it makes me gag when they get too close, so it must be awful for my children and anyone in class at school with them. I know that my friend is trying to help her child but she is at a loss and I’m not sure the health system in our country (not UK) is reacting with enough urgency. Regardless of what’s behind this, if this were my child I would not be at people’s houses with DC smelling like this and would immediately get them to shower/change every time it happened. If out and about I would have the car full of spare clothes and wipes. She must be able to smell it too as it’s very strong. I’m not worried about my house smelling but I am worried about the effect on everyone, especially the other children, being forced to hold their noses and pretend this isn’t happening. They were at our house for 3 hours recently and the smell was there the whole time - the mother did nothing about it. My children were very kind and I talked to them later to commend them for this but I know it’s disturbing for them. There have also been incidents at other people’s houses and I have spoken to another close friend about how she thinks we should deal with this. She’s also unsure. I don’t know how to bring it up with the mother as I know she is very troubled by the problems with her DC and that she has been trying to get help for him. I don’t want her to feel they are not welcome at our house as I know she needs as much support as she can get right now, and in every other way we enjoy their company. Maybe a mental health professional has advised her to ignore the self soiling? Could this be strategic? What is the best way to support this family in my position without offending them, but still helping the mother and DC understand that it is not socially acceptable to expect others to tolerate the smell of faeces and urine in their environs for extended periods of time? No matter what the reason or situation? Or should I just keep quiet and be kind while she figures this out with DC and medical people? It has been going on for a few years now.

I don't really understand what's happening when she's at your house? Is this a smell caused by not washing properly or has the child actually soiled themselves at your house? Three hours is a long time to sit in your own faeces so I highly doubt a medical professional has advised.to ignore.
Could she have become nose blind to the smell and is unaware when said child soils? Could she be embarrassed ( although if that were the case I would leave). Perhaps offer a private space to get cleaned up? Just say in passing 'if dc needs to get changed he/she is welcome to use x room'. And move the conversation along. Minimal fuss.
I do feel a few tears down the line that the is an issue which should be showing signs of resolution. Or at least coping mechanisms. Are you dc in school with them? What happens there?

Her DC used to be in a class with my DC. My DC just told me that the classroom used to ‘smell bad’ and everyone knew it was because of this child. Now they’ve moved to a different class and that class smells bad according to my DC. The smell is like a very strong urine smell and possibly faeces, though I don’t know for sure. My other friend had a faeces incident with this child one time in her car. I didn’t get all the details. It seems this child randomly wees themselves and possibly also poos. This is something my friend has mentioned before about her DC but I thought at the time it was a bed wetting issue. I’ve only recently become aware that it’s a daytime thing too. One time I thought our dog had weed in the house so I loudly exclaimed ‘oh no it smells like wees down here, has the dog done a wee?’ My kids looked really uncomfortable and told me later it’s the DC and I shouldn’t do that. I felt terrible but I had no idea till then how bad the situation had become. I don’t understand why the school haven’t done anything in all this time. The other students must have really been suffering. Should I approach the school even though the child is no longer in my DCs class?.

I'm fairly certain school wouldn't ignore a situation like that. I don't think you speaking to school would have much impact as they wouldn't be able to divulge any information anyway.
One of my dc was a bed wetter, well into secondary school. No matter what I did, his bedroom always had an odour, but I was fastidious in keeping him and his clothes clean, both for personal hygeine/self esteem issues and because let's face it, no one else wants to smell it.
At 11 your friends dc is going to start to hit puberty and become far more aware themselves of the issues going on and how they are perceived by others etc so that may impact the personal hygiene element.
If all medical care is indeed in place, then I'm really not sure what you can do. Minimise time at your house by planning to meet elsewhere? Parks etc? It would also depend for me how close you are to your friend. Some friends I would be open with and yet others I would find it more difficult. Have you been to their house, just out of curiosity?

The web says the most likely reason for wetting and soiling is constipation (when poo gets hard and liquid stuff comes out round it, or it hurts to poo so the child withholds it). A UTI is also a possible cause of daytime wetting, again due to holding because of pain.

In terms of non-physical causes, ADHD was mentioned.

Whatever the reason, this has gone on for long enough to warrant a visit to the doctor. I can't remember if you said there was a problem with that due to where you live, but I would have an honest chat with your friend and ask her if she's discussed it with a paediatrician. Part of me would want to chat to the child himself, with my DC there, in case it's something he won't open up about with his mum.

Very unlikely and dark, but he couldn't have suffered abuse could he? Physical damage can cause problems.

I don't think posters should be giving personal stories about their own children on this topic to be honest.

Sorry my memory is crap. She has sought medical help I see. I would just be honest but make her understand they are both still welcome, and not to be worried about talking.

Is the child incontinent and using incontinence products? Perhaps they are embarrassed to admit (by they I mean either the parent or the child) to this and don’t know how to where to change pads?

@HappySummerDayswhy not? It's an anonymous forum and often advice comes from experience?

Has the child always been incontinent? Or did it develop gradually or suddenly?

I don’t understand the smell situation. A child in a nappy doesn’t smell once properly changed. A potty training child having accidents doesn’t smell once it’s dealt with.
Is the child not being cleaned and given fresh clothes?

Some children let themselves become dirty as a defensive response to sexual abuse so, from what you've written, this is a safeguarding concern.

Thank you for your responses. I guess I was mostly wondering if there is any therapeutic scenario in which the adults - drs, counsellors, teachers, would be advising this mother to ‘ignore’ the smell ‘ - maybe to try to get DC to go to the toilet more, develop more self awareness etc. I mean, it’s not working clearly but… I am no expert. The mother has sought medical help for DC. I don’t know detail and wouldn’t write about it here anyway. But yes - I guess I was also wondering if DC is using incontinence pads properly, even then, would there be this terrible smell? I’m wondering if all the adults are just unsure so passing the buck. If this were my DC or if I were a professional at the school I would be making the smell my number one focus - whilst of course also dealing with underlying issues. If the adults are passing the buck, is there anything I could or even should do to help this DC? Or is the best I can do to offer my house as a safe place to play for a bit and say nothing, as I’ve been doing?

You sound like a wonderful friend to be so patient. And it's lovely you want to offer a safe space... however how safe it it for you, for your children or the other kids in school to be breathing in this for hours at a time? I spend time with a loved one in care home, the smell when someone has gone for a no. 2 while wearing a pad is awful. To answer your question, once changed, there is little to no smell. Sounds like your friends child isn't wiping/being wiped properly.

@ShesTheAlbatross yes I think that’s my question too… why is the child not being given clean clothes and taken to clean themselves? At school by teachers, and when mother is present by mum? She is a friend but not a very close friend even though I’ve known her for some time. For some reason I just don’t feel able to talk to the mother about this. She’s very defensive and I don’t want to make her feel unwelcome in my house. Partly because I care about her DCs, as we’ve all been in the same circles for a long time. They are sweet kids and I want to offer support to them if I can.

TW

@BroadbeanPesto
Maybe a mental health professional has advised her to ignore the self soiling? Could this be strategic? What is the best way to support this family in my position without offending them, but still helping the mother and DC understand that it is not socially acceptable to expect others to tolerate the smell of faeces and urine in their environs for extended periods of time? No matter what the reason or situation?

There's a LOT of reasons a child might be soiling, and I'd put poor hygiene at, maybe, fourth on the list. If they have seen a mental health professional, rather than a paediatrician, the most likely cause is CSA. They will both be well aware of what is socially acceptable, and your sneering and wish to keep a distance is the whole intention.

why is the child not being given clean clothes and taken to clean themselves?

You assume they aren't. You assume that, given the education on right and wrong, and the supplies to make the right decision, this child will want to be clean and attractive... I've worked with children who have changed into soiled clothes at school. There is nothing you can do to force that child to not be smelly if they don't want to.

I’ve worked with children for 13 years. I’ve only come across this behaviour in children twice and in both cases the child was being sexually abused.

@CAMHSDoctor I assume CSA means child sexual abuse given the TW.

Forgive me for being both dense and interested but why would that mean both the mother and child want people to sneer and keep their distance - shame? Or fear of being discovered?

It varies, but two common themes are, nobody is going to touch you if you are dirty, or generally being disgusting because you feel disgusting.

I don't think the op has said the mother wants this for their child, have they?

If it is a case of SA then the mother may not realise. Or she may not know how to deal with it.

I still think this ought to be treated as a safeguarding concern, and if the school hasn't reported it as indicative of SA then someone ought to.

It sounds like from what you've said, there isn't a lot you can do in this situation unfortunately. I know what you're saying is you want to help DC in some way but it's very personal and you're going to risk your relationship with this family unless you can have a very careful conversation with the mum and she's willing to open up about it. Only then might you have some influence.

If you do have a conversation with the mum, I'd ask her if DC has been referred to a continence service and considered medication for it. If she brushes this over then you kind of know, this isn't up for discussion. If she opens up about it, then you can find out what is going on there but it's going to be sensitive. You could direct her to the ERIC website but just be careful not to teacher her to suck eggs - she may well have been there and done that.

It's hard to know the exact cause but it's most likely caused by constipation as other poster has mentioned. The wetting can be a symptom of constipation too or linked to ADHD. The DC may be wearing hygiene products but that won't stop the smell. Really DC needs support through medication and good habits ideally through a child continence service. The mum needs to step up on giving DC laxatives and keeping the colon cleared out this as prolonged constipation can cause lasting problems (e.g. stretched colon) which can take months to sort out and just exacerbates the problem.

To add, I don't think this is a SA situation but of course you never know. I believe it is most likely a result of constipation and innatentive ADHD...she'll never sort this without the right dose of laxatives, too little a dose will make the situation worse.

We had a situation at my old school where a pupil clearly had a problem. It went on for about 3 yrs before the parents finally agreed that a nurse could speak to the pupil.

It turned out to be spurious diarrhoea caused by faecal impaction.

Yes - I've also been aware of one case of this at my former place of work.

95% of the time it’s severe constipation with faecal impaction and overflow diarrhoea. www.eric.org.uk

I'd keep out of it personally. She is getting help from medical professionals and these things can take time, especially if any waiting lists are involved.

My son is bowel incontinent due to a physical issue. He is showered daily and changed as soon as he has an accident but his faeces are always going to be on the more unpleasant side which means that the smell is too and sometimes the smell lingers no matter how hygienic you are.

@CAMHSDoctor I am not sneering at all. I have stated that I categorically do not want to keep my distance, that I’m not worried about my house smelling and that my intention in posting is out of concern that this situation has been ongoing and that the child will suffer social isolation because of this if nothing is done urgently, especially as puberty beckons. Not because of me but because it is difficult to be in their presence without feeling very uncomfortable for most people. Would you like to sit in a room all day, trying to concentrate on your school work, if the room smells strongly of urine and faeces? Whilst of course the cause for this DC matters, I do not wish to speculate about it too much. The reason I know the child’s hygiene is not being dealt with is that during the 3 hours they were at my house with the mother present, smelling so strongly that I was finding it difficult not to involuntarily dry wretch when the child came near me, the mother took no steps to help her child to remove the smell. And my DC has now told me that for multiple years, entire classrooms have been known in the school for being ‘smelly’ when the child is present. I was not aware of this until I asked my DC about how things are at school with this DC.

I am posting because I am at a loss as to why this might be, and I am happy to support them and keep quiet if this is what a health professional might have recommended. It just seems odd that this would be so, especially for such an extended period of time. My intention is to seek advice here in case there is something that I might be able to do that might help this DC and their mother, as I care about them and wish to be a good friend.