Poo with-holding - what best to do to help things along?

[2mummies]

Hello oh wealth of mumsnetty wisdom, I'm looking for your thoughts/experiences/advice on this... Please accept my apologies for the length of this, I really must learn to condense! But it is late and I'm a bit dopey with period pain. I hope you'll have the patience for my post.

We have recently potty trained our daughter (who will be 3 in September), it went surprisingly well to start with, and she's still very good about wees, and will happily do them in any toilet or potty, and only had a couple of tiny accidents. Poos started well too, a little slower than the wees, but we had at least 8-10 in the potty/loo.

Then one evening, she did a wee on her bedroom floor. There was no need for this really, as her potty was in her room and the toilet is no distance away. We did the usual thing, no telling off, just a firm reminder that it should have gone in the potty or loo. She giggled and helped clear it up.

A few minutes later, she came into the lounge beaming "I done two poo poos!" indeed she had, on her bedroom floor. To be fair, we were pretty annoyed, especially as she seemed to know it was naughty, but she was proud of her cheekiness of doing it on the bedroom floor. It was quite unlike her as she doesn't like mess really, and clearly had a good understanding of where wees and poos should go (as I said, she'd been doing so well). We did tell her off a bit, whilst telling her it was very good that she did a poo, but it must go in the potty/toilet next time, but she giggled and answered back in that special cheeky little madam way, so she was told off a little more until things sunk in a bit.

It was by no means a severe telling off, but she's pretty sensitive to our emotions, and I think she knew that we were quite fed up about it. Of course accidents happen, but this did seem quite deliberate. It seems she must have been pretty upset about it though as since then, she's been with-holding. She went 3 days without pooing, her tummy got really hard and she was saying she needed a poo but every time she sat on the loo or potty she wouldn't stay there, as if suddenly remembering that poo coming out could be a bad thing.

She got herself in to quite a state, couldn't concentrate, couldn't sit down, couldn't stay still, and crying out in discomfort. Also not keen to eat or drink. We told her what was happening and that to help her tummy she just needed to do a poo, said and did all the most encouraging things possible. When she finally went it was obvious that it was very painful. But after a couple of big ones (in nappy by the way, we had to put her back in them to help her to try to go - she would still take it off for wees tho), she was a completely different girl, happy and comfortable again.

This same process of 3 days with-holding has happened twice now, with big painful poos each time. So an understandably vicious circle. She doesn't want to go if she knows it's going to hurt, even tho we've tried encouraging her in every way we can think of (including not mentioning it). We are now on to our fourth day without a poo this time. She's cranky and uncomfortable (on and off, but getting increasingly worse), and she hates the worry and discomfort of it all. We desperately don't want it to become 'a thing', as these things so easily can, especially in her busy little mind.

She's also getting soiling/seepage, not much, but a little now and again, which I know means she must be pretty impacted. After all she used to go twice a day lost of the time. I don't like the sound of lactulose from what I've read so far, and am thinking more of trying movicol or a glycerin suppository. We want to be able, if possible, to nip this in the bud, and just ease things along until pooing is no longer bad in her head, which would hopefully just take a few days of regular comfortable poos...

Having read around the subject on here I am concerned at how many children have to have long term constipation treatments. It seems that it doesn't cause long term damage or anything, but it's almost more difficult on us as parents, as we always feel bad in some way at having to rely on anything to help our children, despite how lucky we are to be able to do that thanks to living in a developed country with free/cheap healthcare (at the moment!) But even experiencing this for a week and a half makes me feel so bad for those of you dealing with it long term.

So I know this isn't a major problem, and that it is very common, but we would do appreciate your help for our particular situation, in the hope it will help before things get worse, and hopefully help others in the same position too.

Many many thanks in advance.

Movicol is the way to go!

My DS (now 4 and a half) has had constipation from the day he was weaned, the longest he has been without a poo is 16 days. We started with the odd glycerin suppository to get things moving, were then prescribed lactulose and eventually movicol. We can adjust the dose to get the desired result but have discovered that if we think he doesn't need it any more he very quickly gets impacted again (hence the 16 day slog at easter.) Our GP has told us he may need it for years yet and may never be able to do without it. I can't help thinking if we'd had the movicol at the begining it might not be so bad now.

Potty training has been a total nightmare, he has been dry for over a year during the day but soils regularly. If he soils his pants he'll then wet himself because he doesn't want anyone to know he's soiled. In his life he has done 12 poos in the potty or loo.

He is due to start school in September and I've met with the head to discuss his problem and we have a toiletting plan that we are following to try to get him to go in the toilet, it's slow progress but he has managed it twice since April.

OP I would urge you to see the GP with your DD to get it sorted sooner rather than later to save yourself from more difficulties. The sooner you get some treatment hopefully the quicker it will be resolved for you. Good luck!

2mummies - I feel for you as we went through something similar with our DD1, but without the "accident" on the floor and telling off incident.

How about just offering your DD the nappy every time she needs to go and reassuring her that it's OK to use the nappy for poos?

It may make sense if I tell you our story:
DD1 started off extremely well when potty training, just like you, no accidents whatsoever. But the poo "thing" soon became an issue. A few days into potty training she would start withholding to the point that she would be screaming and shaking in discomfort. We couldn't bear seeing her like that and understood straightaway that we had to find a solution which suited her and not cause her more distress. The solution for her was to do No2s in the nappy, so whenever she needed to go, she would ask for a nappy and once she finished the knickers would go back on. We initially thought this would be our routine for a few weeks max, but it eventually turned out to be almost a year from the day that she was potty-trained for wee-wees. During that year we would sometimes give her the choice/remind her to use the toilet, but she always said no and we never pressured her. She started nursery where, luckily, they didn't mind her being this way, mind you she never once did a poo whilst in nursery, as she always felt most comfortable doing it at home.

We tried the suppository once right at the beginning, but she was freaking out and screamed the house down saying it hurt. Although i'm sure it didn't, but it was a strange feeling for her and she was afraid of the unknown (she's always been like that with pain or uncomfortable feelings). So, again, in order that we do not leave a lasting effect, we never tried suppositories ever again, as we knew that even the sheer sight of one would freak her out.

In the end, I'm glad we decided to let her go at her own pace and not risk causing her any physical or psychological damage. She was nearly four when one day she asked to go on the toilet to do a poo all by herself and boy did we make a fuss when she did - you should have seen her little face beaming with proud! We never looked back since then.

What i'm trying to say is that knowing my child, going down the medicinal route wouldn't have worked for us and I fear that the same thing would have happened to us what Cersei describes above, pain and more pain. However, it may have taken us a much longer time but with lots of patience and perseverance we got there in the end and most importantly she was oblivious to the fact that this was out of the ordinary.

Sorry for the long story, hope it helps and not hinders your situation.

Thank you both so much for your replies and advice, and for sharing your stories.

We have been putting a nappy on her when she asks for it, and any poos she has done since the upset have been in her nappy or pull-ups.

She finally did a big poo today, after being in a terribly agitated state for a good hour beforehand. And she cried with such heart-breaking force as she did the poo, it's so hard to see her go through that. Like your daughter she does get very worked up when anything is wrong with her. I can see how the suppository could easily make the situation worse, and as my partner said, they're really only for last resort.

She still needs to go again though, and even after every encouragement, (whoops of joy when she did the poo, cuddles, present, sticker reward chart, explanation that the poo makes the hurty tummy go away, etc etc), she still seems pretty terrified of doing it.

It feels so horrible that we may have caused all of this upset in her, when she was doing do well.

We did buy some Movicol today, and have given her one sachet, as want to help things along to make it easier for her, in the hope that maybe if she just does a couple of easy poos, she'll forget about the traumatic ones and get back to normal. We're very worried about getting on the slippery slope tho (for want of a better expression!!) as of course want to try to avoid what seems to be the case for so many children, that they have to have their bowels helped for years.

We're trying to improve her diet, which has mostly been fairly good, as she loves fruit, but she has been off it a bit recently, so trying to encourage it more again now, as well as the veg and other fibrous stuff. Also, trying to make sure she has more to drink than usual. But really it seems it's likely that it's more of a mental thing for her than physical, which of course can sometimes be harder to fix.

I wondered if anyone has any experience of using Movicol just for short periods of difficulty? Most instances I've read about seem to talk of months or years.

Again, thank you for your help so far :)

I'm no expert but I really don't think you're entirely responsible for her behaving like this!! I also don't think you mildly telling her off triggered this reaction, it would have surfaced sooner or later. After reading about the subject extensively and talking to people about it, I do believe that some children are just simply mentally not ready for dealing with the poo issue for whatever reason (it's dirty, it's a large something leaving their body, an earlier accident in the bath, etc). All you can do is give them time and space and not make an issue out of the situation and establish a routine which makes them feel comfortable - in our case, it was resorting back to nappies, the only "method" she was familiar with in her life up to that point.

In retrospect, I found it quite handy that we didn't have to use dirty public toilets for another year (I have a mild case of OCD), plus she almost always waited until we got home or was in a "safe/familiar" place, which was also very handy.

Hope you'll find a suitable solution, too!

I'm no expert as my DS didn't progress to real withholding but we had the same issue in terms of starting potty training well with no accidents then sudden and total refusal to use the potty / toilet for poos.

In our case I couldn't find any trigger for the change and DS1 couldn't explain the problem - it may be that it would have happened with your DD anyway so please don't blame yourself.

I wasn't sure what to do but after a couple of weeks we ended up going back to nappies for poos. I was quite reluctant but with hindsight it was not a disaster and once DS1 relaxed again he got into a fairly predictable routine - nearly always at home as another poster said. I just told him we would put a nappy on when he needed a poo and reassured him that there would be no fuss or questions and I didn't push the issue at all for a few months.

Getting him back to using the potty for poos did take a while (basically had to start by using the potty with nappy on and progress from there) but he just seemed more comfortable with it by that stage. He was fine with wees the whole way through and never had an accident so giving him a nappy when required didn't set him back as I originally feared.

It does sound like you might need some help from the GP to get over the initial constipation though - good luck.

Get hold of a copy of 'ollie helps poo go home to pooland'. you can get it from your HV or download it. Read it twice a day, do not talk or pressure about poo. Let it work. It has a 95% sucess rate, it cured my witholder in three months after 2 years of holding. Not only that it fully toilet trained him with no potty, straight to toilet.

My DS went up to 6 days regularly, but had no constipation.

We had something similar. A friend recommended introducing the poo poo monster. He lives in the toilet and is very sad if he doesn't get your poo poo.

Now, to be honest, I was very very sceptical about this and was worried it would put him off the toilet for life, but a small child's love for the disgusting won out and he was very happy to feed the poo poo monster from then on.

I am still amazed it worked but though you might like to hear the story!

here

but i got a better drawn copy from Hv, who also said they did not like using laxatives if they could help it. There are long term health issues with using laxatives, poo holding is mostly emotional.

Another one who has been there! I posted something very similar last, got lots of really helpful info, i'll see if I can find my thread.

If DS did a poo every three days, I'd be delighted. One, maybe twice a week is about his average. In the 36-48 he's before he goes ( with much fuss) he is very grumpy, short tempered, won't eat, can't sleep etc. Christmas Day was day 9 of withholding, and was completely ruining by him screaming in pain, v bad behaviour and my frustration and anger that he would not have a poo.

I agree that withholding is has an emotional root, although it obviously has a physical result.

Another MNer pointed me in the direction of a book called something like "Withholding, constipation, your child and you" on Amazon, which I found very helpful as a parent. We also have "It hurts when I poop" which DS can relate to. We still read that and "Poo Goes Home.to Pooland" when DS needs reminding to go. I am out and about on phone at the mo, but can do links later if you are interested..