My 4 year old will not poo in the toilet - please help!

[mrsm22]

Hi

I have posted a while ago about my 4 year old DS struggling with constipation and received some very helpful advice on here. However, we seem to be struggling again. To give some background, my DS has always been a very picky and difficult eater, and he will only eat very limited meals. For example, he will eat spaghetti bolognese, a jacket potato with cheese, plain boiled rice with gravy, Turkey meatballs in tomato sauce, a beef burger, chips. And those are the only meals he will eat each week, so usually I will make spaghetti bol a couple of times a week. I know those meals aren't bad but it's more breakfast and lunch times which are most difficult. He will not eat cereal or porridge of any kind. His breakfast each day is usually grapefruit and a yoghurt. We all like fresh red or pink grapefruit in our house so luckily he likes that, but I think it ruled be vetter if he'd eat some kind of cereal. Lunch times are hard as he will not eat a sandwich of any kind. He likes plain pasta shapes cooked, a dish of plain rice with gravy, sometimes a bit of cheese and tomato pizza. He loves yoghurts and fruit pots, he will eat apples and strawberries.
Sorry for all that info, but just to give an idea. I don't think his eating is brilliant and I think this may be the reason he suffers so often with constipation. Anyway, a few months ago he was badly badly constipated a do think it was 9 days he went without having a poo. He had awful stomachache and the doctor prescribed Movicol, which has been and still is wonderful for him. He had sachets for a couple of days when he was badly constipated and compacted and it did the trick. The Dr said to wean him slowly off the Movicol, but I haven't quite got there. I have reduced it down and down and he seems ok on half a sachet morning and night or just one full sachet before bed, but any less than that or stopping it completely and he just cannot poo.
I'm not especially concerned about him being on Movicol I it helps him, but the problem is that when he has been a couple of times badly compacted with hard poo that's been hard to pass, he got frightened to let his poo come out because of how much it hurt or how much he thought it would hurt that he stopped going on the toilet. Instead he would stand with his legs crossed trying not to let it out. And obviously eventually it would come out in his pants. I have struggled and struggled trying to get him to sit on the toilet and I try 20 mins after each meal to sit with him on the toilet, which he will do but he pushes and pushes and nothing comes out. Then a little later I'll find he's gone in his pants.
My DS starts school in under two weeks and I made it my aim to try and get this sorted out over the holidays but I am just not winning with DS and he's getting upset over it and I am too. Every day he poo's in his pants, and will not do it in the toilet. I have tried everything, reward charts, bribery, taking to him, treats and the promise of a brand new scooter at the end of this week if he manages to do one poo each day on the toilet. But no.. Been out with him and his younger sibling this afternoon to a park and playground and I could see him stood straining with that look on his face where I know he needs to poo but isn't letting it out. I feel ive tried everything. I am worried that at school he will poo his pants, and I don't know what will happen then. Will school send for me to change him? I obviously don't mind doing that but I wish for his sake that he could go more easily and that he'd sit on the toilet. I don't want him to be the boy at school who smells of poo when he's had an accident.
People say the eating more will come but making his lunch box when he starts school will be difficult.
I am planing a trip to the doctor's with DS this week but I'm not sure what they will suggest. I am wondering if he needs a referral to check his bowels are ok. Does anyone have any useful advice or has anyone got experience of this?
Apologies that this is such a long post and I would be grateful for any advice or shared experience.
Many thanks for reading.

teacher54321 - my main concern is next week when it's his very first day at school on Weds, and just what's going to happen if he needs a poo. I know I need to say something to the teacher but I imagine they'll be really busy Weds morning with all that kids starting, it doesn't seem like it'll be an ideal time to try and have a word with the teacher. They're having a training day monday and tues. It is only 8.55am until 12.30 next week though.

I would call the school on Monday and ask if the teacher could call you back. I would absolutely be happy to call a parent back under those circumstances on an inset day and agree that Wednesday morning would be tricky to try and explain any medical conditions as it'll be pretty hectic! (Am a teacher and my own ds is starting school on Monday-eek!)

also well done him for sitting on the potty!

teacher54321- I thought you might well be a teacher, from the name of course. Good luck for your DS on Monday too! It's a big week for us both then. Is your DS going to be at the same school as you?
As a teacher, is it definitely ok for Mr to call the school on a training day and ask for a call back? I don't want to look like a neurotic mum, but like you've said it'll be too hectic on Weds morning with them all starting to take a teacher on the side. The other thing is that I'm not actually sure who his teacher will be as I don't find out until Weds. At this school, they take 60 children in Reception and its split into two classes with a teacher for each, and I assume teaching assistants or helpers. I know the two teachers if you see what I mean, but we weren't told which teacher our children would be with. Both seem really nice from what I have seen, but there's an Admissions lady who is very involved with Reception and she organises everything. I don't know her proper title but she's like the Head teacher's right arm and my understanding is that she's the person to go to with any issues, so I was going to call next week and ask to speak with her. You're right that monday is probably a better day for me to call just in case she doesn't have time to call me back on tues. Hopefully with teacher training they will get a break of some kind? The lady knows who I am as she showed me and DS around the school and helped him settle in the nursery there. Do I just say that :-
Jack is having a few problems as he suffers quite badly with constipation. He's on medication to make things easier for him to go but we are waiting for a referral from the hospital to go and see someone. Due to being badly constipated he stopped going on the toilet for poo's as he was scared of the pain and we have only recently got him back on the potty when he needs to go, and we need to get him back on the toilet in time, something which the hospital will help us with. I'm a bit concerned in case he does need the toilet at school as he won't have his potty with him and I don't know if he will be brave enough to go on the toilets there. Do I basically ask what they suggest I do? Should I be saying that if anything happens like an accident that I'm happy to come up to school and sort him out?
I feel really daft having to rimg school about it. I hope it's not a big thing.

Just call the school, and say that your son is due to start reception on Wednesday but that he's been having problems with toileting which have become worse recentlyand that he's been referred to a specialist and that you'd like to have a quick word with his class teacher before he starts school so that you both know what to expect and can put a plan together.

That sounds absolutely fine. Our admissions lady was in today (first day of inset) and was fielding calls from concerned parents about all sorts of things, you certainly won't be the first person to have an enquiry before the start of the term. I would call her on Monday and tell her all that you've put down and ask her advice. If it were at my school then the admissions lady would ask the teacher to call you back to reassure you, and hopefully they will be able to make time on Monday or Tuesday. If they can't then just ask politely to pass the message on or maybe email it in so it can be forwarded to the teacher. I wouldn't offer to go in if he has an accident, unless they ask you to. It is very common to have toileting accidents in reception so it won't be the first time by a long shot! Yes I am a teacher at my ds's school, but am not a primary teacher, but a subject specialist who teaches throughout the school. He attended full time nursery there last year so he's familiar with the setting but going into reception feels like a massive step!! I do hope the school are supportive, in my experience reception teachers are usually Angels, I honestly don't know how they do it!

Hope things continue to go well for you!
I have a poo with witholder too and it's a nightmare! He sounds very similar to your ds1 even down to the fussy eating. Ds1 has been on movicol for about 4 months now and we're nowhere near ready to wean it down. I never got to the bottom of why the problem developed but it coincided with the arrival of ds2. We still get lots of skids in pants so the current strategy is to reward clean pants at the end of each successful day. We have definitely made some progress. And as soon as I spot the withholding pose or there are dirty pants I do take him to the toilet and usually get a poo. Unfortunately he doesnt like it if anyone is in the room while he goes!

I am still finding it really hard not to get frustrated with it but are now managing clean pants fairly regularly which is a massive improvement. And we have become very familiar with pooland!

Teacher54321 - I wish you were going to be my DS's teacher! The school you work at sounds lovely and caring. My DS started mornings at the pre school nursery of this school he's starting in Feb but he loved it and actually it was only at the very end of nursery just before he finished for the summer that he had any accudents and it only happened on a couple of days. It's always daunting for any parent when their little one starts school isn't it, but it must be so nice for you and your DS that you'll be at the school, so if anything did happen or he needed you you'd be right there. It must be a nice feeling for your DS to know his mum is around at school somewhere. Right, I shall ring on Monday morning and ask to speak with the admissions lady or ask if it's possible for her to call me before Monday. If I'm told that she won't be able to, I'll ask for an email address and I'll drop her an email on Monday to explain it and ask that she speaks to his class teacher. Is that the right thing to do?
Today hasn't been that good a day, only because I think he's struggling again constipation wise. He's sat on the potty more or less all day and it's come out in drips and drabs but not like on Weds when he did 3 'perfect' poo's on the potty. I guess it's good that he is sitting on the potty. A few times today ive looked at him and seen the face he does when he's trying to withhold or about to do it in his pants and ive quickly put him on the potty. I'm not sure if he forgets. Lots of stained pants today unfortunately, but he is trying. We went to my mum and dad's this morning so we took the potty with us. It was downstairs and he went upstairs to get something and he shouted downstairs to tell me that he needed a poo quick and he came rushing downstairs to sit on the potty but it had just come out in his pants before he made it. So actually yes he did have one good bowel movement but it didn't quite make the potty. There's bound to be accidents along the way, I know.

Cudbywestrangers - Thank you, I don't know if it's going well. A week ago I would never have believed that DS would have got back on the potty to even try for a poo, so yes it must be an improvement but when I see him doing that face and stood in that awkward position with his legs crossed, I know that if I didn't spot him doing that, he'd just either try his best to hold it in or go in his pants. He has come to me a lot today to say he needs a poo and he has sat on the potty but nothing really much has come apart from at my mums this morning. I know exactly what you mean about finding it frustrating, I feel very frustrated about all of this. I know it's something that will take time too and I'm not a very patient person. I'm trying to be and I keep telling him how proud I am of him for trying. He may even have a bit if lazy bowel, which may be why he gets constipated and finds it hard to push poo's out. Today I have been cleaning pants all afternoon just from marks. How old is your DS? And what dosage of Movicol have you got DS on at the moment? Mine is having one sachet morning and one at night time. I don't mean that it's nice, but it's reassuring to hear I'm not the only person who is going through this. It does sound like your DS is making good progress as mine is nowhere near to getting back on the toilet but if I can get him going successfully on the potty each day then that will be brilliant.

He did really well though to tell you that he needed one even though he didn't make the potty on time, that's completely normal on the movicol I hope you have a good weekend and manage to speak to someone helpful at the school on Monday!

teacher54321 - Thank you. I'll post an update next week re school. I hope your DS has a lovely first day at school on Monday and settles in easily. Thanks again for all your advice, you have been really helpful and reassuring.

Well this has brought a lot of memories back!

My ds was very similar , he used to poo behind the couch , in the spare room ..it was a case of hunt the poo down daily.!

OP I'm glad you're getting all this fabulous advice , mumsnet at its best !

My ds is nearly 14 now ..pretty sure he's pooing in the loo now

ps , DS did a poo in his pants in school , 2nd day ..was end of day and school called me in. He only did it the once .

Good luck OP , I'm sure it will go well

ggirl - Thank you for sharing that, it really is good to know others have been through this and come out the other end! I must admit school is my main worry at the moment. I'm ready to ring school on Monday mirhing before he starts on Weds and explain the position but at least I can say he's making progress, he's back on the porty for poo's only and not in his pants... Therefore hopefully in a little time I'll have him back on the loo! You must look back and be so proud you got there with your DS and with only one accident at school, that's great. I really hope it's the same for my DS.

Just an update - this morning DS was up about 7am, had his breakfast then two 'perfect' poo's BOTH on the potty. One at 8am and one about ten mins ago. And he came and told me himself he needed to go. Please may it continue. And it's made me feel much more positive about it having come on here and had such fantastic responses and help!

Best. News. Ever!! You've got 4 more days before school starts-that's amazing!

Things really came to a terrible head for us last year when ds had a tummy bug at nursery school which meant that he had to do a poo, but could only go in a pull up at home. He couldn't articulate his feelings to his teachers so just cried and cried until he had an accident and then of course felt much better. This then gave him massive anxiety whenever he felt that he needed a poo as he had lost control. We had to start giving him baths at really funny times of day as he would only do on in a pull up after his bath. Up to that point we'd had 8 months of pooing in pull ups and I just kept hoping it would improve on its own but it didn't. It took us having a strategy (like you) in order to make things better again.

Teacher54321 - that sounds a lot like my DS, since all the constipation started and the withholding, mine was happier to let it come out in a pull-up. If he was wearing pants and he could obviously hold it no longer or just when he needed to have the poo he would come to me and ask if he could quickly have a pull-up on. He'd so it in pants or a pull-up but I think he preferred the pull-up, maybe because it's less messy. At least you got there and it must be far less of a worry now with starting school. My DS is doing great, I just don't know what to suggest for school. I was speaking to my MIL last night and she used to be a primary school teacher years ago. She said he might train himself to go in the mornings before school and not actually do a poo at school.

Teacher54321 - sorry to bombard you with questions, but DS has now done a 3rd poo successfully in the potty this aft, now my mum has taken him out to choose his scooter as a reward for how well he's doing. But before he went out, DS asked me if he could have his potty at school. Would this be an odd request or can I ask when I ring on Monday?

Your MIL is right-lots of children don't ever poo at school, and train themselves not to-lots of children are desperate when they get home in the afternoon! I think the issue would be disposal and cleaning of the potty in a school environment, so I don't know is the honest answer. I think speak to the teacher/admissions lady and go from there it does sound like you're making such good progress-well done!!

Ah, he's doing really well. As for if they'd let him use a potty at school... you'll have to speak to them. I'm sure they'd rather that than have him soiling himself, but it is a bit much to ask someone to clean out a potty. But you never know unless you ask.

Does he often poo 3+ times a day? Not suggesting there's anything wrong with that, but it makes me inclined to think that he won't be able to hold it in all at school. And that should obviously be discouraged anyway. I'm worried that DD won't want to use the toilets if they are gross and there's water all over the floor (she's picky like that) so I'm going to drum it into her that she must always go when she needs to.

Teacher54321- thanks for getting back to me. It probably won't be an option to take a potty in. The best I can hope for is that the toilets for Reception are small and low and more potty-like than our toilet. You're right, I'll have to see what the Admissions lady has to say and perhaps we will come up with something together. I'm more than happy to go in and change him, but obviously while he's doing so well with the potty I don't want him to have accidents at school because he doesn't want to use the toilet.
I'm still going to ring on Monday, but I'm wondering if anyone will answer the phones on a training day. Hopefully I can speak to someone or even just get the email address of the admissions lady and at least she will read and know my position. It may make it easier for her to come back to me with some ideas.
JinxMonsoon - is your DD due to start school next week as well? Maybe I will try talk to my DS and explain the day before school, so on Tues that he may have to use the toilets at school as they don't have potty's there. There's not really a lot we can do as we won't be there with them in the classroom. Also there will be a lot going on for them and they will be busy, he might even forget to go. No he doesn't normally do 3 poo's a day. It shocked me too, no idea where they have come from today. Normally he has a poo maybe within half an hour of his breakfast and at some point later in the day either after lunch or tea. I'd say twice a day is normal for him. Thursday he didn't manage to go at all so maybe he's made up for that today and yesterday but I'm going to watch and see how many times he goes over the next 3 days and also when he goes, to try get the pattern before school weds. It's a shame I havwbr got him sorted yet before school. I'm really tempted to try get him on the toiket but I don't dare while he's doing so well on the potty.

Just a quick update from the weekend - 3 poo's today all in the potty, not one single accident.

DD starts school tomorrow. Had some tears and worries at bedtime tonight, one being "I don't want to do a poo at school!" She's worried about not being able to wipe properly. I really, really hope this doesn't lead to her withholding and soiling. I've said she can take some toilet wipes in her school bag, but I've no idea where the wipes could be kept for her. Either they get left in the toilet for anyone to use, or they get left in a bag which would require planning on her part - "I need a poo so I'd better fetch my wipes first!" That's never going to happen.

Well done! That's great news

Teacher54321 - Thank you! I'm so proud of him, just hope he keeps it up. I have drafted an email to send to the admissions lady at school if unable to speak to her tomorrow or Tues. In some ways it would be easier to send the email and let her or the teacher come back to me. I know I shouldn't but I feel a bit anxious about making the call. All the best for your DS's first day tomorrow!!
JinkxMonsoon - Wishing you all the best for tomorrow also! I hope your DD has a good first day and no problems toilet-wise. I reckon a lot of children will feel like this about using school toilets. I also bet that not many 4 and 5 years old can actually wipe themselves properly. I spoke to my DS this morning about if he needs to poo at school and he said he will tell the teacher and go to the school toilets, but I know he was just saying that. I havd a feeling my DS will try withholding if he needs to go until he's home from school. I agree about putting wipes in the bag, I don't know about your DD but I don't think my DS would use them or know what to do. I'm not sure he'd attempt to wipe himself at all if he did go to the toilet, but to be honest I'd just be over the moon if he went on the toilet. The wiping clean can come later. You must feel nervous about tomorrow. I'm already nervous and worrying about Weds. Is your DD doing full days straight away?

Teacher54321 and JinkxMonsoon - How did your little one's get on today with their first day at school? I hope it went well for both of you!
I rang school this morning and the admissions lady rang me back within the hour. She said not to worry too much as there are others starting with similar issues and to send spare pants and trousers for his peg. She said he might go to the toilets there when he sees others doing it and also mentioned that they are small children's toilets. I didn't ask if we could take a potty in as I thought that would be a definite no. Two poo's today both in the potty and no accidents. Not cleaning pants all day does feel nice. Still very worried about if he needs to go at school, would be so great if he'd just amaze us all and go to the school toilets. I did have a little chat with him this morning about if he felt ready yet to try sit on our toilet with a foot stool for his feet etc but he said no.