Nearly 3 year old stool withholding and nappy rash please help!

[KirstyP0594]

Hi everyone I’m hoping someone can help, my ds who is non-verbal suspected ASD has been withholding his stools since a short bout of constipation back in early September, took
him to the GP who prescribed lactulose and have referred him to a constipation clinic at the hospital with a 3 month waiting list. We have tried the lactulose to no avail and he is throughout the day clenching his bum cheeks together to stop the poo however each time he does this poo is coming out and due to this being all day every day and the constant dirtiness and wiping he has got a very bad nappy rash (more inside the bum cheeks) that is not getting better due to the constant withholding. We have been prescribed some Canesten cream which has worked a tiny bit we have been using for 4 days now and have been given Laxido and was told by doctor to give him 1 sachet per day which we started yesterday. I think he is becoming exhausted from it now poor thing and it feels like this is never going to end! It is taking 2-3 people currently at home and nursery to change his nappy because he is in so much distress - has anyone been through this and have any advice on how to sort this? I am at my wits end as I just don’t know what else I can do to help him!

For nappy rash sudocrem is great

Hi OP, I've been through constipation and withholding with both my DC. It can take a while to find the treatment that works and often GPs under-treat constipation (e.g. 1 sachet of laxido isn't much tbh) and withholding which just prolongs everything. We got referred to the paediatric continence service in our area and DC needed to take both laxido and senna regularly. The soiling issues won't get better by themselves so you need to pester the GP etc.

The website Eric.org.UK has a lot of useful advice and they also have a telephone helpline, I'd try and give them a call. Also search for "the poo nurses" on YouTube.

There is a simple booklet in PDF form, called Poo Goes to Pooland, that you can print off and read to your son. It's in the form of a simple story, and written to help young children understand toileting. It seems to be quite successful in cases where children retain their poo. It certainly helped my son. Just google Poo Goes To Pooland and you should be able to find it easily.

For the nappy rash the only thing I’ve ever found that works (even for an adult) is the yellow metanium cream.

Dd1 went through a phase of this. We used the yellow nappy cream, beings with a m only thing that worked. We also found that dairy was what had caused the constipation initially, something to consider. We just used to give her plenty of lactose to make it harder to hold in. We also down loaded an app made by the nhs called poo goes home to poo land and bought this book called come out mr poo

www.amazon.co.uk/Come-Out-Mr-Poo-Training-ebook/dp/B072JKGSW6?dplnkId=0e48f20b-8794-4ff6-bb32-90aa5293db2c&nodl=1

Someone kindly recommended them to us on here and over time it worked for us

Good luck op

I can reccomend movicol mummies on facebook to give you some support. And Eric as pp have mentioned. I found the gp was useless. Sudocrem and aveeno was the best creams for us.

I'm sorry you're going through this I found this so stressful with both my eldest two. I'd up the dose so they just can't hold it in so its super soft/loose. Then lots of support around the anxiety of it. We have a lift the flap poo book. When it was really bad for them I'd let them poo in the bath as it helped with the sensations and fear. They both think that's hilarious now but at the time it was like they was in labour I would of done anything to help them.

My middle is 7 and has SEN.We just had to go at his pace no amount of rewards or incentives to go would help so we still sachet him now say once of twice a month if his routine is a bit off. Thankfully he is going on the toilet now as he was only going in pull up pants over night for a while. They do get there in the end but it can be a long road so it's Important to get the right help and support in place early. Really wishing you the best with it all.

Thank you everyone. I am going to try Eric.org.uk and poo nurses, and have requested to join movicol mummies on Facebook. I am unsure how soft the poo will be with just one sachet of Laxido and how long it takes to have any effect, when I spoke with the GP she said I need to be careful not to give him diarrhoea with it as this will make the nappy rash a lot worse. I am planning on giving him a lot of nappy free time tomorrow in hope this can help heal the rash, as he is so terrified of having his bum cleaned even with cotton wool and water which is what we have been using, and when he is holding his poo in he will cross his legs and bend his body over and he looks so petrified it’s heartbreaking. Sudocreme and metanium is what we were using prior to Canesten but due to the constant soiling I think this is the reason nothing has been working. The bath does help when he has built up enough poo as he manages to do some big poos in there but not every day, today there was just a few tiny bits.

Update - woken up this morning to his nappy rash at the worst it has ever been, so so sore for him, done nappy free time all day to try and air it out and ended up calling 111, got out of hours appt this evening and doctor prescribed a different hydrocortisone cream called Nystaform, as well as Dermol 500 lotion to clean it with and also antibiotics as she believed it could possibly be infected. The only trouble is we tried to give him the first dose of the antibiotics via syringe and he chucked it all back up again straight afterwards. It is flucloxacillin and the smell from the bottle is awful no wonder he threw it up! Any advice on how I can get it down him? I am unsure if it can be mixed with anything as that is how I normally have to give medicine to DS as he is so difficult to get medicine into!