2 yr old Witholding Poo and Daily Laxative Cycle - a living hell!

[Emmiejenkins]

My question: How can I persuade my 2 year old to poo sitting down?

The background:
My 2 (and a half) year old son:

• has a milk and soya intolerance
• is on a mix of 2 sachets of laxido and 7.5 mg of picosulphate every day
• still becomes impacted regularly due to an enlarged rectum
• struggles to get to sleep due to needing a poo
• is still withholding poo and openly tells me he hates pooing

After 3 months of new medication and diet, the specialist has now told me that we now need to concentrate on the psychological aspects of this problem, and that as soon as my DS realises it is easier to poo sitting down, things will get easier!

The issue:
Understandably, my DS does NOT want to poo ever. He will only go outside in the garden and will often hide behind trees to let everything out. He is absolutely terrified. He'll happily sit on the toilet for ages but I can see that he's actively still holding his poo in. He even wriggles around to keep it from coming out.

What he needs:

• to be sat down when he poos so that he can experience it as pain-free (to break the belief system he has in his mind)
• to have his knees above his hips to make it extra-easy (unfortunately, I can only create this position for him when he's on the toilet)

What I've already done to try and help

• Bought all of the books under the sun about pooing
• Bought numerous potties which are now discarded, as I'm unable to get his knees high enough when he uses them
• Bought a special high ladder/ stool so that when he sits on the toilet, his knees are positioned higher than his hips
• Bought a comfortable toilet seat
• Sat with him on the toilet for 10 minutes after every meal
• Bought stickers, new toys, privacy walls - I've been through variations of everything to try and create an environment where he feels safe to poo
• Used screen time and chocolate as bait - to no avail

I'm at my wits end. Does anyone have ANY advice AT ALL about how to explain to a 2 year old that if they just crouch when pooing/ sit down when pooing it is easier?

Thank so much!

Yeah you can’t

I’m an adult and due to ibs I sometimes have pain when I poo.

your doctor might say that knees high is the easiest position but in my experience you need to find the least painful position for you and it’s not necessarily the one the doctor thinks.

Okay, I don't think my original message has been understood. We have been told by a specialist to sit him on the toilet (he keeps his nappy on), in order to train him to poo when sat down to break the belief system he has about pooing being painful.

I'm not trying to toilet/ potty train him. I'm simply trying to teach his body to poo in a crouched position but he is too scared to do even that (even with a nappy on and wrapped in a 'safety duvet').

He DOES poo in his nappy at least once a day but only because of the use of laxatives.

I presume he’s on enough laxatives for his poo to always be soft? If not, he needs to be. Have you tried blowing bubbles when on the toilet? It’s hard to withhold poo whilst blowing bubbles. I presume you’re already very familiar with www.eric.org.uk Then a slightly left field thought, but is there anything else to suggest neurodiversity? The vast majority of children I’ve encountered who hated the sensation of passing even soft poo turned out to have ASD, so just something to keep in mind.

He’s only little though OP. If he’s pooing regularly albeit in the nappy, I’d accept that at this point, and ease off the pressure. He only needs a few poos that don’t hurt to swing him to another way of thinking. 🤞

Otherwise, have you done disimpactions? I’d up the dose of the Movicol and blowing balloons worked (eventually) for my DC, as they need more puff than bubbles.
if you’ve read all the books, (including Witholding: What to do when your child won’t poo) it’s likely you already know this, but if he’s been withholding a long time, it’ll take you that much time again at least to get on top of it.
💐 as I know what it’s like. My DC was a pro witholder for 5 years. It was horrific.

FB group Movicol Mummies & the ERIC website are great resources.

I'm not really sure you can do much psychology on a 2 year old for this. The laxatives are there to make him go, so if he is still withholding, you probably need to update the dose. You and the doctor also need to understand that 3 months is nothing and he may need to be on the laxatives for years. The aim is for it to become routine to not hurt and eventually he understands that. Not fun as a parent I know!

Try putting a potty with a step in front of it behind the trees as a first step.

DD withheld and only stopped in her first term of reception. She’d only go in a nappy standing up until then. I just had to make sure she had enough meds to keep her regular until then although it was painful to watch her trying to go/not go.

Sometimes time really is the only answer sadly.

Is there any reason you're not wanting to potty train yet? If he's wearing a nappy he might not get the urge to squat. I've been through this with my youngest. He has problems with pooing even now at age 8. For him I think it's psychological rather than physical and he is now suspected ASD.

I don't really understand why it's important for him to poo sitting down if he isn't potty training.

It's pretty common for toddlers to resist sitting down to poo: both of mine always stood to poo in a nappy and were using nappies to poo (standing) for a good while after they were potty trained. It feels different sitting down!

Isn't the priority to get him comfortable with pooing- in any position he likes, as long as he's not withholding? Can you not wait and tackle the sitting down once you have a better handle on the withholding?

My child aged 3½ has just started poops on the toilet in the last week.
Used to ask for a nappy on and disappeared off to do a poop before.
I was getting worried but kindergarten teacher said best to leave it with no pressure and children will usually come round to sitting on the toilet by themselves.

Is it better Long term to just let your child use a nappy for now? He's only 2. If you're worried about school, first of all, it's ages away and secondly, if he only poops in a nappy then he won't poop at school anyway.

Why the rush? (Genuine question, not sarcasm)

Going just on your message, you sound really controlling and scary, I can only imagine it feels worse for a kid. Leave them alone to poop when and where they want, back off. Only 2 for heavens sake.

Thanks so much for all for your input! This is all helpful stuff. I really appreciate it.

To answer some of the questions:

• yes we've tried bubble blowing but it's not seeming to work, unfortunately :(

• the specialist told us they'd checked for indicators of neurodiversity and had ruled that out (but I did wonder about it!)

• yes we do regular disimpactions because of he has a stretched bowel.

• he's been on a mix of laxatives since being 6 months old, so the mix we have now has been finely honed! Haha. If we give him more laxido his poos become too watery, if we give him more picosulphate he has tummy cramps at night. We've been told to aim for smooth, sausage-like poos which we are finally getting.

Lots of people asking why there's a rush (which I understand). There's a rush because a specialist pediatric gastroenterologist has told us we really need to crack this in order to help him in the long term. We are in a perfect spot with diet and medication, but because he'll only poo in certain places and sometimes doesn't let go of it all at once, he's still slowly creating a back up of poo in his rectum throughout the month.
The aim is to get past the point where we have to disimpact him so regularly, and allow his rectum to heal (it's saggy at the moment). I truly don't care about potty training right now, that's not what this is about.

To the person who says I sound scary and controlling - you clearly haven't been through this, and that's okay. It honestly rules every part of your life. It affects his diet, his sleep and his behaviour in a massive way which has a knock on affect on me and my partner. If he hasn't pooed on one day, it will affect the next and what we're able to do. It stops us having a normal life.
It's been over 2 years of going back and forth with health care professionals, paying all our savings for private care, waking up with him in the night to him screaming that his stomach hurts, staying up until midnight together waiting for poos. It's affected my ability to work (due to lack of sleep) at times.

I'm just trying to do my best for the person I love most in the world.

There's no rush to get him fully potty trained but he's 2 and a half and it's slightly late to not have any plans for him to start unless there are other issues. If you start helping him wee on the potty, the poo will come naturally sooner or later. If the aim is for him to recognise he needs a poo and then get into position, then he's ready to potty train. Until then, he won't sit down.

It sounds like you've really been through the mill, and having had a baby/toddler with a chronic illness you absolutely have my sympathy: it's really tough.

I absolutely see why it's important to crack the witholding. That's obviously absolutely key. I'm still confused as to why he has to poo sitting down at this point in time.

The reason I'm asking is that from my (completely non-medical) perspective, it seems to me that you might be trying to inadvertently tackle two barriers at once. The first is that he withholds because it's painful. The (possible) second is that he doesn't poo sitting down because he doesn't like the sensation/hasn't worked out how to do that yet. In trying to get him to poo sitting down it seems you might be trying to deal with both of these simultaneously and that might make the first (really important!) one harder to manage. Does that make sense?

Oh, I agree that the first step isn't potty training. The first step is getting the poo reliably out of his bum, before worrying about where the poo goes. Frustrating that the bubbles thing didn't work...though in fairness you usually need to get the poo softer than smooth sausage to get past withholding.

To the person who says I sound scary and controlling - you clearly haven't been through this, and that's okay. It honestly rules every part of your life. It affects his diet, his sleep and his behaviour in a massive way which has a knock on affect on me and my partner. If he hasn't pooed on one day, it will affect the next and what we're able to do. It stops us having a normal life.

This is very much true and we went through it with DD. It has an insane knock-on effect on everyday life and people who have kids who were smoothly toilet trained have no idea what sort of dark places it sends you.

In my experience, only time helped the most. Don't let the doctor put you under pressure about having to "crack" the problem before it becomes worse. We dealt with it for 2-3 years but DD gradually understood the importance of doing poos as she became older. Our experience unfortunately was a long journey but it eventually ended without any lasting issues.

DD was on Movicol for 2 years however I always had a feeling it wasn't the ideal solution. Doctors love to put kids on that because it makes you need to poo so urgently you can't control it, which sounds quite unpleasant. If you had to experience that as an adult, it would create a lot of negative associations around poo. DD often complained of tummy aches and was overall grumpier and worse behaved when on Movicol.

The two main things we did was dietary adjustments wherever possible and always prioritising sitting on the potty. Even if it meant cancelling plans or going home early, nothing would disrupt the schedule of potty sitting. She was allowed to have screentime or play ipad games on the potty to make it more relaxing. The potty was easier in the beginning because you could be in the living room and it didn't feel as unfamiliar as a toilet. We transitioned to the toilet around 5.5.

Diet wise I bought all the wholegrain foods that were well disguised and didn't taste awful. There are lots of kids cereals that have a large percentage of wholegrain. I also mixed wholegrain pasta with regular ones, and disguised the texture with lots of sauce. Lots of fresh, raw fruit whenever possible or blended into smoothies or ice pops. Milk was only for cereal and not alongside meals or to satisfy hunger.

In desperate moments I also promised her all sorts of toys for doing a poo. A small price to pay for the alternative of becoming seriously ill from bowel impaction. As mentioned, time made most difference and it just felt like she gradually grew out of it. Weaning off Movicol made a huge difference to her behaviour (most likely because she wasn't dealing with daily tummy aches and cramps). If nobody reminds her to sit on the loo, she still has a tendency to withhold, but I always make sure she gets toilet time after meals. With this schedule, she poos normally every single day and the phase where she withheld didn't seem to have had a lasting physical impact.

I know you said you’d tried every potty under the sun, but humour me on this one.

If outside behind trees is his thing, then may be worth trying taking the potty outside. The mycarrypotty’s seem particularly good for this as they can carry them round themselves, choose own animal, and they’re very low to the ground so get much closer to the knees up position. Feet on tree roots and potty further back so it’s downs hill slightly and you may get the knees up position. Probably not in one jump, but in a take it out with you, play with it in woods with lid on, sit on it ignoring the poo topic etc.

I’m assuming you’ve already done the them watching you poo, you using the stool etc.

(also if you’re a diary and soya free gig, watch out for barista milks and too many peas - they seem to have a big overlap).

Could he sit on a potty instead with the nappy? That might be easier for his height. I guess the other question is, can you leave him to figure it out and see what works for him if he's in a nappy. 2.5 is quite young as many children don't like pooing anyway when they are potty trained that don't have the issues your son has. He might prefer to sit in a corner? Could he try the bath or something similar?

Something like this could work well with a stool?

Hiya, I'm fully aware it's been AGES since the last person responded to this post. I just wanted to say a massive thank you to everyone who has offered advice 🙏🏻. I am definitely going to start with a carry potty outside and am sat now building a schedule for us to stick to through the day. Ive also done lots of research on wholegrain and fibrous foods so I'm hoping this all helps.
Honestly all of your help has been a lifesaver, and hearing that others have been through the same has helped my mental state too ❤️

I had this with both of mine - maybe slightly less chronic.

we struggled valiantly on and found it just eventually resolved when they did potty train and they learned to push the poo out. Both about 2 years and 8 months. They are both ok now.

neither of them are good drinkers and this contributed.

i know this is not the case for all but just to give you some hope OP. Fingers crossed for you, it is a huge daily stress!