Advice needed please

[Tink010]

Hi

I have a 4yr old DD (she is nearly 5) and she has never done a poo on the toilet. Since we began potty training at 2 1/2 she has always done it during the night. I had to take her to the hospital on Tuesday as she had been complaining with a sore leg and was limping, they did an X ray which showed she was bunged up! I explained to the doctor the problems we were having and he prescribed movicol (1 per day) with the aim of getting her to go during the day as it may be hurting her.

I didn't think she was constipated as she does poo every day just in the night! But she must be if she's bunged up? I have talked to her about it and she says she doesn't know she's doing it, I have tried reward charts with her and I dont make a big issue out of it. She has had the movicol since Tues but is still going through the night....I just don't know what to do???

It is a common misconception that a daily poo means not constipated, in fact the blockage can be higher in the bowel, meaning that softer poo leaks around it, giving the impression that the child isn't constipated. I believe it can take a while for the blockage to clear completely, so an immediate improvement may not be seen.

I can believe DD may not know she is pooing in her sleep, after withholding all day she relaxes when asleep and so it happens then. Once the Movicol starts stimulating the bowel to work properly (it will have become sluggish due to the blockage) it will become less easy to withhold during the day and you may be able to identify when DD needs to go and encourage her to go to the loo.

You can help the whole process by giving more drinks and high fibre foods. I don't think you can reasonably do rewards and charts until DD's constipation is well managed and she is pooing normally, then you can do them for poos in the right place. Sometimes trying about 15-20 mins after a meal helps, as peristalsis (the natural movement of the gut) increases after a meal. Also, squatting is the most effective position to poo in, so sitting on a potty or on the toilet with the knees higher than the hips with a footstool or step will help. I would do whatever it takes, a potty lined with a nappy for example, if she will actually consciously do a poo during the day. (Buy some cheap value nappies for this)

Oh, I forgot to mention, lots of exercise will also help to stimulate DD's gut.

Thanks girlywhirly you seem to know your stuff! I will try the footstool idea, its hard keeping her on the toilet long enough she 'tries' then jumps off.

Thanks again

Well, I haven't had to deal with the problem with my DC, but read a lot of stuff about toilet training! Also I remeber reading a scientific article that claimed adult toilets are too high for adults to be good for them! Legs dangling isn't a good position, and most toddler steps are too low to achieve the knees higher than hips, so you may need to improvise with a stool. To keep her on long enough you could use a kitchen timer set for 2 or 3 minutes, say; when it pings she can get off but not before.