Potty training 3 year old with constipation, need help!

[ItalianDiva]

My three year old daughter has constipation, which is making potty training very difficult. We have been trying to train her on and off for almost a year now. She does all her pees in the loo, but refuses to tell me when she is doing a poo. They 99.9% of the time end up in her pants, unless I smell something and entice her to sit on the loo (I tell her a story as incentive) and then she will do the tiniest, hardest little poo (it tends to just fall out, there is no pushing).

She does 7 or 8 of these hard rabbit poos a day. I have tried laxatives, prescribed by her doctor, and they worked (in that she did big poos, but still in her pants) but I don't want to keep giving them to her. She was on them for a month and I want to try something more natural. Her diet is good: she eats lots of fibre and drinks loads. We have tried all sorts of things like prunes/ raisins/ rye bread/ baked beans. None of them work. I just don't know what else to try. So, my questions to you lovely mums are:

Do you know of any natural remedy for constipation? Can a child voluntarily refuse to do a poo (i.e, is she holding them in for psychological reasons?)What on earth do I do?? I am convinced she will still be pooing her pants when she is a teenager.

Well had similar to you with my son but he is a lot better now. It all started with an anal fissure making poo-ing v. painful. This cleared up and he then started holding onto the poos because he thought that they would hurt, and of course they did BECAUSE he held them in. Having said that his poos, when they did arrive, were good healthy ones, not like the ones you describe. Also I could see him holding on, was v. obvious.

I decided to potty train him anyway and tbh that really helped him, I suspect that as well as the pain from the fissure he didn't like pooing in his nappy.

However I tried all sorts of other things before potty training. In the end I gave him a small dose of Califig (mixed with tinned prunes) after he hadn't been for a week. You could try this, it's not what you asked for (ie natural)but it worked. I used it for a week or so and it got him out of the habit of thinking poos will hurt.

Also I started a sticker chart, so he got a sticker every time he did a poo (you could alter so she gets one for every poo on the potty). This was my Dr's recommendation.

Also there is a PDF file (I can send you) called 'Poo goes to poo land'. It was written by a student for the NHS at some point and isn't easily found on the internet. You would need to PM me for me to send it. However, it is a great little story about sending Mr Poo back to his family via the loo. If you print it out your daughter might enjoy making it her own by colouring it.

Finally do a search on here for 'constipation' and you will find loads of advice.

Finally, finally do go back to your Dr because there might be something you haven't tried yet. Also all these rabbit dropping types don't sound great.

Yes, withholding can be for psychological reasons; fear of the toilet, fear of pain when doing a poo, fear of the poo dropping away from their body, and a whole host of non-toilet related reasons like new baby, death in the family, moving house starting nursery and so on. And also knowing that mummy is stressing about it!

I think that your DD may have a slow digestive system (although I'm not a medic) In addition to dietary management of the constipation, consider upping the amount of exercise she has every day, lots of running, jumping, dancing, climbing, pedalling trike or bike. Most small DC don't do nearly enough. This will indirectly stimulate the gut. She would probably benefit from a stool softener to help her retain some water in her poo so that it is soft to pass. Make sure she drinks plenty of water based drinks. Other foods with high fibre are oranges, pineapple (fresh or tinned) grapes and raisins, celery.

I think the best thing is to make sure her poos are of normal size and soft before you tackle the loo issues. You could try the cheap disposable nappy draped over the loo seat, with a view to getting her at least to go on there instead of her pants, then you could cut a slit in the nappy so that the poo drops through it into the loo, and when doing well with this do without the nappy altogether. Make sure when she is on the loo that her knees are higher than her hips (as in squatting) which is the most efficient position to empty the bowel in. You may need to use a much higher stool than the ones they sell for toddlers normally, which are far too low for toilets, the childs legs are still left dangling.

Thanks for all the tips ladies. The exercise idea is a good one - I always think my kids get enough exercise because we walk everywhere and they are constantly jumping around and dancing but maybe I need to focus on it a bit more.

Am worried about the psychological issues because I can't see a way round it, but I will just focus on getting her to do normal poos before tackling why she refuses to do them in the loo..... She doesn't have any problem sitting on the loo, she will sit quite happily for a few minutes and then poo in her pants about 20 minutes later. I think it's the constipation rather than her doing it on purpose (ie the poos just kind of drop out and she's not really aware) but maybe that's wishful thinking.

Anyway, onwards and upwards.... what a nightmare!

i would really recommend medication to prevent long term damage. The bowel can become so stretched the child loses any sensation and can take years of medication to try to regain the muscles. much better to be on a low dose of movicol to prevent it occuring. If she is not aware of pooing then she may have lost the sensation already in which case you need long term medication to ensure recovery