4year old poo situ - at my wits end!

[Rainysunday2022]

Good morning,

I am having a really tough time with my little boy and his willingness to poo in the toilet.

For context, he has been 'trained' for well over a year, mastering the pees no hassle and is now dry at night.

The poo situation has been a rollercoaster - i think he is getting it then regresses. We are going through a particularly bad spell with it, but hes never cracked it.

He doesnt hold in, just poos his pants. Has also started lying about it.

Reasons given from him are ' too busy playing' 'scared of sharks' and then 'don't know'

Things i've tried:

Stickers and rewards
Not making a fuss about it
Back to basics (trousers off etc)
Special pants
Encouraging him regularly (this has never worked and causes real conflict)

I work full time and he is at nursery 3 days a week. We are off on holiday at the end of june and I am dreading the poo situation.

What can I do? Thank you if you read this far!

Firstly - sending you lots of hugs because it can be super stressful these situations and feel like it's never going to end, it will ❤️ both of my children had slightly different issues but took them over a year to fully get it and I was at my wits end.

Secondly - when he poos in his pants is it a normal poo as would be if he had gone in the toilet? Or loose/small poos?

I definitely think to continue with the not making a fuss and lots of praise when he does go to the toilet. (For a wee)
Eric.org.uk website is very helpful and local health visiting services sometimes run potty training webinars/groups.

Some people will disagree but 4 is still little and they all take time to learn in their own way.
I'm sure someone else will come along with something more useful but didn't want to read and run ❤️

There’s a video on YouTube called sending poo to Pooland. Could you get him to watch that?

another thing that can be helpful is get him to sit on the toilet, (same time each day). So, if the accidents are happening in the evening, that’s an indication of when his bowels are needing to be opened. So, get him to sit on the toilet about 30 mins before you’d expect an accident, and plonk an iPad in front of him. I would try and get him to watch something he doesn’t usually get to watch/or something that’s a treat for him. And he only gets to watch it when he’s on the loo. Firstly, this will create an association with sitting on the loo and pooing (like Pavlov’s dogs), so he starts to link watching the programme as a treat and pooing, and secondly, it’ll create a distraction, help him relax and take the focus away from what he’s doing. I’d also put some toilet roll in the loo before he sits - some kids don’t like the ‘splash’ and it also might help to create less erm ‘drama’ when he does poo. I’d also stop the fuss and celebration when he does poo - so don’t make it a big deal when he does poo because you’re giving the event a lot of power and emphasis. So just wipe him matter of fact without any well dones. Just acknowledge if he’s finished - and if he says ‘I’ve done a poo ‘, just say ‘okay’ or ‘yes, you have’. Make it a non event and hopefully you’ll remove the intensity and focus. Good luck.

At that age it's nearly always constipation, even if they are pooping every day. Constipation stretches the bowel and affects the nerves which tell you when you need to poo. So he might not be able to really feel it until he's done it. I'd have a chat to the gp and the health visitor in the first instance.

My daughter had this and it was a food intolerance - fructose in her case.

Poo Goes to Pooland worked like magic on my son

Are you sure completely sure he isn’t constipated? It may not be completely obvious if you have an overflow situation on your hands. 4 is quite old for frequent ‘too busy playing’ type accidents so I think I’d be making a GP appt to rule out if there’s a medical cause.

Is it normal poo? He might be constipated so having over flow so he doesn't actually know when he needs, I'd do what a pp suggested and sit him on the toilet the same time every day with his feet on a step to help with transition, and try and not to react

I had this too. He’s 4.5, and finally potty trained. What did it for us was a full week of not leaving the house and keeping him with no bottoms on and a potty in the living room.
i was so stressed he wouldn’t be trained by school in sept. But he’s finally nailed it after a long struggle. Good luck

I had this exact thing with my girl, it was constipation, even though on paper she shouldn’t be as she eats a good diet. Her problem is she doesn’t drink enough water. She too potty trained really easily for wees at 2 but kept having poo accidents. She used to say she was ‘busy playing’, now she’s older she admits it comes on too fast and she can’t control it. She’s on lactulose now morning and night and it works well. They offered movicol first but she completely refused it. She’s now nearly 5 and she has had a couple of small accidents this past year, but now we know why, we just up her dose and it clears and then we don’t have any accidents for a while.

I agree with the others saying it could be constipation

Hi, I had exactly the same with my son and was at my wits end! It turned out to be chronic constipation with overflow and I had not noticed all the signs (despite being a health care professional myself!! 🙈)! I thought it was behavioural - which it probably used to be initially, as he used to withhold. Anyway, long story short - GP sent him to Paediatrician who diagnosed it straight away, put him on an ‘impaction regimen’ of movicol, which slowly sorted it all out. I kept him on a low dose of movicol for a while after that and it has never come back (he’s 16 now!) good luck x

Wow thank you for all these really helpful replies.

I really thought it couldnt be constipation as the stools are not hard, actually quite sticky and sometimes he can go 3/4 times a day! No routine as when the come.

I have called the health visitor and will definitely follow up with the GP. Will also try to poo to poo land video when he is home. these are great ideas.

Much appreciated.

hopefully the HV will be able to help, it might be a food intolerance if its sticky.

2 really useful sources of information:
The ERIC help line via their website.
The Poo Nurses video
Both easily found via google.
Watch the poo nurses video all the way to the end and study the Bristol stool chart.
I agree with pp that it is most likely to be impaction with overflow.
Some GPs are helpful, others not at all, so arm yourself with knowledge and information so you know what is important to discuss.

I really thought it couldnt be constipation as the stools are not hard, actually quite sticky and sometimes he can go 3/4 times a day! No routine as when the come

My eldest when age 4 had 3-4 sticky poos a day that he couldn't feel coming. It was feacal impaction with overflow soiling.

As @endofthelinefinally said, the Poo Nurses video on YouTube is a great resource. I would watch the whole thing before you go to the GP as some GPs are more knowledgeable than others.

A poo update for any interested parties.

Took him to the gp today and she checked him over, she didnt find any evidence of constipation but she was really kind and listened to my concerns.

She has referred us to the paediatrician and also said she will make sure the health visitor is in touch.