PLZ HELP! Toileting troubles, Lies and difficulty co parenting.

[ILLJ]

Hello, I’m new here and was seeking advice and opinions, I’m a mum and step mum close to tearing my hair out. Apologies for the long read, there’s a lot of info to consider.

Heres a summary of the situation so that you can understand the background and subsequent dilemma here:
My partner and I have his daughter (for anonymity we’ll call her M, age7) half the week every week, and my daughter (age 4) all the time.
M’s Mum is a qualified counsellor, v intelligent, v manipulative and v challenging to co parent with as has a lack of boundaries and lack of respect for my partner and myself. My partner is a v involved and present father and always has been going above and beyond to be a good dad.

M has never gone more than 2 weeks without soiling in her life, and her mother is of the opinion that it isn’t a big issue as she herself was doing it till age 6,7, then 9 (the self comparison keeps changing). It only becomes an issue for Mum when the soiling inconveniences her plans, then she will tell M she is being lazy or making bad choices - otherwise she makes excuses for it (e.g Tired, has a cold, tummy ache, didn’t feel it etc.). However she has now come round to the idea that M is making the choice to ignore bodily signals in order to continue what she’s doing, then soiling and sitting in it till found out.

The school put a care plan in place to get to the bottom of the problem and get medical professionals involved to solve the issues. M’s Mum has gone off plan and believes she knows best so doesn’t consistently follow the plan provided by specialists. She believes it’s only an issue when they get to secondary school and are doing it, and that soiling at this age is v normal. We have tried to stress that a Carb heavy diet of fast food or “meal deals” isn’t going to help the possibility that she could be constipated, but they are a regular occurrence when she is not at our house.

We are trying to get M to be honest about when “accidents”/ bad choices have been made so we can get her cleaned up ASAP, we got to a fantastic place of transparency where she would tell us immediately and we’d get her cleaned up, or she would clean herself up discreetly with privacy. Then we encountered a huge setback that was down to a toilet chart being implemented by Mum and the school that peers could see, this set M back into a place of concealing it and sitting in it for ages.

We are still having soiling, and M seems to be holding in number 2’s and then soiling and sitting in it, we’ve explicitly said there’s no punishment for “accidents” we want to help keep her clean and prevent soreness and infections, yet she is still fibbing about them and hiding them and sitting in excrement. She seems to have a skid and then refuse to finish the bowel movement and holds it in which leads to another “accident”.

I am at my wits end, we have tried every approach we can think of to help her through this soiling to get clean and dry, but she just doesn’t listen and act on it. We have passed the possibility of it being a medical issue as we have followed a course of laxatives to rule out chronic constipation - it really seems to be a psychological block that she can’t get over. She is having healthy bowel movements at least once a day every day.

Basically, what I’m asking is… should there be a consequence for lying? And if so, what should it be?
I am fully aware that she may be hiding it out of embarrassment or shame - however she doesn’t actually seem to be bothered by either of those issues, the problem seems to be - that she doesn’t want to stop what she’s doing to go get cleaned up for Fomo.

We are fed up of cleaning number 2’s out of pants, and sometimes it’s 3+ pairs a day. I am also fed up of being lied to. The toileting habits and lying seem to be rubbing off on my child and it’s now Twice the work to sort out.

Thanks for reading 😞

whatever she’s doing which is preventing her from a) shitting in the toilet b) cleaning herself from her own shit, stop that activity / distraction

id struggle not put a consequence into place tbh because she’s old enough to know when she needs to go ignoring that is one thing but to sit in it is another

maybe try therapy if a consequence seems too much but it’s vile and I wouldn’t be able to cope

Everyone has got to be consistent in all environments or she’ll be getting confused. Same rules, same consequences for fibs. Could it be an attention thing ? When did the soiling start ? Could dsd be struggling with having another little sister that gets her dad all the time?

Soiling has never stopped since potty training age.
Mums house has v little rules and boundaries as a way to gain favour I feel. Taking away distractions would literally equate to her being in a room with nothing in it because everything is an excusable distraction it would seem.
My partner and I have been together for 3 years and the routine is pretty settled so I don’t think it’s a battle for attention with my daughter

I feel for you as I have children who have struggled with this at a similar age (and older).

Can't advice on the step parenting situation but what has helped here is making them sit on the toilet at certain times an sit until they do a poo or at least have tried. Ex 10 minutes or more in the morning to really try and 10 minutes when she gets home from school. Give her a book or tablet and make it clear that she can not get off before the time limit unless they poo. I felt that sometimes my son was too concerned with going back to playing.

I imagine you're having to bin a lot of pants. Could you get M to pay to replace them with her own pocket money. Or get her to wash her pants when she soils them? Maybe her dealing with the consequences related to the soiling will stop her doing it.

This is almost certainly encoparesis. She is badly constipated, and liquid poo is leaking around the blockage. Her bowel is stretched and she doesn't feel it. Please look at the ERIC site for advice and see a paediatrician about treatment. It is a long road, particularly if it's been going on for years. Regular treatment of the constipation will eventually allow the bowel to get back to normal but you could be looking at years, not months I'm afraid. And please don't punish her, it's not her fault.

I would also agree with this poster have a look at Poo and The loo on Instagram she is a paediatric constipation nurse and she goes through it all really clearly clearer than it was explained to me by anyone else I have come across

Hey,
we’ve been to specialists who suggested this however it’s not liquid, it’s a formed poo 98% of the time and she poops regularly, like every day.

Ask for a referral to your local bladder and bowel team. Ours are absolutely worth their weight in gold. It could be encopresis as PP says, it could also be behavioural. It could be something totally different - the cause of my DC's difficulties was really poor interoception and they now have targeted occupational therapy to help with this. If M is sitting in it and either not realising or not bothered by it then there could be a sensory element. The bladder and bowel team will be able to work out what is going on and how to address it, otherwise you're just flailing around in the dark.

We’re currently doing a maintenance dose of laxative but have seen 0 improvement, she’s pooped regularly like once a day for a long time so it’s hard to run with encopresis. She is also fully aware of it happening and can tell before she sees it when going to the toilet and has said she’s done it because she hasn’t wanted to stop what she’s doing

Was going to say this. Happened with my son. His was triggered after a round of prescription pain medication made him constipated and it just kind of snowballed from there and got worse and worse.
I agree that punishment is not going to help.
After 3 months of over the counter stool softener being used consistently, and not issuing consequences, the issue resolved itself. I cannot remember the last time he had an accident. The accident which necessitated the prescription pain medication happened when he was 5. He had accidents from the moment the hospital discharged him until the issue was identified closer to his 7th birthday.

Then it sounds behavioural - in which case the bladder and bowel team can still help with strategies to support without shaming her (which you say triggered a regression last time with the toileting chart).

Please don't punish her. The poor kid is struggling, for whatever reason, and needs support, even if it's not 'over flow'. Trauma and/or emotional dysregulation can cause all sorts of challenges around elimination. You mentioned that she has always soiled herself. Is there any chance that this is a sensory issue and that she's neurodiverse?

I just want to say - we do not want to shame her at all, and I’m not seeking advice on how to punish for soiling.
It’s the lying about finishing the poo on a toilet, or it’s lying about being clean and dry (and she does know when she’s soiled). Also just lies in general I think

Just for clarification- we are under a bowel and bladder specialist and have expressed our concern that it’s more of a mental block than a physiological problem. We are continuing maintenance dose of laxative. We are familiar with the information on Encopresis and have researched it - and it doesn’t seem to fit this case. It’s more like withholding. Which the same treatment of a disimpaction with laxatives is advised. Mum thinks it’s more psychological too. We are all in agreement that it’s very very unlikely to be encopresis.

The problem with taking away all distractions so that she doesn’t get FOMO when going to the toilet is that we would have to empty the house if anything and everything, because playing with a friend, reading a book, watching tv, playing on a tablet, colouring in, helping cook have allllll been used as Fomo excuses,

Every hour you stop her from what she's doing and take her to the toilet, don't ask if she needs the toilet she will say no and not go, it's a we go and try for the toilet. Clean up also has to become part of her responsibility, so play is interrupted by them. Eventually they learn that play is interrupted less and it's quicker to just go. 7 is older for this though in my experience so I would keep exploring medically.

Could you enforce a toilet break at set times. Many people poop at the same time every day so she literally just goes to sit on the toilet for say 15 mins and that's that. She can't get up or come back to her activity. If she's going to the loo and pretending she's finished then I'd enforce a stop gap of 5 mins after every toilet break. So she is never able to rejoin the activity immediately. I'd also enforce regular activity breaks so that once an hour or two there's a 15 min stop where everyone sits and does nothing. That way she learns that stopping activities is ok and normal.
I'm no expert though sounds v tough OP

That can still be constipation. My youngest dc (9) is like this- the poo that comes out is formed, but he is still prone to backup in the small intestine. They are on daily movicol for 2 years now, and it has been life changing. No accidents. Better mood, anxiety disappeared. Mild allergies cleared up (hayfever, dermatitis). DSD needs referred to the paediatric continence service. If they rule out a physical cause then she needs referred to CAMHS to work out what is going on.

in the meantime, look at the Eric website, which has lots of great advice.
the mother sounds very tricky indeed, but your partner has an equal right to ensure this is properly dealt with by medics.

We've been through this with my daughter and I was so sure it was behavioural and maybe it was slightly.
But it was mostly due to constipation. We've found hers was dietary linked, she follows a low dairy diet which really helps.
What laxative is she on? Lactose is not very effective. Movicol is the one you need. Once we tried the movicol that's when we noticed a big difference.

We had sometimes larger, dry soiling, it wasn't wet, and she was generally going to the toilet most days, but she was definitely constipated.

We had episodes of soiling up to 5 times a day before the movicol. Now it's only a few times a week

i think this can be a sign of sexual abuse? I’d take her to a psychologist either way .

This really sounds like constipation. It sounds a lot like my daughter’s symptoms. We did a disimpaction regime with Movical and she takes Movical every day now.

It can seem behavioural because they stop feeling like they need to go.

I appreciate you all taking the time to reply, as mentioned in a previous reply - I’m familiar with encopresis and the ERIC website, and she is on Laxido as prescribed.

Toilet breaks don’t seem to help as she seems to withhold to prove a point, as like a “see I told you I didn’t need it” but then soils. She also can fly into a ragey meltdown when asked to stop doing what she’s doing. It doesn’t always happen, but it has happened and it then affects the whole household.

We ask her to have Try’s on the toilet if it’s been a while since she has been and also if she is farting lots because that usually ends in soiling too.

The lying about it is what’s hard to navigate, as I said, we are not punishing for soiling, and I know I keep saying it, but what the specialist and ERIC website describe encopresis as just doesn’t seem to match our situation. We are continuing with the laxido so that we can show the specialist we have followed her guidance but it hasn’t worked, and are hoping she will point us in the right direction for getting some psychological support for M. It really seems to be a mental block of FOMO.

I sympathise with those who have gone through encopresis diagnosis with their kids but I just don’t think this is it. It’s also not just poo, she will wer herself too by leaving it to the very last minute and dashing to the toilet but her pants are already wet and then she finishes the wee on the loo. When it comes to poos she just goes “I don’t need it, I don’t feel one” and I have known M since she was in preschool and I can tell it’s not the truth from her little face as she says it.

Has she ever actually been told off for this?

My SD used to wet the bed every time at ours for months after supposedly being dry at night. Turned out she was taking us saying “accidents happen, it’s okay, don’t worry about it” as gospel and choosing to do it in bed because she didn’t want to walk to the bathroom. Being wet and smelly didn’t bother her at all.

DH sat down with her, and firmly told her it was dirty and needed to stop or she’d have to go back in nappies. Never happened again.

SC often get confused with mixed messages but can learn different rules for different homes.

This poor little girl has so little stability and control over her life. She spends half the week with a narcissistic mum who she loves but who doesn't seem to know how to be a good mum, and half with you, her dad and her little sister which though I'm sure you're doing your best is still going to be difficult in different ways.

Dealing with this through punishment and reward isn't going to help here because the reasons behind it are much deeper than conscious decisions. The child has some enormous unmet needs and is subconsciously in a mess. I think she needs some kind of child-specialist creative therapist (eg play therapy or art therapy or music therapy) to give her a context where she can start to talk about all this without any parent or step-parent present (so that she doesn't have to navigate the complex balancing between loving her parents and admitting how unhappy she is)

In a highly abbreviated oversimplification - her bowels are sort of, to her, the only thing she feels she has control and self-determination over. It's not that she is consciously choosing to soil but that the changes that she would need to make in order to not soil herself would remove from her something she is trying to use to patch up some really complex unmet psychological needs.

Ultimately I suspect that she's only going to start to get better if her living arrangements are drastically changed. I suspect the 50:50 arrangement really doesn't suit her and she would be happier with one stable main home and seeing the other parent EOW. It does not sound to me as if her mother would be the best option for being the resident parent though. However, fighting for this now isn't likely to succeed right now. Therapy first, and see if the therapist recommends the same. A professional recommendation for a change like that would be helpful, but they may be able to identify even more significant issues.

Thanks for taking the time to write that.
The 50:50 is 4 days with us one week, and 3 days with us the other week. Mum has a couple chronic illnesses that I’m not gonna lie, it sounds unreasonable of me to say - she plays on. They affect her when she doesn’t want to do something but aren’t a problem when she wants to go out. She has also diagnosed herself and then paid for an independent diagnoses of ADHD which she plays into massively.

We have proposed us having M more, but I think Mum knows it would affect her “disabled super mum” title and also any money she’s currently reviving.

We would like her to see a psychologist, that hasn’t been chosen by Mum due to the possibility of bias towards Mum’s agenda. We have to see the course of laxatives through before we can move onto a next step like that though as Bowel and Bladder specialists have pushed medication first.