Serious stool-holding problem . . .

[lmintzer]

. . . I may have posted about this before, but it has gone from bad to worse. Here's the story. Short version: my ds, age 3 1/4, is holding stool. Little bits leak out, so we literally change 10 diapers/day on him. He does the typical holding behavior (going up on tippy toes, crossing legs, turning red in the face).

This started out a constipation problem, but we believe it to be more behaviorally driven at this point in time. We took him to a peds GI doc 3 weeks ago who put him on MiraLax (sp?), a non-stimulant bulking agent that came in flavorless powder form (we dissolve in 8 oz of water, and he happily drinks it). The MiraLax has softened his stool to a paste (sorry if TMI), so we know that's not the problem. He seems to be afraid to push it out as well as not used to relaxing those muscles.

This is not only a pain for us with the diapers but has completely halted any toilet training progress (he's terrified to sit on the potty because then his legs aren't crossed and he can't hold as effectively). Also, he sometimes seems to be in pain and cries and screams when trying to go or hold. Unfortunately, we probably reinforced some of the more hystrionic behavior that surrounds the real problem (we just felt bad for him and gave him too much attention around the crying/whining). Also, his poor little bottom has, on numerous occassions, gotten red and raw so that diaper changes are anxiety-provocing and painful.

Here's what we've tried: talking to him (he understands that his tummy and bottom will feel better when he can push out large poops), putting him on the toilet in his shorts and diaper so he can push in a sitting position and get used to the idea of being on the potty, given pretzels (his favorite snack food) as a reward for anything reasonable produced in his diaper, physically uncrossed his legs, talked about making a sticker chart, taking away diapers in exchange for "big boy underwear" with a big reward when he gets there. All of these things have failed miserably! We don't know how to break the cycle.

Tomorrow, we are going to make a sticker chart. We have to decide if we want to reinforce attempts with no holding (regardless of what they produce) or actual poops. At any rate, we're going to try this and we also waiting to hear back from the Peds GI doc.
We're not feeling too hopeful right now (Peds GI said next step would be to add DucaLax). I'm not thrilled about the thought off using a stimulant laxative, but at this point, we'll do what works.

Has anyone experienced this problem with their toddler or preschooler? It's really not even constipation anymore but the holding that we're trying to address.

Thanks,

[stella]

We are right there with you!!! My son is 3 years and 2 months and NOTHING will make him poop in the potty. We don't have the leaking probem, but he is holding it, hiding while he poops, and totally avoiding the potty for #2. As far as pee goes, he is totally potty-trained.

I have offered m&m's, popsicles, a new toy, a DVD. The last time he pooped in the potty was a month ago and that was for "Shrek." I am at my wit's end. It is very frustrating for me - I catch myself wanting to scream at him - and I know that's not going to get us anywhere.

I am so sick of asking "what are you doing?" when he's in another room and hearing "I'm not pooping!" or "the poop doesn't hurt me!" It is funny, but I am getting SOOOO frustrated.

My sympathies to you...should it really be this hard?

[KCR4]

My son turned three a month ago and also will not poop on the potty. We gave up after 2 weeks of his wearing underpants (during which time he withheld stool) and went back to using disposable pullups. With him, this ended the withholding stool behavior and now he is pooping as often as he did before, in the pullups. And, he has regressed and now pees in the pullups although he had learned to pee on the potty when he was in underpants. I'm not sure what to tell you.

My son has been on MiraLax for 2 years for chronic constipation. However, when he was withholding (for those 2 weeks) we also gave him a suppository and Milk of Magnesia to force him to poop, about every two days. He was very upset about this. He would run around crying and screaming and then poop on the floor or outside. It was really upsetting. I am dreading having to go thru it again when we try underpants again.

I have heard that telling them they can stand and go on newspapers in the bathroom is a possible option. Then eventually they are supposed to decide it would be easier/cleaner to go on the toilet rather than on the papers next to the toilet. We may try this next.

We have watched Bear in the Big Blue House Potty video and Once Upon a Potty video, to no avail. Bribes have also failed. Recently, I thought I could trick him - he pooped in his pullup, so I took him into the bathroom and sat him on the toilet. Some poop fell off his bottom into the toilet and I made a huge deal about his "success." He got to immediately go buy Cheetos at the closest gas station/quik shop store with Daddy and called the grandparents. We hoped this would be the hurdle we were hoping for (as in, "it's easier than you think"), but it didn't work!

[MamaKath]

I didn't read the previous posters responses so I apologize if this is a repeat on any info. My dd had the same behavior! Our ped told us to take her out of diapers/pull ups even at night (when she would have her leakages and go through a dozen in a couple hours). It was hard because she would hold for a couple weeks sometimes (they kept reassuring us that she couldn't hold it forever). When she finally had a couple successful potty trips for #2, she relaxed entirely about it. And she was completely trained at that point which was a positive. I will add though that kids really need to be able to put their feet flat on something in order to have the proper muscle control to push, so make sure he has a stepstool or something else to balance in a bit. For dd, she prefered a small potty and actually would cross her legs as she figured out how to "do it" while sitting vs standing or laying down which are more typical of diaper positions.
Hang in there in the meantime!!!
HTh~

[Melanie]

Ds had this, I think in reaction to constipation and pain. It helped to read the book, "Everyone Poops," to an extent, as well as feed him lots of stool-softening foods. He may be holding it in out of fear of pain.

[lmintzer]

Thanks for your stories and suggestions. I WISH we could just take away diapers, because I have a feeling that might work--he wouldn't want to poop on the floor. But he is so anxious and upset when we do--I think it might wind up being counterproductive.

Unlike some of your kids, his holding isn't about the potty. He holds even with diapers. So it's not primarily a pottying issue, but instead just delays potty training.

I know there is a strong relationship between fear and pain--we have both going, though mostly just fear now.

We've done books--haven't tried the videos yet. That's an idea.

Poor little guy--we feel so bad for him (and for us, since we are changing 10 of his diapers/day PLUS all the ones our 9 month-old makes).

[momathome]

This is where we are with Kasey right now. At 3 and a half, she is completely pee-trained but adamantly refuses to poop on the potty - she will only poop in her pull-up. This had led to extreme constipation (she can go 4-5 days at a time without pooping) and even a hemmorhoid. I am at the end of my rope with her - we have promised her the sun, moon, and stars if she just poops and she refuses. I talked to the ped months ago about this and we have been giving her milk of magnesia when we really need to get things moving but we are no closer to her actually pooping on the potty. She has always had control issues so I know that is what this is about but I have no idea how to get her over this. Sooo frustrating! Good luck, I am right there with you!

[starrynight]

We have this problem also, my dd was chronicially constipated her first year of life until we finally figured out it was a dairy problem. I tried to tell doc that but she kept assuring me that lactose intolerance or dairy allergies don't cause constipation. Anyway...I think that is what is causing her problems now. Now she isn't constipated but is holding.

Now that we have been potty training, it is a problem. At first dd decided herself she was ready to PT, she was using the toilet fine and I didn't realize at first that she was holding back because she was pooping, just only a little. Well after about a month she kept complaining of a stomach ache and her belly was very swollen so we took her to the ped who did a quick xray and said she is holding back a lot of stool. We used a suppository to initially clear out everything to cure the stomachache so she wouldn't be afraid to go anymore (hopefully). This worked for a few weeks and now she is back to holding it, and she also poops on the floor or outside in the yard! She tells me she has to go, I can tell she has to go so I sit her on the toilet and after awhile she gets sick of sitting and wont' go. Well a few minutes later she will go on the floor or in her pants urgh. But she refuses to wear training pants again or diapers. She is peeing on the toilet just fine, I have no idea what to do or any advice just you are not alone!!

[momathome]

As soon a I complain to you ladies that Kasey refuses to poop on the potty, doesn't she actually FINALLY poop on the potty this afternoon? WOO-HOO!!! I was actually on the verge of calling the ped again this week because this has been going on for so long and she finally did it! She said she had to poop and asked for a pull-up which I refused to give to her so she held it for a few hours and finally came running up from the playroom saying she had to do it so I told her again to try and use the potty and she immediately sat and went! Excellent timing, seeing as pre-school starts for her on Wednesday and they expect the 3 year-olds to be fully potty-trained. Sorry if I sound overly excited but this has been about a 7 month battle so I am hoping it is finally over. She is VERY proud of herself right now and I just gave her the Jeff the Wiggle doll I have had for her FOREVER as a congratulatory gift. Woo-hoo - I will get a 6 month break from changin poopy diapers until the baby comes! Time to party! :D :D :D

[lmintzer]

Yay, you go Kasey! Congrats, Lauren. Hope she keeps it up!

[american_mama]

Three of my sister's four kids all have poop issues, either constipation or holding. I believe her now 4 year old daughter regularly holds back poop, or at least she was up until a few months ago. Her DD will poop in a diaper at "naptime," but that's the only time. Her "nap" is often 20 minutes or less, no more time than it takes her to poop and play for a little bit. But at least she poops every day.

For constipation when the kids were younger (pre-potty trained), my sister sat one in a bath with baking soda, which made her poop, and puts a little mineral oil, I think, in their milk, which makes the poop softer. She thinks the constipation may be related to a medication that two of them take, although the doctors claim no. I also wonder if it might be a dairy thing since the daughter with the worst constipation loves milk. I am usually a big lover and defender of all dairy products, but another poster and a pediatric nurse mentioned that there might be a connection between dairy and constipation.

I know my sister gets very frustrated about this too. I haven't had this problem, so my suggestions are pretty meaningless, but I have noticed that my 2 1.2 year old daughter can poop more easily in a little kid potty rather than a full-sized toilet.

[tippy]

No suggestions here....just hugs to you and ds. So sorry you are all having such a hard time with this. I also was getting frustrated for you while reading the replies to your post because you mentioned a few times this wasn't about potty training.

Here is a link to a few articles I found on the topic. Good luck. Please keep us posted.

http://www.ohiohealth.com/healthreference/reference/734275FC-F33F-4DD8-B1460A3D15785810.htm?category=questions

http://www.drgreene.com/21_1504.html

http://www.med.umich.edu/1libr/pa/pa_soilpres_hhg.htm

http://community.healthgate.com/GetContent.asp?siteid=ucsd&docid=/dci/encopresis