Toddler Pooping Problems

Question

My little girl is 3 years old (she will be 4 in July). She is fully potty trained when it comes to peeing on the potty. However pooping is a different story. When we were first starting the potty training, she started holding in her poop making it hard for her to go.

We took her to her to the Dr they put her on Miralax said, "this will help" for 1.5 years she was on Miralax, we took her off because she was pooping in pants, with ease, but not on the potty, it was as if she didn't know she had to go, it would slip right out. So we took her off the Miralax and put her on Fiber Gummies, it seemed to work, she was pooping on the potty!

4-5 months go by, doing well, then all of a sudden she starts having troubles pooping again. We will have to start the Miralax all over again. She starts pooping with ease in her panties so once again we take her off Miralax & she is once again pooping on potty with gummies.

One month later, we are having troubles AGAIN. The thing about this ordeal is that her poop is NOT hard and she is pooping just a bit in her butt cheeks but enough to soil her panties. I have tried everything I know! I don't know what to do any more. I have tried talking to her, asking her if she feels if she has to go potty, she won't tell you. We've tried rewards, making her clean her own panties and even taken things away, nothing seems to help. It's not that she is scared to go to the potty, because she will go, has done it before... but when we are having pooping issues, we got through 4-5 pairs of panties in a day for 1-2 weeks then she will start pooping on the potty again.

We have taken her to the doctors over this several times, even to the point where we did a CT to see if she had a tethered spinal cord. All was clear on that. Her doctors do not seemed overly concerned by this, however as the parents of our DD we are and do not think this is normal almost 4 year old behavior! Before she moves up in her pre-school she must be FULLY potty trained!! We are at our last wits end. Has anyone else gone through this? What was done to correct this problem?

Any advice would be much appreciated! Thank you in advanced!!

Answer 1

As the parent to a withholder (from 6 months to 2.5 years!) you have my sympathy, but I must stress to you that it's vital that you completely back off the pressure right now. She absolutely has to be 100% comfortable pooing first and foremost - and as inconvenient as it is if that is in her pants, THAT is where she needs to poo. Holding poo in can cause serious health issues and I don't know about you, but I'd rather my kid was pooping in her pants than in hospital dealing with a bowel obstruction.

I'm not familiar with American medications but over here we Lactulose and Movicol as the most common prescribed meds to deal with constipation and withholding. Whatever the med though, you need to wean the kid off slowly. So for us we had to first give a dose high enough for the poos to come out completely - totally runny - so it was not possible to hold them in. We had to maintain this for over a week. After this we slowly dropped the dose until we found our 'maintenance' dose - enough for the poos to come out nice and soft, but not so soft that they were running everywhere. Gradually (very gradually) we were able to reduce that down until the dose was so low as to probably not providing any relief, but at the slightest hint of a held poo or problem we upped the dose right back up. This process took months - in fact over a year I think - but we did eventually get to the point where we were off the meds completely.

Even though this hasn't been an issue for nearly 2 years now we have to CONSTANTLY talk about poo, what foods make poo soft, why its important we poo every day. My daughter is 4.5 and we have to remind her to poo every day so we don't get back in the withholding cycle. I imagine this will remain a constant for the next few years or more.

Few things to bear in mind:

1. Soiling the underwear but not doing 'full' poos can be the sign of a backup and what you're getting in the underpants is overflow - this needs checking out because it can progress to an obstruction.

2. If activity and diet are not maintained and your daughter feels in the slightest bit bloated this can bring back memories of bad poos that hurt or caused her whatever psychological issues are preventing her from going and you're back to the beginning again - fruit is great for poos.

3. Relax! this will not happen forever.

Good luck.