3.5-year-old still pooing in underwear

Question

I have a 3.5-year-old daughter, who has got peeing on the toilet down fine, but poos are another story. We've been on the change from nappies to undies for about 6-8 months.

She will simply poo in her undies, continuously (as in 5-6+ times a day). I'm getting over it, wife is getting over it, daycare is getting over it, grandparents are getting over it etc. etc. you get the picture.

Now, additional info - I suspect she may have Dyspraxia - as I have mild Dyspraxia and some of her mannerisms (arm flapping, clumsiness etc.) lead me to suspect this - however, I do not have any formal diagnosis (so take this with a grain of salt).

Things I've tried:

• Forcing her to wipe her own bum (based on a suggestion from here).
• Corruption and bribery (offering ice creams/donuts/cupcakes/other sweet treats if poos are succesfully done in the toilet) - this did result in one successful poo in the toilet - but subsequent attempts have failed.
• Changing from nappies to undies - just resulted in pooey undies
• Going commando - if there is nothing against the skin, then maybe she'll have to go to the toilet.
• Not making a big deal of it (Not to worry, try again later)
• Making a big deal of it (You're a big girl now, you should be pooing in the toilet like a big girl)
• Trying to explain to her (When we've got a funny tummy, sit on the toilet and try and push the poo out)
• Laxatives (prescribed by doctors)
• High fibre juices (kale, kiwifruit, carrot, orange etc. in a juice maker)

Some theories I have about this - her toilet training was going okay until one day she was running round in the garden, free as the day she was born, and then did a poo and freaked herself out when it went all down her legs (I suspect this to be the cause of some of the problems) - since then, poos have been a bit of an issue.

The multiple poos in the undies a day I've put down to the fact she knows she shouldn't poo in her undies, so when a bit does come out, instead of going to the toilet, relaxing and having a nice solid bowel movement, she tenses up, sucking it back up inside (as she knows she shouldn't poo in her undies) which results in the multiple small poos throughout the day, as opposed to 2-3 solid poos a day.

We've also got an appointment with a specialist to see if there is an underlying medical issue (My gut feel is that it's more mental than physical).

So, dear people of the Internet - any other suggestions?

Answer 1

No one has answered so I'll give it a go. I had problems with the first who reverted after his first sibling was born, but otherwise I don't remember any problems.

In my opinion, you're doing a lot of things right. The things I especially agree with are: bribery, trying going commando (though that backfired badly once, my guess is she'll hold it til she has a safe place - not the toilet, unfortunately - to poop, not making a big deal of it when she fails, talking to her about what it feels like before needing to poo. I would not try to guilt her into it (you're a big girl now) because part of the problem is the diet you're providing. On a high fiber diet or osmotic laxative, it's really easy to have 5 small poos a day. You might want to keep her in nappies and cut down a bit on the fiber. I'd aim for two a day, for several reasons: you'll be 60% less frustrated when she does poo, you'll have less clean up, she'll have less practice holding it in (if she is), etc.

I was very laid back about when my kids were toilet trained because without serious medical conditions, it always seems to happen sometime appropriately. We did use a star chart, so rewards for going were immediate positive reinforcement and small toys for every few stars. We never tried to guilt him; it was all praise. He trained himself this way to underpants with very few accidents (he did wet the bed on occasion, though.) But when his sibling was born, it was right back into diapers.

He really wanted a movie: Alladin (this gives you an idea about how long ago this was.) Alladin was installed on the bathroom sink, along with a star chart for the number of stars needed to get the movie and watch it. As I said in comments: he earned it in a week, and never messed up again.

Some high points from the AAP position paper:

• Parents' expectations often exceed the child's abilities or understanding, and the child's frustrations and imperfect attempts at self-control are easily mistaken for willful disobedience.

• the toddler should be able to indicate wants and needs verbally, and should have the motor skills to sit on, and rise from, the potty chair. (So using the adult toilet is out.)

• If... it is determined that a child is not physically or emotionally ready for toilet training, parents should be encouraged to delay training.

• ...non-punitive, reward-based techniques are more effective and that their recognition and affection are the best rewards

That article provides a lot of high quality resources for potty training, e.g. Toilet Training.

I don't know if it gets easier with each child, but I honestly do not remember toilet training my other kids. Maybe the older kids did it! One child did have a medical problem that was worked out just shy of him having a bowel wall biopsy for Hirshsprungs, but that was when he was a baby.

Good luck, and as the paper says, staying positive is important, if difficult!

_{Toilet Training (The American Academy of Pediatrics paper}