Advice for Solving Non Retentive Soiling - 4.5 year old

[steph_hopperdopolous]

Wondering if anyone has any experience that can help.

My daughter has been diagnosed with non-retentive soiling which basically means she does all her poos in her knickers, every day. She doesn't suffer from constipation. The trigger the first time was moving rooms at nursery (when she turned 3), then we solved it briefly for 6 weeks a few months later with the help of the health visitor & a couple of simple strategies (that incidentally have never worked again!).

As soon as she was told she was moving house (at 3.5) it started again and has never stopped (14 months later). We are under a paediatrician at the Evelina in London who has referred us to a child psychologist.

Our daughter is very open with the psychologist - no one can understand what is causing her to keep doing it. We have regular toileting routines and now with the psychologist's support we are starting to not only reward the right behaviour but introduce sanctions. As a family we are exhausted, sad and so frustrated by the issue. In all other ways her development seems entirely normal - she is sociable, friendly and happy in herself. The psychologist is baffled that there seems to be no underlying anxiety which could explain the soiling continuing. We can't currently leave her with other families, or clubs - we always have to be there so now we feel it is impacting her development.

School is a challenge as she often denies she has soiled but everyone can smell it. Briefly when things got really bad she started wetting herself as well but since we have started seeing the psychologist this thankfully has stopped. When we saw the two combined for the first time I realised that the experts must be correct and it had to be behavioural rather than medical. I guess I have always worried whether someone has missed something medically.

There seems to be loads of support for children with persistent constipation & retentive soiling - I just can't find the same with non retentive soiling. Really keen to hear from anyone who has lived through this nightmare and survived - and SOLVED the issue!

Thank you Steph

[Nikki_1985]

Hi there!

So sorry to hear what you are going through - it must be incredibly frustrating and upsetting for the whole family!

I can't offer much advice as my daughter deliberately withholds and her soiling is the soft stuff sliding past the more solid stuff (sorry TMI)

When you say non retentive, do you mean she poos in her knickers and that they are formed and normal?

What has she said to the psychologist? Is she scared of the toilet? Or what happens to her poo after it has left her body? There are tons of books for kids covering these subjects.

I know that changes to the norm such as moving rooms or house can be stressful for everyone involved and sometimes can cause children to have problems in areas that they never did before.

I did read online a "tough love" approach to potty training, whereby the parents made their child wash their dirty underwear in the sink. Apparently the kid got fed up of doing this several times a day and quickly decided that it was easier to go on the potty/toilet. - I'm not saying that I condone this approach necessarily, but it did work for this particular child.

Sorry, I'm probably not much help, just want to offer my support and hope that this issue gets resolved soon for you.

[steph_hopperdopolous in reply to Nikki_1985]

Nikki - thank you.

Yes all in the knickers all formed and normal..... She has a dislike of school toilets that's for sure but she only started school at the end of September and this problem had been occurring for 9 months before - and happens everywhere (at home as well). She can sit on the toilet or the potty after a meal and then go and soil herself sitting on the sofa....

Interesting about the washing the knickers! Something we have implemented is her cleaning herself after it happens which is painfully slow and doesn't seem to deter her but was one of the strategies the psychologist suggested - she needs a consequence to want to make a change.

Now she is trying hypnotherapy with her - some gentle scripts which we hope may help around the whole subject. I'm also going to start her on kids yoga in the hope that raising awareness of her body and sensations in her body may help. Anyway thank you I feel a virtual hug by getting your response. Wishing you well with your daughter's withholding.

[Nikki_1985 in reply to steph_hopperdopolous]

All of these sound like fantastic ideas, especially the yoga - wouldn't have thought of that myself!

Funnily enough, my nephew (also 4.5 years) started wetting himself recently, after being completely potty trained for a year. Apparently there was an incident at school where one of the bathrooms had flooded and the teachers told him not to flush the toilet. Now he's scared of all toilets because they might flood!

It seems so odd to us as adults, but one little thing, be it a bout of constipation or conversation being blown way out of proportion, can affect a child for years! I've been dealing with our little problem for nearly 18 months now!

I hope that you can discover why your daughter does this, because if you can find the trigger, maybe you can put an end to it.

Sending big hugs your way!

[steph_hopperdopolous in reply to Nikki_1985]

Thanks Nikki - they are complicated little things aren't they! x

[Luella19]

Hi Steph

Sorry to hear you and your family are having a hard time with all of this. I can empathise.

My daughter (now nearly 7) has had various poo issues since about 3 years old and potty training. A mix of constipation, withholding and sometimes just a general resistance to use the toilet to poo in. She would often do whole formed soft poos in her knickers, but not every day. It would usually be when playing in the garden or standing by the sofa whilst watching tv. It was all baffling and I can so relate to not being able to leave her with other friends and at clubs.

To deal with the whole poos in knickers issue one thing that really helped was a sticker chart that I persuaded her older sister to have (sister was 8 and had no poo issues, she agreed to help as she knew how desperate I was!)

Although I had tried the chart for just my youngest daughter she wasn't incentivised by it but when I made the chart for both of them, days running along top and their two names down the left she became interested. Every time the older sister pooed in toilet she got a sticker. As she pooed most days her chart started to fill up with pretty stickers and younger daughter didn't like that so her competitive streak made her start using the toilet to poo in more and more so she too got stickers. Had she not had a sibling I think I would have done a chart for her and me and her dad. I was game for anything!

The above is just a suggestion but I understand how complex children can be and all so different.

Our situation was different as my daughter had constipation issues too and we used different laxatives over the years.

Positive news is that she now doesn't poo in her pants and hasn't for some time and doesn't take any laxatives any more. She still likes me to be in the toilet with her though when she poos but I can handle that. We haven't braved a holiday club yet but I'm hoping maybe this summer or next we will try.

Sending you lots of support, it's tough but should get better with age. Age and awareness has been the biggest help to us x

[steph_hopperdopolous in reply to Luella19]

Luella - thank you so helpful to hear your experience. We have had abandoned sticker charts in the past.... The psychologist got us to re-instate one when we started working with her six weeks ago and it has helped. She gets a star for sitting when we ask her to (after each meal), and then for any wees that are on the toilet and then a smiley face for any poos on the toilet. We didn't feel like it made a massive difference for the first three weeks (and they are so hard to maintain aren't they!)... then the psychologist suggested a sad face for a poo in knickers as well which I really think has started to help. I love what you said though about the sibling rivalry - I'm so aware this isn't a quick fix problem and that we need lots of strategies so as she has no siblings a chart with us on it will be my next step!! Thank you so much. Steph xx

[Luella19]

It's worth a try!

All I can say is that it takes such resilience, patience, positivity and lots of support from forums like this to get through it. Sticker charts are hard to maintain indeed. My daughter used to show her charts to anyone who cared to see them so that everyone celebrated her successes on the loo!

Even though things are so much better for us now I still stay on top of things, routines, diet etc. And I still find forums like this really helpful. I also remember how desperate I used to feel when I couldn't see an end to it.

It can get better x