My 3 year old will only poop in knickers

[Jwallace1988]

My three year old daughter was potty trained at 2 and was absolutely fine with going on the potty.

About 4 months ago she became constipated and was unable to go poo for over a week. She was prescribed movicol 2 to 3 sachets a day by gp which helped to soften the stools.

But she now refuses to use the toilet or potty at all and becomes hysterical when I try to get her to sit on either one to poo.

I have seen a paediatrician who put her on a disempaction but 8 sachets was too much for her and her stools were like water so she is now back on 2 to 3 per day.

I have tried books, you tube videos, we made a sticker chart and nothing has worked.

She will only go poo in her knickers, resulting in her having 2 to 3 accidents per day.

I would be grateful for any advice or options to help as I an unsure where to turn.

Thank you in advance

[squizita]

My daughter (almost 3) has something similar but is getting better. She potty trained (we were later advised we did this a little early), had bad constipation (after a year or so of hard but not quite movicol level hard poos, just about 4 a week etc so I didn't think as ERIC/NHS says 4 per week is borderline OK... but clearly she tends towards constipation) so we used movicol --- and promptly she un-trained for poo once the constipation was treated. Wouldn't go in the potty and pooed in her pants.

I emailed ERIC, spoke to a potty training expert at the children's centre and obviously my GP. Consistently the advice was:

-Her guts and rectum might be stretched and numbed for a while;

-She will take a while to accept poo is OK and not fear that poo will hurt;

-The sensation in a pull up or knickers is a bit gentler (see above)

-She will be used to the 'needing to go' signals being for absolute week-long desperation, not a daily tickle/tummy rumble. As well as the physical side she needs to re-learn.

Anyway the upshot is we have been on movicol for a month and a bit, she still has accidents maybe once a day or every other day (I find a 'dry like me' pad or Tesco value panty liner catches it out and about) but WILL NOW ALSO GO TO THE POTTY! Basically we went back to step 1 for poo potty training, although she's fully wee trained.

I showed her youtube potty training songs and videos and got her to sit on the potty every day after meals and nap, 'just to see'. No pressure. Then when she would sit and always wee I went to phase 2 - I shamelessly bribed her with stickers, kinder eggs, poundland tat if she made a 'good poo' in the potty. Once she managed one a couple of times (this took a good couple of weeks though) I kept reminding her 'remember that big girl poo, it didn't hurt at all, did it?'. Now she is herself re-learning the sensations etc (there's an app called poo goes to pooland which helps explain to under 5s) hence she sometimes has accidents but will also try on the potty.

I didn't go back to pull ups and instead used pads in knickers, as she's doing soft-but-solid poos and the pad often saves the day, and she feels she hasn't regressed.

The potty training lady told me that her slow progess is expected when they have had constipation but that in the grand scale of things, provided the movicol keeps working and we stay on for the recommended time, she'll get there, and she is now using the potty for poo.

[Jwallace1988 in reply to squizita]

Thank you for your advice .

I am bribing beyond belief but she is just so distressed. I did try getting her to blow bubbles whilst sitting on the potty and she didn't cry but didn't poo but it is a start. Will have a look at that app and let you know.

May go back to retraining then and see if that works also.

Thanks again xxx

[Luella19 in reply to Jwallace1988]

I think the advice you have had above is great. I can add that when you are in the thick of it with pant pooing it is awful (was there with my daughter at 3/4) for me it was the thought of it never getting better that caused a lot of the stress.

Years on my daughter (just 7) is fine now and doesn't ever do a whole poo in her pants just the odd smear every now and again.

I think right now maybe you need to take a step back and accept that she wants to poo in her pants but do some things that gently encourage her not to.

We had a doll with a potty. I would sit the doll after meal times on the potty with a book (sometimes my daughter liked this, other times she would get cross!) we had a body book with lift the flap parts, the colon has a poo in it and she loved that page!

Reinforce the message every time she poops in her pants that soon she will be able to go in the toilet and put the poo in the toilet and say that's where it wants to go with all the other poos (that kind of thing) if she will stand next to the potty/toilet to poo in knickers that's a start too. Or in the bathroom. Would she sit on potty/toilet with knickers on and poo?

Try using sticker charts creatively, make them at home so you can personalise it, reward even the smallest step of progress. Doesn't matter if mompoo happens it's the sitting that is to be encouraged. If she will allow, show any one who visits the chart so they can praise to (my daughter loved this and would show anyone interested, but others may be embarrassed I guess?)

Try to relax and I know that will sound like a joke right now but she is very young and chances are it will get better for you all. Be open about it to everyone as I found trying to hide the issue to family and friends made it more stressful.

Also play around with movicol dose, if you want to lower ever so slightly try that. 2-3 a day sounds quite a lot, my daughter had one a day at that age but of course all children are different and the Gp is better to advise obviously.Don't worry about what anyone else thinks, it happens and is quite common.

Best of luck xx

[squizita in reply to Luella19]

Yes in terms of dose we found going to 1 or 1 1/2 a day, plus a bit of natural help (prunes, lactulose - that kind of thing) means they are firm enough for her to sense them but not hard.

[Jwallace1988 in reply to squizita]

Hiya I've tried the prune juice which was a no no as she hated the taste so am trying as much fruit and veg. Will look into the lactulose as well. Thanks so much for your advice xxx

[Jwallace1988 in reply to Luella19]

Thank you so much. I cannot thank you enough have been going through this alone for a while so it really helps getting advice from others. The gp put her on 3 a day then I saw the paediatrician and he put her on 8 a day which was far too much. I have now started on 2 and will see how that goes. We've done a chart together just recently and I can see it helps a little. She actually knows that she shouldn't go in her knickers but I think the issue is more mental so I understand it will be a long process.

I will look at the doll idea as it sounds good and try her on the potty with her knickers.

The worst thing that frustrates me is some of the nursery staff make it sound like such an effort that they have to change her which makes me feel really bad. But I know she cannot help it.

Thanks for your help xxx

[squizita in reply to Jwallace1988]

Can you speak to the key worker or manager? Ours had a word as it comes under inclusion/health.