My 4 year old won’t poo on toilet

[Essexnot]

Hi I’m literally at my wits end with my 4 year olds soiling situation?! He refuses to do a poo on the toilet & will only do in his pants? I’ve done charts, rewards etc & NOTHING will entice him to go on the toilet? Sometimes but very rarely he will say he needs to do a poo but as soon as he sits on toilet he says he can’t do it? I’m rinsing out 4-5 pairs of pants a day? His poo is soft & “normal” so I don’t think his constipated he just cant physically go on the toilet???

[Emsta1]

Hi. It sounds like they're might be an underlying problem that you should get checked out. We struggled for 2.5yrs to toilet train, my little girl (now 4.5) was terrified of the potty/loo and refused to go. Fortunately, after much stress and upset (and no diagnosis from the health visitor or gp), we saw a paediatrics doctor at the hospital in the summer and got a proper diagnosis. She was proper constipated and bowels backed up, so didn't want to do it sat on the loo as it was too painful. I wonder if you're little one is soiling 4-5 times a day, that means there's a blockage somewhere and only soft bits are getting through when then can. And he's too scared to go on the loo. I'm no expert but would recommend asking your gp to refer you to the hospital.

After a month of laxatives, my daughter is now confidently using the toilet for a wee and building up to a poo (she sits, but with a nappy on, hasn't braved the full experience yet!). In comparison to how she was and having struggled for so long, it's a revelation and relief to finally have got to the bottom of the problem, and know it's not just my child being naughty.

Good luck with it all x

[Hidden]

Went through simular issues, sounds like stool holding, also known as functional constipation but in young kids it's not typical constipation but constipation that results from when they are holding in their poos. I advise to see ur gp asap. Find a health professional with experience with encoperesis- u dont need to manage it alone and support and reassurance goes a long way. I also imagine an osmotic laxative will be ur solution after a doctor considers all possible issues. Lots of online resources, start with the "poo nurses" utube video.

[Skyfullofstars1]

Hi, I can totally sympathise with you! Iv have been in this situation. This time last year I was at my whits end. My daughter now 5 was potty trained age 2 for 6 months until the problem started. It took me years to get to the bottom of it. It completely took over our life’s. In the end her bladder ruptured because she was so blocked up and her stomach was in a spasm. They had to take us seriously. Many a&e journeys later and we got invited in last December for a complete clear out. The hardest week for me and my daughter. But also the best because it was the beginning of the end. Her bowel had been stretched to 3 times the size and she had no control. She had to go back into nappy’s age 4. Slowly and with medication and a sitting on the toilet routine for ten minutes with no pressure just sitting playing her I pad or reading a book or drawing we have got there. I still keep a chart of every poo and we still sit after every meal and now she’s at school she does it there too. Ask to be referred to the hospital. It really is such a hard time and so frustrating. But he can’t help it right now. The doctor told me that once this happens, when they get the feeling the need a poo they automatically hold it in. And breaking that cycle is a slow process but don’t give up! You can and you will get there. I hope you have supported from family and friends ❤️ Wishing you all the best xxx

Ps. Reading poo books also helped us along they was and there’s a send the poo home app too.

[Essexnot in reply to Skyfullofstars1]

Thank you I’ve got an appointment with our GP next week! We have been getting great advice from my sons occupational therapist (he has mild cerebral palsy) but nothing is working as yet?! I can’t stop reading people’s stories about the same problem? Can’t believe how common it is!

[Skyfullofstars1 in reply to Essexnot]

That’s really good. It really is more common than you’d think. It’s because people just don’t take about poo. Not in my house we talk poo a lot 🤣 xx

[Essexnot in reply to Skyfullofstars1]

We’re on send the poo home app! He loves it! Let’s hope he takes it on board 🤞🏽

[Hidden]

He's not too old to use a child's floor potty. Lots of kids don't like pooping in water - it's not natural at all. Also try some soothing massage on his heels (large intestine area) and head.

[Essexnot]

Thank you! I’ve tried the floor potty but he wouldn’t have it 😬 I will try the heel & head massage! We’re currently watching poo videos on YouTube 🙈

[Skyfullofstars1]

Totally opens up the poo convo.. there’s a book Liam goes poo in the toilet.. my daughter still likes reading this book. It’s so simple but it’s says all that needs saying about the situation ❤️ xx

[redtomato]

Hi there, my son has cerebral palsy too (GMFCS level 3), uses a walker, tripod sticks and wheelchair for distance. He's nearly 8 and toileting has been a long hard journey, but we are really getting somewhere now. He was never fully toilet trained, with pooing in pants and daytime wetting. Night time wetting stopped when nearly 5 though. If you have an occupational therapist, I assume they have kitted out for toileting needs with a toilet seat etc, so that's good. We have been through the system. Firstly with school nurse then referred on to specialist bladder and bowel nurse. My son was diagnosed with constipation and he did a disimpaction. He has said for a long time that he wants to poo on the toilet, but it wasn't happening. It would end up in the pants and the only way I got it in the toilet was to sit on the toilet for 10 mins after meals. They advise to do this about 20mins after a meal, but he was a bit quicker, so we did straight after. This made sure he pooed in the toilet. However it meant he didn't have much control over when he goes to the toilet and he wasn't actively involved really. I think he started to resent the time spent on the toilet. I had planned on toilet training his toddler sister this summer and I thought it might encourage him. With her, I bought a book ("Oh Crap"), which I agree with some of the advice but not all. It advised naked from the bottom down. I thought I would try it with my son and toddler as I hadn't tried with no pants. I thought if he doesn't mind pooing in pants then if I remove them, he can't poo in them. I did this in the hope something would work as I didn't even know if he could feel when he needed to go, maybe the CP had affected his nerves or something? I actually was desperate for improvement, wasn't getting that much professional support as had just been denied a referral for urology consultant and bladder and bowel nurse a bit unhelpful. If he knew when he needed to poo, he would have to choose to poo on the toilet or let it out wherever he was at the time (floor, sofa etc). I didn't relish dealing with mess, but I had to try, I also stopped any "trying" for the toilet after meals, no more 10 minute sits. It was successful!!! My son saw the toddler 's accidents and also I think he needed pants off to make the connection for himself. He started talking to me about poo, which hadn't previously and he described feelings in his tummy, I then knew he could feel when he needed to go and so I knew he was able to choose where he did the poo. He was surprised and a bit freaked out when he pooed on the floor. He did not want to poo on the floor and so he chose to poo on the toilet, when he needed to go. I gradually introduced pants back and then trousers and he is now pooing on the toilet. I think for him too, he is reliant on adult help generally and especially getting on the toilet, undressed etc so much and I think from his perspective, I was sort of "micromanaging it" and he didn't really think about it all, it was sort of delegated to me, but he needed to take ownership of it all.

My advise would be to get the GP to refer to bladder and bowel nurse (though they may try HV as under 4, but push for it) , see if he's constipated, if he is , treat that with laxatives for disimpaction etc and then I would choose a school holiday, stay at home and go naked from waist down and see what happens. There is hope!

[Loutylegarw]

Read ‘what to do when my child won’t poo’.

See GP who will feel his tummy to see if they can feel any poo backed up- you’ll know if he is or is not constipated then. 4-5 motions a day is quite a lot and could be poo leaking around backed-up poo. Worth checking.

Getting a tablet with games on that he’s only allowed to have while sitting on the toilet and sitting him on it for 15 minutes after meals worked well for us. From refusing to go, to refusing to get off the loo!