my daughter is 4 this month and still pooping in her knickers. what do I do?

[TTmummy]

So I have read a lot of info and still feel confused, my daughter can poop a few times a day but still has small accidents in her knickers, sometimes she will sit on the potty after an accident and push a poo out but she doesn't seem to be at all motivated to stay clean. I can't tell if its a physical issue or behavioural. I feel terrible because its affecting the family dynamic, causing stress and seemly unending. She is on one movical daily as suggested and prescribed by the Dr but didn't advise doing any more than that. We have just tried switching from night time dose to morning dose as before this she was dry through the night and now often she wakes up with wet and dirty nappy, which she only wears at night time.

My husband is taking her to see the Dr for an actual hands on review as previously she hasn't been properly examined. I don't know what to expect from this and what we should push for or even if this counts as a big deal? I keep going back and forth from is this serious, should I be insisting on x-rays and blood tests or is she just playing up and we are bad parents for not being able to get her potty trained? It feels very frustrating and reading other posts makes me feel like either my kids problem isn't bad enough to warrant to amount of stress I feel about it or that its all going to get so much worse before it gets any better.

Any advice, support or anything would be great.

[Yaleamanda]

She is withholding and you need to disimpact her. vimeo.com/179497116

bornready.uk/blog/the-mecha...

There is lots of information that you may find helpful on the Bladder & Bowel UK website at bbuk.org.uk/bowel-resources/ The leaflet that may be most useful at this stage is the one at bbuk.org.uk/wp-content/uplo...

[Le15]

I agree - this sounds like a classic case of impactation. I could have written this exact post a year ago so I know what you’re going through - you’re not alone but it is a journey and you will discover patience you didn’t know you had!! It sounds like she has a blockage and poo is leaking round. It often looks grainy or like a runny tummy but she will have lost some sensation in her bowel so if it seems like she doesn’t care / isn’t aware - she’s probably not.

So I would definitely start with the GP. Be aware that within 10 mins and a feel of your little one’s tummy, there is only so much advice they can give. They often can’t feel the impactation but it doesn’t mean she isn’t impacted. We’ve done the X-rays, bloody tests, paediatrician etc. and it really didn’t help in any way. The thing that did help was speaking to ERIC on a regular basis and educating myself (I’ll attach a few books that are really helpful). One thing to remember - idimpactation is messy but can’t do any harm. So I would go for it. You may have to do it a few times but it works.

My experience is that after the age of 3.5 -

most likely it is not behavioural. It look me while to get on board with the fact that this was a physical issue with our son but once I did, life became easier some how. This is important if it’s affecting your family so don’t feel like you can’t get this sorted! You can control the situation so it’s manageable but it’s not something they just grow out of without help in my opinion.

This is what I would do

1. Disimpact (properly - more is better than less!!) see the Eric guide

2. Get a lot of movicol from the gp. 2 boxes on repeat prescription.

3. Once disimpacting is finished, lower to 3 movicol then 2 a day nice and slowly. We keep a maintainance dose of 2 movicol a day - it’s just a softener so you can be on this stuff for years with no harm

4. If the movicol doesn’t get things moving, add a stimulant like Senna but this shouldn’t be used regularly. Once in a while to get things going

5. As well as the maintainance dose, I could ‘re-train’ - so potty out (if you need to) and pants off at home as much as possible. You don’t need to ask her if she needs a wee-poo - just prompt if you see the signs.

6. A toileting regime gets this to the manageable stage. My son has movicol and ‘toilet time’ for 20 mins after breakfast before school and this keeps things manageable at school and occasionally we start the whole process again when he gets backed up.

I’m still at the point where I can see me doing this for at least another 6-12 months but hoping he will stop withholding and just get used to pooing when he needs to. Understanding why they withhold is a whole other issue!

Best of luck x

Books

[Tiredmum_]

Hey! I don’t have much advice but I just want to say please never think that you are a bad parent. You are doing very well. My son still wears pull ups and he is 4.5 year old.

[Minnie654]

Hey, I just came across your post and currently in exactly the same position, with my little girl turning 4 in August and starting school in September. Just wondered if you have made any progress resolving this and have any advice? Doctors have dismissed my concerns and I'm thinking of asking for a second opinion.