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5 year old soiling himself.
Question:
My son is 5 in three weeks and I'm at my wits end. He has maybe done three poos on the toilet in his whole life and all three occasions where very stressful. He gets incredibly grumpy when we find out he has pooed but he makes no effort to go to the toilet at all. He will just poo in his pants regardless of whether they are undies or pull-ups and continue doing what he was doing. We have been to countless doctors and even got referred to a peadiatrican but all we got was some laxative and that was it. I just have no idea where to go from here. We have tried rewards but he just doesn't care that he doesn't get it if he has an accident. We even tried punishment for a while but that just made things so much worse. I need some help. I have no idea what to do from here. I even have to have a meeting with his new school principal next week about his issues and I have no idea how to explain them to her other than I'm a failure as a mother in the potty training area. I have spent many many nights awake upset and scared about what going to school is going to mean for him. Can you please point me in the direction of someone who can help.
Answer(s):
First off, you are not failing as a mother in the potty training area. These sorts of things are more common than people realise, and it is not a subject that is talked about in most circles. There will be a reason why he is not toileting as per expectations, and once we find that, we can get on with things. Points you have raised:- - He gets grumpy when you find he has poo’d his pants. He is probably as frustrated about it as you are, but ignoring it is a way of not dealing with something he can’t control. - Making no effort to go to the toilet. He may not be aware that he needs to go. It may be that his rectum is stretched from holding on for so many years and now he cannot sense when a bowel motion is eminent. - Stressful the few times he has passed a motion in the toilet. Is it because he can’t actually make it happen at will? What type of bowel motions is he passing? Pebbles, dry, lumpy, soft, formed, loose, a combination? If he has any constipation it will be uncomfortable for him to pass a motion. The other side of the coin is that he may be trying too hard to pass a motion, but hasn’t quite got the mechanics of it working yet. Things you can implement to help him gain some control over toileting include:- - Timing. Eating and drinking stimulate the gastro colic reflex (movement of bowel motion through the bowel). Get your son to sit on the toilet about ten minutes after eating and see if things happen while it is on the move anyway. - Positioning. Leaning forward with his elbows on his knees opens up the muscles of the pelvic floor so the bowel motion can come out more easily. Make sure he has a foot stool to support his feet so he doesn’t topple forward. Also, ensure he doesn’t grip the side of the toilet seat as this causes people to draw their muscles up rather than relax them to allow the bowel motion to be passed. - Laxatives – probably useful for several months while he is retraining his bowel. Laxatives can make it more difficult for him to “hold on” and also keep the bowel motion softer and don’t cause him any discomfort when he is passing them. - Reward. Don’t worry about whether he passes a bowel motion on the toilet initially. Reward for actually sitting on the toilet comfortably and confidently. It is obviously not a happy place for him so he needs a chance to get over his fear of the toilet before he will be able to relax enough to pass a bowel motion there. Discuss with him what the reward will be ie. One on one time with mum or dad, a trip to the park etc. - Once he is happy to sit on the toilet in the right position, get him to blow up a balloon while there. It helps the right muscles to pass a bowel motion to work without over trying. - Peers – once he starts school he will notice that most of his peers go to the toilet and don’t have the smell of poo about them (don’t worry about teasing – it is generally not a biggie in children so young) He will want to be like all the other kids. - Stay positive. It is a hard one to deal with, but it should all be sorted with time and patience. If there are no changes within a couple of months, it may be asking your GP to refer him to a Paediatrician again. Best of luck to you and your son.
