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My son will be 6 in January. He has never had proper control over his poos since we started toilet training when he turned 3. He seems to go through spells where he is mostly in control, to days where we have messy pants 2-3 times. When this happens he would rather sit in them then rush off to clean up or ask for help. When we've talked to him about it he says he was playing. He also says his bottom goes to sleep. W'eve been from thinking it was just going to take him longer to him being lazy and everything in between. We've tried the supporting approach, sticker charts, rewards or things taken away and then rewarded back, cleaning it up to asking him to clean it up. To be honest we are lost now for what to do. It's obviously very upsetting for all of us. The worst recent thing is he is now hiding poos and messy pants in his room. Please help


It is very frustrating for parents, and children when this sort of thing happens.  You are on the right track with rewards.  Make sure your reward the effort or attempts rather than the result though, as it may be beyond his control at this time. 

Soiling is more common than people realise in general.  That he hides his underwear or ignores it when has soiled is also common.  He can’t control it, therefore he ignores it or hides it.  Talk to him about letting you know when he has soiled, and that it is not his fault.  He did very well to explain to you that it happens when he is busy playing.  Children can get so engrossed in activities that they don’t feel the urge to toilet.  His analogy of his bottom going to sleep describes it very well.

On the days when he soils, can you identify any triggers?  -change in diet or fluid intake, change in activity level etc.?  What are his bowel motions like ie hard or pebbly, soft/formed, runny?  Does the consistency of his bowel motion change between those he passes in the toilet, and those when he soils?

Tips that may help resolve the problem –

- Sit on the toilet ten minutes after meals (particularly breakfast)  eating stimulates gut action, so while everything is on the move is a great opportunity to let nature take its course.

- When sitting on the toilet, give him a foot stool to rest his feet on, and get him to lean forward with his elbows on his knees.  This ‘opens up’ the pathway for the bowel motion to come out.  Some children grip the sides of the toilet seat, and this actually pulls up the pelvic floor muscles and prevents the bowel motion from coming out.

- Get him to sit on the toilet for around five minutes at a time.

- If motions are quite varied, it may be that there is some constipation occurring.  This can cause the inside of the rectum to stretch and lose its sensation of needing to pass a motion.  If his motions are hard, increase fruit and fluid intake.  If loose, increase his fibre.

Good luck.