Poop Issues and a Stubborn 4 Year Old

Updated on January 23, 2012
K.B. asks from Detroit, MI
12 answers

My daughter is 4.5 and has had some issues with going poop regularly on the potty. We got her potty trained for pee first last year and she's great with that. But she was reluctant to use the potty to poop and started withholding it. I started giving her some Miralax over the summer here and there when I felt she needed it and made sure she was drinking plenty of water, as well as eating fresh fruits, veggies and whole-grain products. She still would only have a BM every 3 to 4 days and they would be huge - they would take a fair amount of pushing on her part, she would complain that sometimes they hurt, and they would clog the toilet! But at least they were on the potty and she wasn't have accidents in her pants otherwise (except for when we had to load her up on Miralax - like 1/2 capful twice a day - and she ended up with some soft stool that left "skid marks" in her panties). Then a week ago I had her in to the pediatrician for an ear infection and discussed the issues we were having - I was trying to manage it at home but she would still go only every 4 to 5 days. He told me to give her 1/4 capful of Miralax every other day and also every day after eating, to make her sit on the toilet for 10 minutes and see if she would have a BM or not. He said it was to help her get in the habit of sitting on the potty every day to try to poop. He even told her himself she needed to start pooping more so she wouldn't get sick. When she goes, she gets to put a sticker on her chart and then 10 stickers will earn her a special prize or treat.

So it's only been a week, and we've been following the doctor's directions, but she's still only had 2 BMs - one the next day (which was Wed, and it had been 5 days since the last one), and then one on Saturday. She's getting 1/4 capful Miralax every other day (got it this morning) and she every day she is eating apples, or a pear, or raspberries, carrots, celery, whole-wheat bread, etc. The big issue I am having is that when I tell her it's time to try sitting on the potty to poop, she flips out and starts yelling, "But I don't NEED to!" We are going through this twice a day, and with only doing 2 BMs that whole time, there's been several times she's had to sit on the potty for 10 minutes and nothing happens. And the whole time she's screaming, "But I don't need to! I don't need to!" over and over. It's like she's mad that I am making her do this and not listening to her when she really doesn't think she needs to go, but I'm like, OMG, you must have to go! You can't be eating all this high-fiber food and taking Miralax and not have to go at some point - certainly more often than every 3 days!

How would you handle it when she's yelling and screaming that she doesn't need to poop? I've already told her multiple times that this what the doctor said to do and if she doesn't try pooping every day she could get very sick. I've told her that holding it in is why is sometimes hurts later when she does go, and if she goes every day, they will be smaller and it won't hurt to poop. We're supposed to go back in another week to get her ears rechecked and I'll be letting him know how things are going with the plan he recommended. Has anyone dealt with this themselves and did your kids end up being okay? I hate to have her end up with long-term issues, either physical or psychological from all this! TIA!

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So What Happened?

Just wanted to add that she has no issues with the potty flushing - she likes flushing it and watching it go down. If she does a poop she always wants to see if it actually goes down or not. :P

Also, we've tried the whole "read a book or hold a toy while sitting on the potty" thing and it doesn't matter - she will still scream and yell the whole time and is more focused on not having to sit there rather than easily distracted by something else. She also does NOT want me in there with her until she is done! She's got a very strong-willed personality and I hate for this to turn into a battle of the wills. Thank you to everyone so far for your suggestions!

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K.M.

answers from Denver on

I dont know what to do about the screaming while she is on the potty but we had this issue with my son also. He would get so constipated from holding it in he actually got a prolapsed colon and I had to call an ambulance for him because literally his colon was coming out! We had to give him massive doses of the mirilax, like I am talking the whole capful. It was a bummer because he was potty trained and not poop trained I felt like I needed to put him in the pullups again. But anyway with those mass doses of mirilax he couldnt help but go and he got used to going poo on the potty and we havent had to use mirilax since. I would definitely at least talk to the ped about increasing the dose we were having to give a capful EVERY day especially after his prolapsed colon. Good luck!

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S.H.

answers from Honolulu on

Take her to a Pediatric Gastroenterologist.
"Withholding" poop or not pooping, is a 2 pronged issue: emotion based and then biological based.
If she is all backed up internally, then the Specialist can tell you.
And for constipation, which your daughter has, the Specialist can tell you what to do too.

Holding in poop, is a sense of control for whatever reason. But holding in poop also causes pain and can cause bulging bowels etc. And more constipation and Encopresis in some cases.

She will not be convinced by you, it seems.
See a Pediatric Gastroenterologist.

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L.R.

answers from Washington DC on

Besides the other good advice from moms and your doctor, I would add: Have a special, new, very interesting book or books (even a puzzle book if she likes those) that is ONLY for when she is sitting on the toilet. Make it as tantalizing and interesting as possible but stick to your guns if she asks for it other times -- emphasize that it is only for potty time. If it helps, have a special book that you read to her while she's on the potty only -- you sit on the edge of the tub and read it to her and make it as lively and interesting as you can. Lack of privacy for her, yes, but that's not what it's about right now; if your stayiing in the bathroom and reading to her gets her to sit and to relax while sitting there, that's what you want to do. She doesn't care if you're reading to her? Then try this: A story on CD, about 10 minutes long, that you play only for potty time. Whatever it takes to get her to stay there AND to relax her and distract her.

I agree with the poster who said that your girl's adrenaline kicks in and she then can't go -- she is so tensed up that even if she were full up, she would not be able to push it out. Finding something that relaxes her could help.

Also, stick to that 10 minutes of sitting -- resist the temptation to extend it a little here and a little there in hopes she will poop. When the time is done, just say, OK, times's up and thanks for trying! Don't let her see any disappointment or exasperation on your part. You may without knowing it be telegraphing to her, even without words, that you're disappointed in her, which -- instead of making her want to poop to please you -- might be making her more resistant and wanting to exert her power more by not pooping.

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R.R.

answers from Los Angeles on

I realize that she gets a sticker when she goes, and that at 10 she gets a special prize or treat, but that actually may be too far-fetched to be meaningful to her, since she poops so infrequently. Since the problem you're having is getting her to even sit, have you thought about or tried some sort of incentive for sitting on the potty without complaining and arguing she doesn't have to go? There's excellent advice on a site for potty/pooping refusal:

http://rogerknapp.com/medical/pottytrainingrefusals.htm

that you possibly can use to your benefit to get her to sit without arguing, which would be a positive step towards getting her to poop regularly.

Say, if she would go willingly to the potty and sit quietly for 10 minutes without any fussing, then she would get to watch a video, TV show, play a game, etc., for 30 minutes that she doesn't get to use otherwise. You would retain ownership of the video, game, etc., and she would "earn" the right to use it by sitting nicely.

And, I agree with S. H. that your daughter should to see a pediatric gastroenterologist.

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B.C.

answers from Washington DC on

My girl only goes every few days and we have given up on forcing her to sit. It just makes things worse!!! the rewards just add pressure. We give her some prune juice and encourage healthy eating. If she has a hard or painful movement that's when we remind her of what she can do (eat good foods/drink water) we tell her to "listen to her body" when it's time to go, so it's not mommy forcing it's her body telling her). some people don't go every day!

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R.J.

answers from Seattle on

1) The moment her adrenaline kicks in either the entire response gets shut OFF -she couldn't poo if her life depended on it-, or it will come raging on and she'll wet her pants and poo her pants. ((Depends on how much fear/stress/fear/anger gets turned on.))

If it turns into a battle... you're wasting your time. Plain and simple. The moment she gets upset, you'd have to beat her (literally) to make her be able to go.

2) In the vein of keeping things "fun"... Explain about "sneaky pee" & "sneaky poo". When you don't have to go, but you can still go!

3) Some kids and adults are once a weeker's. If you're a once a day person it probably seems insane... but I DARE you to poo every hour. Go sit down and push something out. If you do, you get an adult sticker (martini, $50, whatever). You will be INCAPABLE of pooing every hour, no matter how cool the prize, because your body just doesn't make poo fast enough. It's a sign of an efficient digestive tract (that it's using every last bit of what goes into it) and is completely normal and natural.

Adding all 3 of these things together:

- The on the toilet after meals is a GREAT idea, as long as it's NOT a battle. It works for a lot of kids IF AND ONLY IF they're not freaking out over it. So have this as a goal... and not a starting off place. Give her a book to read, tell her she DOESN'T HAVE TO poo... this is just to get her body used to sitting for when she needs to later on, and let her sit and read/color/whatever for 5-15 minutes. (don't worry about hemorrhoids yet, when they're intentionally trying not to poo they're keeping their bums tight... and are less likely to get hemmorrhoids than someone sitting in a chair. Worry about long sitters with relaxed bums in a year or two and you're shoeing her out of the bathroom)

Relax a bit yourself. Your daughter probably isn't a once a week'er, but she's also probably not a once a day'er, either. Try every OTHER day at most. Especially right now when she's freaked over it.

HINT: A little vaseline on the *outside* of her rectum will smooth things along / make things hurt less. And it feels kinda icky, so the natural response of people is to kinda wiggle and relax. Which also helps with the actual pooping. But it REALLY helps with the "It makes it not hurt" lessening the fear.

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D.S.

answers from Kansas City on

DVMMOM, the moment I saw this question on the sidebar - without your name - I knew it was from you! Why? Our kiddos seem to have a lot in common and you always ask what I was going to!

So...I know what you are going through. My 4 YO son has never been a fan of regular poop and it is so much worse now that he's been potty trained for almost a year. High fiber foods, plenty of water and very little results. He is quite stubborn about it. We are constantly asking him if he needs to poop/telling him he is going to try whether he thinks he needs to or not. And yet he will go days without one and then they are epically large, sometimes hurt and take FOREVER to finish. He gets very cranky, too, because his tummy starts to hurt after he's missed a couple of days or so. If he hasn't gone all day then it's a standard part of his bedtime routine to try but yeesh, who has 45 minutes to waste when he's so good at holding it in?

At our 4 year checkup the ped recommended a small amount of Miralax every day instead of waiting until it had been a few days and giving a larger dose all at once. It has made a bit of a difference so far. Still waits forever to try/go but we've had more daily success. And just yesterday we let him decorate his bathroom (our main/only guest bathroom so visitors now get to enjoy an eccentric collection of ABCs, sea life, dinosaur and thomas items) so he'd feel more at home in it.

Reading him a special book has helped, too. Our current one is a Richard Scarry dictionary filled with a zillion things to read/look at arranged by letter. We read one letter each "session" and if he still needs to go after that, we just sit and talk (he was pretending he still needed/wanted to for extra letter/story time and that got out of hand). Still, I've learned to put a comfy towel on the edge of the tub b/c my butt will be there for a long time.

Good luck!

2 moms found this helpful

J.P.

answers from Lakeland on

Her system may just be slower than normal. Give her probiotics (the probiotics will help her become regular). Set a time to sit on the potty, like while you get her bath ready. And praise her for sitting, even if nothing comes out. I have my daughter poop before her bath (or shower) every night. I give her some books or toys to play with so she doesn’t get bored while I fill the tub.

My daughter was afraid of pooping in the toilet (or potty) and it became a control issue. Once your daughter feels she is in control she will go. I also found that arguing, fighting and disciplining like she was bad made it much worse. My daughter would also only have a couple of BM’s per week for the longest time and she is fine, as long as it comes out before a week is up.

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M.P.

answers from Portland on

Have you tried sympathizing with her? for instance, " I know this is no fun and it makes you mad." Still we must do this every day." Remind her that going poop now is difficult and painful for her but once she's able to poop every day it won't be so difficult. Keep reassuring her for the personal reason for doing this as you are already doing. Make that the focus. More than just the doctor says so.

Is she frightened that something that comes out of her gets flushed away? This is a fairly common fear that prevents some kids from pooping. You could try using a potty chair or not flushing the toilet while she's in the room.

How about giving her stickers just for sitting on the potty?

It's only been a week. It'll take longer than that for her body to become accustomed to pooping daily. Every other day may be normal too.

I highly recommend the book, How To Talk So Kids Will Listen and How To Listen so Kids Will Talk by Adele Faber and Elaine Mazlish.

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J.B.

answers from Los Angeles on

if it was me i would continue with the miralax but only ask her to try to go poop in the morning about an hour after she eats then about an hour after she eats lunch. then before bed. if you give her more miralax it could cause accidents because it will flush her system.

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S.C.

answers from Des Moines on

Give her a book or a hand held game or something to DO besides yell for those 10 minutes......

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C.W.

answers from Washington DC on

My 5 yo seems to have a long history of off and on again potty issues. For the longest time he refused to go in any toilet outside of our house, pee or poop. He didn't like the sound of the flushing and he was afraid of sitting on the outside toilets for some reason. He held it for quite a while in Disney World and then after a hot bath he couldn't hold it anymore and it came out on the floor. At home he saw the toilet over flow once, and he refused to sit on it again for a month. He found his baby potty and would poop on it. Finally got him back on the toilet when the baby potty mysteriously disappeared. Then, horrors, the toilet that he liked got cleaned. He claims that now he cannot possibly poop in a clean toilet. So he stands with his butt next to the toilet and it ends up on the floor and then he tries to clean it up before we come in. I have given up. I guess it is better that he goes in the bathroom and actually goes. I am hoping it is a phase. I would stop arguing with her. She is trying to have control. Find a good reward and just wait it out.

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