Seeking Help with 4 1/2 Year Old That Is Pooping in Her Pants Constantly

Hi Hana,

I am going through the same thing with my daughter. She started holding after a painful experience with constipation last year. She was almost 2 at the time. We have gone to a GI Specialist for the last 6 months and she put us on Miralax. It is helping us with her holding issues. From what I was told we need to get it so she can no longer hold it (she would hold it for up to 9 days) and in time hope that she gets back to going daily. I have also been told that there is no quick fix for this and it will take time to resolve. What I tell myself when things get rough is that it could be so much worse. This is not a life threating issue, it's only poop. We can get through this.

I hope this helps. Hang in there

Hello Hana,
First I want to offer my sincere prayers for your daughter and you- I know that this situation has gone on long enough that you are seeking help from anyone that can give it to you.
Often we look at doctors as the answers to all of our health issues. however, their method for diagnosis and antidote is one of "trying" what they have been taught works-it is a game of biological science. However, we need to follow our instinct. Has this situation got worse for your daughter since the Miralax? Have you done your own investigation or research on Miralax? If you feel like this is not helping, discontinue the Miralax and let your daughters body relax. Its reacting to a medication that your doctor "hoped" would work. Pay attention to whether her episodes happen after meals, after naps, when she is excited, etc. The muscles in our body react to different things and while this is obviously due to her colon being traumatized, there may be things that trigger your daughters episodes.
Also, as crazy as it sounds, cut back on fruit and fruit juices and watch out for sweeteners such as sorbitol and saccharin, doctors have said these can be contributors. While this is not a solution to your daughters issues with her colon (which may only be fixed with a medical procedure; I had a nephew who had to have this done), it can help the number of episodes that she has.
I am sure you have talk to your daughters teachers and providers, help them help her by offering reassuring words that this is not her fault and that it was an accident. SHE CAN NOT HELP THIS THE SAME WAY YOU CAN'T HELP SNEEZING. Making her clean it up, scolding her, trying to tell her to hold it unfortunately foreign concepts to a 4year old who can't even explain what is going on with her body.
On another note, I also have a demanding career (my job includes flying 30% of the time) and 5 children ages 13, 11, 9, 7 and 3. When your baby needs you, your baby needs you. While it may be a way that you define yourself (as you did in your "about me" section) your career does not define who your daughter believes is her mother. Your career will be there-believe me, after 5 kids, mine has not left me. If its not, you will find another-it will be worth it to show your daughter during her most helpless time, that you were there.

Dear Hana,
When kids have severe constipation and the rectum gets so stretched out and blocked, the normal wave-like functioning of the rectum stops functioning normally and poop does in fact leak out multiple times a day - and the kid cannot control it. The miralax is a good idea - the goal is to get her cleaned out completely and then institute regular potty times and a maintenance dose of miralax so that she never gets that constipated again. But, again, she cannot control it...
Good luck. Parenting is a messy business in so many ways.
Sincerely,
a doctor and a mom

Hana,

One suggestion to try is to put her on the brat diet, like you would for anyone who has diarrhea. These letters stand for banana, rice, applesauce and tea. Not exclusively, of course, because these foods don't offer an enormous amount of nutrients.

I hope that helps and good luck!
J.

The exact same thing is going on with my daughter, who is also 4.5.

We have discovered that constipation and the big colon that quickly results is really common in kids 4-7. It is not psychological but a physiological development issue, that begins when they avoid pooping because it hurts or they are too involved in something to bother to go to the bathroom.

For us, it started in April and we have been managing it with Miralax (or the Miralax has been managing us) since then. Another thing we've discovered and confirmed w/Internet research is that this type of constipation (w/enlarged colon) usually takes a long time to resolve.

When we started w/the Miralax, the Dr prescribed 1 cap/day. After that the poop seemed to be leaking out just as you describe so I stopped the Miralax, convinced it had given her diarrhea. We too were on some level convinced that she was just too lazy to go, but now know that's not the case. We went to a different dr. who took the time to explain what was happening in her colon. That amount of Miralax (1 cap for 2 days) loosened things just enough that poop seeped around the blockage, and out, uncontrollably. The blockage remained. Your daughter really can't control the seepage.

The solution for us was yet MORE Miralax (and I hate medicines...) but that did the trick. With one cap a day the blockage passed after about a week, and then when it happened again about a month later we went up to 1.5 caps for a few days...which cleared the second blockage. The colon must stay clear, and that's the only way it can heal back to its normal size. We still give her 3/4 cap to 1 cap per day (on alternate days), and the plan is to slowly decrease the dosage over time...like months of time.

From personal experience and Internet research I can state that Miralax has tricky dosage!! But it seems that your daughter is not getting enough to clear the blockage. The good news is, once the blockage is gone the constant flow of poop is gone too and life gets a lot easier.

I'd be happy to share my practitioner's name if you'd like to consult w/her. She has a lot of experience with children's health and really has made us feel like we are in capable hands. Her office is in Albany but she will consult over the phone too. Also, you can call me if you want to discuss poop in detail (I know)...just email and I'll email back my phone number.

Let's keep in touch if you like to see how things go! I know this has been one of the hardest challenges of my parenting life. It's frustrating and seems endless. Thanks for posting.

J.