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Beyond a Fever and Runny Nose, Medical Woes for the Toddler Years: The Poop Scoop
Beyond a Fever and Runny Nose, Medical Woes for the Toddler Years: The Poop Scoop
Okay, so this is not a cute topic that parents tend to sit around and chat about at play-groups, but it is a topic that back in the day, I am sure mothers, aunts and nursemaids passed on from one family to another. And while it’s too late for me, a little shared knowledge on this topic may save other parents of tots an emergency trip to your pediatrician who may or may not make you feel like an excessively worried hypochondriac who runs their kid to the hospital every time they sneeze.
The Problem: My Toddler Won’t Poop!
No, I’m not talking here about the kid who just hasn’t gone for a couple days. Where a glass of prune juice might help things move along. I’m talking, in this case, about the kid who through some amazing will-power and muscle control can and will intentionally hold it in for a week or two at a time. (Note: I’ve posted this as a toddler issue because it most commonly occurs around the time potty training begins).
Believe me, it sounds crazy and a little unbelievable. But when it is your kid, and this happens to you, it is a really easy situation to totally freak out about. So, for those of you who might know this problem from first hand experience or for those of you who have little ones headed toward toddlerhood, here’s the scoop on our story, what we found out, and how we resolved this mini-crisis.
When I look back, the trouble first began after my daughter, who was 2 1/2 at the time, had been sick with bad cold virus. She had a short bout of constipation (about three days without a stool) followed by a painful and hard bowel movement. In the weeks that followed, we noticed she was expressing fear about going to the bathroom. She no longer wanted to use her potty, and when she felt a bowel movement coming on, she would hold onto her butt cheeks as best she could and squirm about with a worried red face trying to keep her poop from coming out. These episodes became more dramatic as she took to screaming “Owie. Owie. Owie. Go away mommy! Go away daddy! I don’t have to go poop!”
At first she was only able to hold it in for a short time, a day or two at the most. But we really started to panic when the days between bowel movements turned into a week or longer. We were incredibly worried as it appeared she was experiencing extreme discomfort. She was also eating less and less and her sleep (and ours) was becoming severely compromised. The longest holding period she went through was 14 days.
We tried everything we could think of to change her pattern of behavior and to get her to go. We jumped onto the web to look for answers, called the doctor and anyone else we could think of who could help us out. At first we focused on diet, cutting out foods like cheese and bananas and increasing foods like bran and peas. We also tried glycerin suppositories which not only didn’t do the trick, but made a bit of a mess.
What Our Own Research and Pediatrician Eventually Told Us
“Stool withholding” is described as when a child feels the urge to have a bowel movement, the child purposefully holds their stool in. It may even appear to the parent who is coaching and encouraging the child on, that they are making an attempt to poop when actually their attempt is to hold back.
There may be many reasons for this but most commonly the behavior is related to a child's desire to maintain control. A child who is actively engaging in this behavior may also have other issues related to eating and sleeping. It can become a more severe issue as the child becomes more adept at withholding because there is a possibility of developing a fecal impaction in the rectum. Discomfort from this impaction may lead to soiling in the underwear and a foul smell frequently throughout the day. This was happening to our daughter after her pattern became withholding for several days at a time.
On occasion, and as in our case, when the stools finally come out they can be huge, so big in fact that you can't believe it came out of your child. When this happens it can be very scary, and information on the web regarding the consequences of this action taken by your child are even scarier.
One article I read led me to believe that my daughter would be emotionally scarred for the rest of her life, not from the withholding, but from the emotional impact of having a soiled pull-up. I thought it was bad enough that I was losing sleep worrying about the physical impacts of the situation let alone wondering whether I was turning my child into a mental case.
Not surprisingly the advice in these articles was to seek medical attention right away or hire a child psychologist who specializes in toilet training to help your child through this important life phase. We settled on trusting our own parenting skills, common sense, and showering our little child wonder with an excess of encouragement. We set to creating our own plan of action which incorporated a little bit of advice from all our sources.
Our Plan
First and foremost we realized that we needed to approach this situation in a calm manner. I personally think the best thing you can do in this situation is not freak out. Be calm, don’t be aggressive about trying to change the child’s behavior. The reason is that the issue, in the tot’s mind, is control.
The more control you try to assert over the situation and them, the more they will try to assert in return. And since there isn’t some magic remote gadgit in which a parent can press a button to control the actions of their child, we need to resort to other tactics like reverse psychology and incentives. In our case we bribed (yes, flat out bribed) our child. We first used stickers, but our child was not in the least bit impressed with them, and we settled on candy. M&M’s to be precise. She got three pieces for going poop in her diaper and if she had the courage to actually use the potty, her prize doubled.
We also paid very close to her diet for a few weeks. We increased her intake of juice, cut out dairy and other foods which tend to have a counter effect while adding foods into her diet that helped her system flow better like raisins, prunes, peas, certain fruits and grains. Since at this age it is very difficult to introduce new foods to a picky eater, we found that ground flax seed was a life saver. We added a tablespoon to her Cheerios at breakfast, we mixed it in with peanut butter, and the most tasty solution was baking it into chocolate chip cookies. (I now add it to my cookie dough every time I bake, it gives the cookies a light crispy texture and a slight nutty flavor...very yummy.)
One of the first things we needed to do, since she had plugged herself up quite substantially, was flush her system. This is where the trip to the doctor’s office was most helpful. His recommendation was a medical regiment to follow for this incident and the ones to come. There were three to four more long periods (7 to 10 days) of withholding that we went through before curbing the behavior.
His advice was that if she went 7 days without pooping, to give her a child’s size dose of Mirolax (note: always consult a physician before giving medication to a child). He wrote a prescription for this and she was to be given one dose each day until she had a bowel movement. This worked each time with just one dose. Each time she had a movement within 10 hours of receiving the medication. Once the child has a bowel movement stop giving them the Mirolax.
He also recommended giving her a tablespoon of mineral oil each day. This can be kept up until the child starts to have regular bowel movements each day on a regular basis. Note, getting your toddler to swallow a tablespoon of mineral oil each day takes heroic effort.
Lastly, and probably the most lasting technique within our regimen was our “Its your Job to Poop Once a Day” Campaign. This included (and still does) a lot of positive communication, much candid discussion about poop itself, the bribery which was aforementioned, and several great books like “Everybody Poops”, and “The Gas we Pass”.
After four months we noticed that our daughter was no longer “holding it in” and she is most certainly now (eight months later) a proud pooper, asking for privacy in the bathroom, calling out that she’s “workin’ it” from the stool, and reminding us when she’s do some candy for doing her job.
Disclaimer: I just want to make a note to point out very clearly, I am not a doctor. I am a mom. This is our story, about our child. If you are experiencing a similar situation please make sure to talk to your child’s pediatrician.
Comments
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Thank you, a reassuring post for anxious parents on day number 8! We just got back from the supermarket where he choose his prize, our 3 year old named them himself -"poop popsycles prizes"!!
Thank you for such a detailed and insightful post! I have done so many internet searches on withholding bowel movements and been to our pediatrician a few times, spoken with numerous friends and family members including my mother of 5 kids and my husband's mother who is a registered nurse. Things have helped but we are still struggling with this at 2 1/2, a year after the first incident with constipation which led to this problem. Now I set my son on the toilet every other day, after being sure his diet is full of lots of liquids, fruits and vegetables and flaxseed within meals. He has soft bm's but tries ferociously to hold them in and will for several days unless I physically place him on the toilet. It is hard for him to hold it for very long in that position but he tries his best and will sometimes last an hour or more. I find it is most helpful if I don't make a big deal of it and mostly ignore when he says "me happy, go potty no way" as he says it and gently remind him to relax and let the poopy out, and it won't hurt. The thing is, when he has a bm, it is soft and I know it is not painful but it does hurt and is very uncomfortable for him to hold it. When he does finally go, he seems very angry that he couldn't hold it any longer. He gets mad and says "leave me alone" and "no wipe me buns". A few minutes of him wiping his own nose from crying and sitting going pee and actually making a genuine effort to poop more (usually without results) he is ready to wipe and get down. We put a diaper on and he inevitably goes poop at least twice more, in his diaper, very soft sometimes runny (sorry tmi). I am thinking maybe it would be best to try to have him go once daily instead of every other day, because he gets very grumpy and irritable by the time I have him try to go. This article has been very helpful along with all the comments. Good luck to everyone dealing with this difficult situation!
hi thankyou everyone for your stories! again it's sort of reassuring that I am not alone.. my heart goes out to all the other mums! ESP who mentioned that dad was being no help at all and was rather annoyed at child! I know the feeling! and I think it's all part of the control game! just frustrating when dad seems unwilling to be of any actual help!
I am a feeling relieved that my family isn't alone! my son is 3 and has been withholding for about a year now. i have tried to encourage but that hasn't worked. Bribing wont work, my son is autistic and doesn't quite get the gist of bribes. he is terrified of pooping and he starts panicking and sweating when he has to go. it makes me soo worried because its just making things harder for him(absolutely no pun intended) i am desperately clinging to the hope that he will out grow this behavior!
I have the same problem that I am reading...my son is 4, we have been going thru this (off and on) since he was 9m. I have been prescribed Restolax PeG3350 which has worked great. I am concerned with 'dependence' though. As soon as I take him off the product, it happens all over again. (I am getting more gray and more gray b/c of this) Soooo frustrating, I just get used to him making good BM's, and with a respectful amount of time, I take him off PEG3350, and whammo here we go again. It brings tears to my eyes to see other stories of frustration, stress, on the child, and all that x's 10 for the parent. I really appreciate the reading about the serious change of his diet, it's something I was thinking I was going to do, and reading someone else has done it, with some success. Confirms it. Thank you for posting your story, it has helped me alot.
Take this very seriously, I had the same problem and didn' t know he was being molested!! I didn't see the signs and they were right in front of me!! It was his older brother who he loved very much, we never would have guessed!!
My daughter will be turning 4 in a week and I have been dealing with her withholding for about 2 1/2 years now. I'm at my wits end. I've taken her to her pediatrition who reffered me to a gastrointerologist who could only say give her mirilax. She has gotten so bad at times that she will even hold her pee to prevent her from pooping and that has only led to her vomiting the next day. I've tried praise, stickers, treats, toys, even punishing for not going and nothing works. Your article has giving me a new avenue to try but she is a stubborn cookie. I hope there is a light at the end of this sometime soon.... Soooooo stressed.
Hi" I've posted twice already and just wanted to leave another follow up in hopes of helping other families going through this. My 3 year old daughter had a painful bm just before turning 2 and we have been battling withholding for 15 months now. We have finally found a dose of Miralax that seems to work best and that is a half cap every morning. During the last year and a Hal, we have tried every incentive under the sun. We bought books that include, Everyone Poops and Poop hurts. We've ignored it, pleaded, begged and I have cried many time. Recently, I finally tried something that was recommended to me but that I never really tried...potty time. She is pee potty trained and so about 20 minutes after each meal we go into the bathroom and do potty time. I found a few activities that she enjoys and we do them together on the potty until she feels the sensation to go. Even if she doesn't go, we still make it a routine. The key is to make sure their feet are planted on a stool which helps them push the poop out. Another trick is to swipe their behind with a little "magic cream" (Vaseline) right before they start potty time. This will make things slip out easier. Yet another trick is to play games like blowing up a balloon or a pinwheel in order to give them the outing sensation. I've done this for two weeks now and she has gone almost everyday with little hesitation. I wouldn't say we are out of the woods yet because she is still holding it in and not 100 percent happy to go but we've made great progress. I also took her to a GI last week and they recommended that in addition to the Miralax every day that I give her a pedia-lax dissolve strip every night. I have to admit that I didn't take their advice. I gave her the laxative twice and it only caused her to be more uncomfortable and have a distended tummy. I think the key is to know that this is behavioral and that as long as they have soft stool and positive poop experiences it will surely fix itself. I will post again down the road to give an update. If anyone wants to contact me fir support please email me at jpkloss930@hotmail.com I know how difficult this can be on bit us and our little ones.
I am a grandmother of a 2 1/2 year old. After spending half the night in the ER last night with my grandson and his parents I am reading your article and posts today. My grandson goes through spells where he is in terrible pain, gets clammy, cries, can't sleep. We have all been so worried about him. After reading all of this, I think this is what is going on with him. Thank you so much for enlightening me. I am going to share this information with his parents.
I was so glad to hear a mother's side of this tough issue. I am a mother of a 3 year old who has been afaid to poop because of a painful bm. It is nice to know that i'm not the only one dealing with this. I am looking forward to the day my son stops withholding and has smiles instead of tears. Thanks for the great article and comforting story!
Hi. I read all these comments with complete sympathy. My eldest daughter started withholding her poo when she was 2 and after 6 months on lactulose it seemed to cure her until thus weekend. I must say it was only 4 days worth but she was crying for two days. We tried bribes cuddles sitting for ages in loo getting cross. Everything. Until I turned to my friend mother of 4 who told me to completely ignore her. Which I did. And after a few mins of out and screaming and shouting she pooed and was all happy!!
Just and update on my daughter...I had posted six months ago. Well, we are on almost 8 months of witholding now and it's killing me. We even have stopped trying for a second baby because of the stress this has caused our family. It's awful! No doctor seems to be able to give me a straigh answer as to what to do. What's worse is that when she has to go to the bathroom she gets really agitated and angry. She cries, throws things, runs around, throws herself to the ground. We've tried stickers, candy, a million different thing with no success. Some nights she's unable to sleep because she's so uncomfortable and she wont' eat some days either. For her 2 1/2 year check up, her ped. recommended upping the Miralax dose to two full caps twice a day. I'm just wondering what other mother's use for their dosage? All this has done is make her have runny poop and it's just messy. Sometimes I get so frustrate I hold her in my arms hoping that she will just get it out! Really, please someone help me. Someone tell me that this will really, really, really go away! Should I ignore it? Praise poop? Bribe with candy? Up Miralx? What, what what? I'm so desperate!!!! help
Me too! I went months thinking my son's discomfort and straining was from trying to make a BM until I learned it was WITHHOLDING a BM! He started around 1 1/2 years old after a couple bouts of constipation. My doctor recommended Miralax and mineral oil. My son is now 2yrs 2 months and he's been on the treatment for 6 months! Twice he got sick which threw him off the treatment. I'm worried because even WITH the treatment he's been going for several days without a BM. It's like he's getting better at withholding! I guess I could increase the mineral oil amount. I add it to baby food prunes in the morning and baby food meats or macaroni and cheese in the evening. 2 tsp's each time. In a pinch I'll mix it with ice cream! It's tasteless and odorless. I like to think that this is something he will grow out of - whoever heard of a grown man withholding stool? But it sure is a source of anxiety for this mom!
What a great article, it is so reassuring to hear another Mom's point of view regarding this issue. My son, who is 2 1/2 has an extreme fear of pooping after experiencing a couple painful bm's. He has also started Miralax so hopefully it will help him. He is on day 7 without a bm and last time he had a bm it was only because I broke down and gave him a Pediatric Fleet Enema. Not many people understand the worries a mother can go through after watching their toddler run around for days, saying their "poopie hurts" or "I poopin" with no actual results. Thank you for the great advice!
This was great to read! I've felt so alone in this process and everyone has a different opinion! Some are extreme- like give her a suppository every time she refuses to poop, and others are on the other side of the spectrum-- just let her work it out herself. My 2 year old daughter started withholding after one bout of constipation and she does exactly what everyone mentions- hides in a corner and says, "go away Mommy!". I've already tried making her sit on the potty for an hour, telling her she can't get off until the poop comes out and what I've learned is... I can't control this. I like the idea of scheduled positive potty times that are only 3-5 minutes with small rewards for positive times and large rewards for actual defecation! It was helpful to hear that this was a control issue and for me to relax and let her feel some control with this. Thanks for helping this Mom out!
Thank you so much for this fabulous article! I've been going through this with my two year old daughter for two months now and it's been very stressful on the whole family. I've read a bunch of post online but there was never an ending to the story, so I never knew the outcome for each child. My daughter has been on Mirolax for two months now and even though she's had soft stool for almost a month she still freaks out. She holds herself, crosses her legs, screams, goes ridgid! It's horrible to see your child in pain and not be able to help! She kept pointing to her stomach and saying "It hurts" or "owie". So sad. What's worse is she starts preschool tomorrow so I'm scared they are not going to help her through these tough times. I've felt so alone...I'm home all day so I see it first hand and it's weighing on my already frayed nerves (I have anxiety disorder). My Mom says she's "never seen anything so abnormal" (thanks Mom for your lovely support) and my husband is at work all day and only gets the idea on the weekends where he actually seems annoyed with her behavior and frustration. Anyway, we are going to continue with the Miralax and just help her through it and hopefully too, this will pass (no pun intended)!
THANK YOU so much for sharing! We've been going through this as well as potty-training resistance for a while now and it's so frustrating and upsetting--it's great to know that others are going through it, too, and to read their advice.
This article is exactally what I am going through! The only thing I have found on-line to help ease the worry. Yesterday my son had a high, high fever and didn't eat anything. We are on day 5 without a poop. He will hide in a corner when he has to poop and yell at us to get away. I bribe him with dinky cars and I even let him squirt food coloring in the toilet so he can poop on it. This worked for a little bit, but now we are back to with holding the bowel movements. Thank you for this article!
I am so thankful for finding you're info on "witholding poop". My daughter is 3 and has been witholding her poop for about a year now, but this time is the worst...she is going on day 9 without pooping :( and I would scream and cry if I could, b/c I am so scared for her, but I know it will only make things worse. She has had a fever and thrown up 2times today, so I rushed her to the ER and surprisingly she was acting like a new kid when we got there, so after waiting 30 minutes I made the decision to bring her back home and take her to the doc in the morning! I just hope I'm making the right decision, I am afraid to go to sleep so I'm on the computer watching her sleep...I'm just praying for us to get to the doctor in the morning and find out everything will be fine. Your post has helped calm me down for the time being, Thanks.
Wow! I am reading this with teary eyes! I've been dealing with my toddlers constipation for about 6 months now, and of all the articles I've read, this is by far the best. Your advice is so wonderful, just from a mom perspective - I've been freaking out all day because we're working on day EIGHT now with no poop, and this made me feel so much better. Thank you much for your candid advice, it is truly appreciated! :)
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