Tuesday, November 25, 2008

all aboard the poop express

When I brought Henry in for his one-year-checkup back in July, I had a long talk with our pediatrician regarding what to do with a child who refuses to go poop in the potty.

He told me what I already knew, which is that some children take longer to train than others. But if I was concerned, I should bring her in for an evaluation.

Which I did.

That was four months ago.

After his evaluation, he determined that this was a behavioral issue, not a medical issue and he suggested that I put her on the potty throughout the day and reinforce that this is where she needs to go.

When that didn't work, and after I had that one particularly regretful incident where I put her on the potty for four and a half hours one night (I really don't recommend that), I called our pediatrician and asked what other advice he might offer.

Maybe there was a pill I could take and I'd automatically wake up when it was over?

Unfortunately, no. But he suggested I contact a pediatric psychiatrist.

So I did.


But they never called back. And maybe I should have just driven the one-hour north to the pediatric psychiatrist's office and stood outside of their door and demanded an appointment, but something told me that this was something that she would outgrow.

I just needed to give it more time and have more patience.

In the meantime, I talked with her teachers at school and told them the struggles that I was having and perhaps they could help to encourage her. And I talked to her at length about why she wouldn't go. And for that matter, why she wouldn't put forth the effort to get dressed by herself or buckle her own seat belt or a host of other things that her same-aged siblings were chomping at the bit to do on their own. And for all of these things and more, she would tell me, "I'm afraid!" or "I can't!"

So when I received a progress report from her swimming instructor that said "You need to have more self confidence and not be afraid because you can do anything you set your mind to!" it just reaffirmed that the challenges that I am facing on so many fronts are entirely psychological.

All the while, at night time, whenever we would put her in a Pull-Up before bed, she would poop. If not at night, than early in the morning before school. So I would give her a bag of wipes and she would go in to the bathroom, take off her Pull-Up and clean herself up. Because I told her that I wasn't going to do it anymore. And she was fine with that.

If it was only that easy, it would be one thing.

But it wasn't.

If she was a little younger and I could put her in a onesie or her pajamas on backwards, that would be another thing.

But she isn't.

And more times than I count, I have been faced with sheets, pillows, blankets and walls that have poop smeared on them. And the poop! The poop! The poop! was starting to drive me a little crazy, despite my best efforts and staying calm and practicing deep breathing.

So this past weekend, I decided to help her. Not by punishing her, but by showing her that she can go poop. On the potty. I was temporarily assuming control of a situation that had grown completely out of control. So I gave her the enema on Saturday and she has never pooped so much in her life.

And last night (two days later), I told her that I was going to give her another enema. But the words no sooner left my mouth and she RAN in to the bathroom and in less than a minute, created yet another poop masterpiece.

Everyone was so excited about the pooping and the peeing and how grown up they are, against my better judgment, I caved to the pressure of letting the four-year-old children in this house go to bed sans diapers, wearing only underwear beneath their PJ's.

And of course, despite placing three groggy children on the potty before I went to bed at 11:00 PM, I woke up at 3, 4 and 5 AM to three different children that were crying and crying and crying because they were WET! WET! WET!

Everyone was miserable. So I figure I'll put everyone back in Pull-Ups until they are at a point where they wake up at night to use the potty. Or, they wake up dry. Which ever comes first.

I suspect that by the time Henry is transitioning out of diapers, I will be an expert. But as for now, I am figuring it out as I go and washing an exorbitant amount of laundry in the process.


  1. oh. my. well atleast the enema worked its wonders and then some! just keep threatning an enema everyday and hopefully she'll go, but maybe keep the pullups on for a while. i babysat kids in college that were 7 and 9 and both wore pullups to bed!

    or chew on this...my son took a condom to school. he.is.three!

  2. Hooray for success! Sounds like you're on the right track. We finally got to that point in potty training my eldest where she KNEW what she needed to do and REFUSED. Strong measures were taken until she got the message. Sometimes it just has to get to that point before the magic happens.

    If it's any consolation, I wet the bed until I was 11, and now I've got a 6 year old who wears a pullup because she still can't make it through the night.

  3. The weeing in bed thing is normal until way later than 4, I shouldn't stress about that.

    The psychological thing is so hard to cope with. I think that most parents would refuse to name a favourite child but would admit to a most difficult one. I certainly have one that can wind me up in 3 seconds flat and I yell at him in a way I would never, ever to the other 2. He knows every button to press!

    The other observation I have is based on a set of triplets I teach. They are now 7 and I've known them for 4 years. They are each of them at entirely different stages of development. I would go so far as to say there is over a years difference in reading ability between the most advanced and the least. BUT, although there have always been major differences in development between the 3 at any given time it has not always been the same child to be the last to do everything. Things have changed dramatically over the past 2 years. The long view is always hard when we're stuck in the middle of a crisis but sometimes it helps..... Maybe......and maybe I should shut up and go away now!

    Maybe the thought of another enema is all she'll need and suddenly it'll be normal for her to go ... normally!!

    Good luck

  4. Jen,
    Most of my boys as well as I wet the bed. I had every test known to man and took every pill, had every alarm etc...sometimes they just can't help the middle of the night wetting. 2 out of my 5 wet the bed on a regular basis and 1 of them is a teenager. Believe me nobody likes to wake up wet.

    I also sympathize with the Poop issue. My 3rd son struggled with this. He would hold it so long that it was painful when he finally had to go. I guess that feeling remained regardless. We had to put him on Miralax daily and eventually he couldn't hold it and decided he better use the toilet. OMG!! I remember those days. She will get it, I promise. I always told people "by the time he enters college he will be trained" LOL! Good luck!!

  5. Jen ~

    Nighttime dryness of my children(or lack thereof)is an issue I have come to terms with and decided will happen when their bladders are mature enough. As someone told me when my oldest wouldn't give up his bottle well into his two's, "He won't go to college with it!"

    I have a seven-and-a-half year old boy and a five-year-old girl (names won't be used to protect the "guilty!") who STILL wear Pull-Ups each night to bed. We have progressed from dual nightly SOAKERS, to one soaker once every 10 to 14 nights. I have found when I feel confident and say, "Why don't we try it without the Pull-Up tonight?" its as if someone has turned on the urine faucet! I watch their liquid intake after 5 p.m. and make sure they "go" before they go to bed.
    Both children are independent putting their Pull-Ups on and placing the dry ones back in their PJ drawer the next morning for recycling (it gets expensive). If they get cocky and don't want a Pull-Up, I always give them an enthusiastic "Sure!" but tell them if they wet the bed, they're washing the sheets and changing the bed...

    I know my situation hasn't given you any solutions. Just know I feel your pain!

    Hugs ~

  6. Okay. I don't buy what your doctor told you. But, then again, I never do! After Amanda's impaction a few months ago, I learned doctor's do not take this stuff seriously. If he didn't take an x-ray of your child's stomach, how can he say for sure that it's not a medical issue? If the problem continues, I would seek a referral to a GI doctor.

    But either way, whether it's mental or physical, it's still encopresis. I read more than I ever needed to know when we went through that obstruction drama.

    Here's a website that talks about it.


    Then here's a forum that helps people find answers and helps parents learn to deal with the anger surrounding the issue.


    If it continues to be a problem, I would press the doctors, Jen. I just have a problem believing he knows this for certain without diagnostic tests.

  7. Yikes - I keep telling people that there is no dignity left to mothers. Sigh. It sounds to me like she has figured out that the helpless role works for her. With three sibs to compete for attention with, she has figured out that being helpless gets her the attention she needs. Unfortunately, I have no suggestions to offer. Like so many other things, I think you are just going to have to ride it out. Hang in there! You can do it, and this too shall pass. (Just keep chanting that over and over, "This too shall pass, this too shall pass." It keeps me from screaming... mostly.)


  8. I used to pick my 3yo up out of bed right before I laid down (11:30ish?), sit her on the potty, and whisper in her ear to pee. Usually she did, but I had to hold her onto the toilet lest she fall over. She never woke up and rarely wet the bed. Not sure I could've done it times three, though.

  9. Hi Jen--
    I think I mentioned this a while ago when you first mentioned this issue. My oldest, now 7, had encopresis and our pediatrian gave us a stool softener, which helped a ton (makes it easy to go, tasteless, one a day which we gave him for 2 months). Once we started him on the stool softener, I would get up before him, pick him up from his slumber, and carry him to the toliet. He would protest a bit, but I would sit him down on the potty and hold him steady. I would tell him "Don't worry honey, mommy will take care of everything, just keep your eyes closed, you don't have to wake up yet, all you have to do is relax and go potty". Worked like a charm!

    Lastly, my middle child went through a time where she wouldn't do anything for herself when she was 4. Drove me nuts! What finally worked was.. when she'd say she couldn't dress herself, or buckle her seatbelt, or feed herself, I would say very gently & tenderly "Sure you can honey, but I'll do it for you today, cuz sometimes it's just nice to have a little help from mommy". Typically she would say "Yes it is mommy" and we would have a nice hug. This 'stage' with her corresponded to times when I was 'too busy' and I think she ultimately was looking for some tender attention. I used this technique and it really made a difference!

    Take care,
    Michelle McKeig

  10. I have to second what Michele said. My pedi got an x-ray to determine how much poop there was and to confirm our action plan. If you are getting that much poop with an enema, I suspect there is much more lurking.

  11. I love Michelle McK's idea about how she handled her dtr's wanting help. I have 3 y.o. twins and they both have heard practically since they were born "don't worry, Mommy will take care of you" and this is a line that still brings them comfort, even though they don't seem to need to hear it as often (It also lead to them saying at an early age, "don't worry mommy, we'll take care of you!") But if they are looking like they just want tlc, it really comforts them. They say "you will?" and it really seems to calm them.

    I agree w/ Michelle S on the diagnostic thing and there are a host of things that some docs don't take seriously. Having said that, the light bulb moment for mine was when I miraculously uttered the words "Your poo-poo needs a little push, can you help it? It's stuck. It's saying help I need to get out of here" That lead to them asking every imaginable similar question: What's the potty chair saying? What's my underwear saying (thanks for putting the poo where it belongs/for not putting it on the Diego underwear, etc.)As time goes on they hardly ever say it but it worked like a charm, even if it did get old at 8 p.m.!

  12. forgot to add that we also use Miralax with my dtr as her stools were so hard (she refuses many fruits and veg. which would help)and the poor thing struggled so much. Doc said if there's always stool in the track then they run the risk of infection.

  13. I guess I should really feel lucky that my not quite 2.5yr old twins trained easily. They are also dry at night and have not worn pull ups or anything for months.

    Each child figures it out in their own time.

    Good luck

  14. Oh, I think the enema threat is brilliant :). At a Mom's Group I was in, we had three moms visit whose children were over 18 years, so we could get some insight on what worked for them and what didn't... specifically potty training. You know what? They couldn't remember! All three ladies said they don't remember the specifics of potty training, but it must have worked since all their adult children have been using the toilet for years. That made me realize that sometimes we moms really cannot see the forest - we're too busy staring one tree in the eye.

  15. My daughter was about 2...she had a fascination with tampon applicators...the plastic ones!? She would go into the bathroom, get under the sink, get into the box and open one up...take the cotton out and use it as a...(are you ready for this?!)WHISTLE!!!! Yes...she would put it in her mouth and blow air out of it like it was a whistle.
    I can sympathize with you on the diaper situation. We would buy the footie pj's and have to safety pin the zipper to the top of the neck of the pj's because if we didn't, she would take it off, pull off her diaper and then pull the stuffing out (the gel stuff) and have it strung from one end of her bed to the other, by morning. It was HORRIBLE! She never did it with poopie diapers...only pee!
    I know it's Tuesday's blog I am posting on, but today is Wednesday and you have not posted today, so I will try to remember to post my progress tomorrow from home since I am off the rest of this week until next Monday. I have lost 3 more lbs this week and am slowly climbing the hill to the 20 lb. mark by Christmas! Thanksgiving will be hard, but I have not ate all day today (too busy at work) except for a few crackers with p.b. on them to get me through until I get home for dinner. Hope you and your beautiful family have a WONDERFUL Thanksgiving!

    Susan in Missouri

  16. Hi Jen,
    I commented you after you bought your new Sonicare saying I had taken your advice and bought one myself. After using mine twice daily for 3 months, I had my dental cleaning today. The hygenist was very impressed with the improvement of my teeth. No more bleeding gums, NO plaque, and a significant reduction in the staining from my daily coffee!!! It was a painless cleaning today! 6 months until I go for the next cleaning!!! Whooooo Hooooo

  17. Back in the 30's an enema was a cure for everything, "Oh, my poor son, you have a headache? Let's go into the bathroom & I'll give you an enema." My husband learned not to get sick pretty quickly. I also remember enemas (in the 50's) for any type of stomach ailment. I also quickly learned not to complain about any minor (or major) aches. They were also routinely given before any surgery, no matter how minor, and also before childbirth (women were also shaved).

  18. This is not a criticism thinly veiled but it is plea based on my own experience.

    A few blogs ago an Australian General Practitioner left a comment saying that the poop issue may be medically related and even went so far as to recommend some testing that could be carried out to see if this was the issue.

    I know you have already been to the paed doctor about this. You know if they ran the tests the Aus doctor recommended, I don’t.

    If the tests that she recommended haven’t been run – please reconsider and get a second opinion (with the tests). I say this based on experience of Pediatricians versus general practitioners.

    After having my third child in a “bells and whistles” hospital (not by choice) I prepared to move back to my local hospital the day after she was born. The Pediatrician checked my newborn out and signed her off as perfectly healthy.

    The next day, when I was giving her a bath at my local hospital, my normal doctor came in and took the opportunity to examine her. That was the last bath I gave her for 20 weeks. Both of her hips had not formed properly. Three days after she was born I had to take her back to the big city hospital so that she could be put into a body brace.

    She had two operations, 8 weeks of chest to foot plaster (opening for nappy – that is it –baby with arms free, but that is the only movement possible) and 12 weeks of body bracing (physio gave her a bath once a week for this stage – so not as smelly as the plaster) – after which she was indeed perfectly healthy.

    If I hadn’t gone back to my local hospital and stayed under the watchful eye of the pediatrician, she would be walking with a severe limp now, or, she would have had to have even more operations and had to do the plaster time when she was a toddler (which would have been frustrating to her, and an absolute nightmare to me (because she was heavy and didn’t fit in a pram, and there were 2 other kids that still needed to get out of the house).

    What I’m saying/nagging/trying to persuade you to do is……..get a second opinion (with the tests) – just in case.

    To sit on a toilet for 4 hours and not go, just to be defiant sounds like a teenager, not a 4 year old.

    Anyway, my sympathies go out to you – I can’t imagine having to deal with 4 year old poop on walls etc. Must stop reading your blog when I’m having lunch.

  19. I read your posts with awe and wonder at all you do for your kids! they are adorable! I am a mom of a kindergartener and toddler twins and my patience is tested daily. you are a saint! I just wonder if your little one who is afraid of pooping might have other developmental issues - maybe it would be worth talking to a specialist? I know it's so crazy that you barely have the time to cover the basics. You do all that so well! (plus homemade cranberry sauce on top! I'm going to have to try it too). Good luck and keep writing - I really enjoy your blog so much!

  20. My 23 month old is refusing to poop on the potty. She's also refusing to poop in her diaper.

    I feel you. Oh Mama, I FEEL YOU!

  21. I'm a bit late in the comments on this one...I've been a bit out of the blogging game.

    I was just thinking...have there been any studies about kids who were premies and development of intestinal tracts? Cause your kiddos were early, weren't they? So while they are 4, maybe because they were a bit premie, there's some actual differences in the growth of their large intestines. And because there were 3 of them inutero, how do we know that everything developed as it should?

    I agree that if you are getting THAT much poop in an enema, something might be off. Do you have a children's hospital in the vicinity? A pediatric GI consult might be a good idea....let's be honest, is your pediatrician treating her like a regular 4 year old, or one who might have issues stemming from her early birth? Maybe they haven't kept up on the latest trends. Just my 2 cents :)

    Good luck!

  22. Our third child, Kenny at 3 1/2 years, was also not willing to use the potty!!!! We tried everything we could think of and then followed the advice of lots of experts and some not so experts with the same frustrating lack of results. One afternoon I went grocery shopping and left Kenny home with his 13 year old sister. You guessed it... he pooped his pants. Now Shelley being the ornery (hormone driven) teenager that she was and not appreciating the job of cleaning him up reacted very badly. She hosed him down with cold water from the shower wand and told him that if he EVER did it again she would flush his head down the toilet along with the poop! Poor little kid was still sobbing when I got home an hour later BUT that was the last time he ever filled his pants. I wouldn't recommend this method and I'm sure child care experts would call it abuse.... and they'd be right but I wouldn't trade the results for all the months it would have taken him to get it figured out on his own.

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