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My 4 Year Old Still Poops in His Pants

I am not sure how to approach this situation. I took my 4 year old to the Gastro Doctor for constipation. My son is on Miralax twice a day. He holds his poop when he is on the potty so therfore he has lost some sinsation to feel the urge to poop. We had to do the whole cleaning out process( that was a mess) anyway now he is going regularly, but he will not tell me when he has to go until he has already gone and he says I need to go sit on the potty. Im not sure if he has his sensation back or if he is just being stubborn. I don't want to punish him but I am at a loss. I have tried everything to a Potty chart, rewards buying presents etc.... Help any suggestion.

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Well I have started potty time and so far twice this week he has came and told me he needed to potty. there has been just a little bit in his underwear, but I made him sit on the potty until he pooped, We will keep trying this, We went to walmart and got him a suprise for pooping twice in the potty this week. hopefully it will keep working. Thank you all for your advice. Thats what I love about this website. Everyone is so nice and actually takes time out to read peoples problems and help them out. Thanks You again. J.

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Although my son did not have the medical issues we did have problems with him pooping in his pants. My mom told me at the time that it was fairly typical of boys at that age, they do not want to stop playing long enough to take care of business. My solution was I made him wash out his own underwear everytime there was an accident and then take a bath. He soon decided it was quicker to go to the toilet on his own. L.

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I agree with the Ginger S and Ginger B. Whatever you do, do not punish him. He will get it down when he is physically adn psychologically ready. Put him in pull-ups and try to predict his "poop schedule" and schedule potty time. It won't last forever. He's been through enough with the "cleaning out process" and doctors. He may relating pooping sensation to all of that. I think if you just put a pull-up on to minimize the mess (which he may not like if he's in big boy pants already), and be patient then it will happen. Hang in there and love him and praise him - potty issues and food issues can cause the most psychological issues later in life.

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I agree with the Ginger S and Ginger B. Whatever you do, do not punish him. He will get it down when he is physically adn psychologically ready. Put him in pull-ups and try to predict his "poop schedule" and schedule potty time. It won't last forever. He's been through enough with the "cleaning out process" and doctors. He may relating pooping sensation to all of that. I think if you just put a pull-up on to minimize the mess (which he may not like if he's in big boy pants already), and be patient then it will happen. Hang in there and love him and praise him - potty issues and food issues can cause the most psychological issues later in life.

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I read a couple of your answers and i agree with Becky B (I'm V. C. Maybe there's a kindred spirit there! LOL) Kids need to know that THEY have responsibilities and consequences. Why should Mom have to do all the 'dirty work' that the kids caused. I'm not cruel, but I have 4 fairly well-adjusted adult children and 3 wonderful Grandkids. Parenting has been pretty much my 'life', but I don't cater to kids as if they're ALL I live for. They're gonna find out soon in the 'real world' that everything's not done for them, so the earlier they learn to have personal character and be independent, the better they'll feel about themselves. (I have a brother-in-law who had seizures all his life, and my mother-in-law pretty much 'kept' him (even when he was married). Now, he's 53, she's in a nursing home, and he's stuck with her house and 2 vehicles to care for with no income . . . My point is that we can 'over-do' the parenting thing. Rewards are great, but negative consequences are also a part of life.

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You probably already know this but I was told to make sure that the child's feet are firmly on the ground or on a stool. This way they don't have to tighten there legs muscles while sitting on the potty. Also use one of the potty trainers that fit onto a regular potty. This sits right on top. It helps them not to fall into the potty. Now all muscles are relaxed. This is where they can sit comfortable and read a book, listen to soothing music, etc.

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My daughter had issues with her bowel movements too. I was convinced she would never get out of "pull ups" before high school. My suggeston is patience! patience! patience! He is experiencing anxiety about having bowel movement, so do NOT punish for his accidents, instead praise every time you see a measure of success. We did reward our daughter when she used the potty, or even tried to use the potty with little motivaters, like little toys and or an M&M candy (one or two). He is probably ready to get over this hurdle very soon, but he has to do it on his own time. Learning takes time and everyone does it differently. The less of a big deal you make it, the better. Just calmly help him into a fresh pair of pants, and speak positively about how good he'll feel when he can use the potty. He'll feel clean, fresh and grown up!

Just know that it will work out, and he'll get it in time...
Hang in there!

1 mom found this helpful

Although my son did not have the medical issues we did have problems with him pooping in his pants. My mom told me at the time that it was fairly typical of boys at that age, they do not want to stop playing long enough to take care of business. My solution was I made him wash out his own underwear everytime there was an accident and then take a bath. He soon decided it was quicker to go to the toilet on his own. L.

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I would emphaize cleanliness. Instead of wiping him off like a diapered baby. Have him stop all fun and head straight to the bathroom for a bath. Gently explain how big boys want to be clean and if an accident happens that it is important to bathe. Teach him how to wash, then follow up with your own washing. Explain that whenever he poops in his clothes that it will have to be taken care of in this clean (more time consuming manner.) Since he is 4, lessons on why and how we wash clothes might help him too. So involve him in the process of washing the soiled clothes. In no way should this be punitive, but more a way to help him have a more mature understanding of proper hygene. Good luck!

This is going to sound gross, but it has worked on both of my girls and I only had to use this approach with them twice each time. If your son is in underpants and has an accident, kindly take him to the batroom and dump out as much of the mess as you can into the toilet. Then, put the underware in the toilet and have him physically help you wash them out in the toilet. It really grosses the child out and they say they don't like it, etc. Then you can nicely tell them that mommy doesn't like to wash them out either becuase it is yucky! And tell them that the next time they go in their underpants that they will have to help you again. The next time, you need to be sure to follow through and have them help you again even if they don't want to.

After two times, my girls knew I was serios and never had another accident. I know it sounds nasty, but their hands will wash, just like yours will and it is worth it.

I had this same challenge with my sons. The problem is most of the time they get to stand when going to the potty so unless they have to sit they may not realize they need to poop. We went through the same process with the gastroenterologist and constipation and Miralax. My sons now take Calm a natural calcium/magnesium combination (available at Whole Foods) because even though they say Miralax is not addictive, I'm not so sure about that. Anyway when my youngest son was in pre-school he would stand on his toes and actively try to hold the bowel until he could get home. So they knew when he was standing on tip toe to make him go sit on the toilet. At home every other visit to the toilet, he is required to sit still at least five minutes to help keep the body communication open to having bowels. The problem only got worse when entering school because he just did not want to have a poop anywhere but home. All the males in my household tend to be that way. With your diligent effort this issue will subside, my son is now 6yo and rarely has an accident or holds it too long before going whether he is at school or home. I try to give him the Calm (a powder it mix in his juice) the same time every day and he usually poops about the same time each day. I just think it is a little more difficult for little boys than with little girls, we have to sit all the time and they have to decide whether to sit or stand. Most little boys will stand if they can because it is faster. Keep up the good work and be careful not to chastise, that may confuse him. Just put more emphasis on praising when he poops on his own. A. Burnette, Hillsborough, NC

It sounds to me. He is not feeling the sensation because of all he been through. Maybe tell him if he has any pains in his tummy down below he should go to the restroom. I really hope you can find a way to help him.

I am also a nurse and had a similar problem with my son. Turns out the problem was getting worse because I found myself in a power struggle with him. His poop was the only thing he could control and as a nurse, this was not ok with me. As I backed off on bugging him about sitting on the potty and just made it routine to do so for 10 minutes after meals, when the urge should be the strongest due to peristalsis, it seemed to help. I also rewarded him with M&M's as potty treats for poops on the potty only. WHen there were NO other treats at all during the day and he realized he had to poop on the potty to get them, it became his choice to earn what he wanted. Then he could control getting them. He had chronic constipation and miralax therapy for almost 2 years also. Of course, it didn't hurt that I went nuts clapping and praising the first time he voluntarily pooed on the potty and he was happy to please me. The harder I pushed though, the worse it got. Good luck. I know it's hard.

My daughter did this also. She was nearly 5 before she was completely potty trained. And there were still accidents in the years that followed. Our doctor told is that when children do this, that they have a very high IQ, because they have learned to control something. In our case it appears that that was true. She is in high school now and still has issues with the bathroom. But, she now knows what to do and handles it without problems. I understand where you are coming from, we tried everything possible. Like you said they loose the 'feeling' to know when to go because everything has been stretched out. Patience is the key and it will come around. One piece of advise is it is more embarresment for the child than us. That took a while for me to learn, basically my daughter told me that after she had gotten straightened out. Also, the clean out process may have to be done again later on. We did that with MG several times, until she reached 12 or 13 years old. Hang in there - it does get better. :)

i took psychology 101 years ago. i remember a professor saying that a childs bowel habits are the hardest and last thing they learn how to control. i don't think buying presents will help, just keep on working with his self esteem and confidence and he will work through it , maybe longer than most but, not imbarrased.

How would you feel about having him go without any pants on for a couple of days? Of course he needs to stay inside, but at least he might feel like he needs to use the potty if he is going to go the bathroom. At least that way you could guage better if it's just being stubborn or if he really can't tell if he needs to go to the bathroom. That was the way I potty trained by children, but they were 2/3 at the time.

Have you tried putting him on a schedule? Little children even at age 4 can be predictable. I might be difficult at first, but if he's regular you could probably try putting him on the pot say 15-30 minutes after a meal. You might want to have him go try every hour as well.

There are also exercises that he can do that will help increase his urge to go. You could try sqat-thrusts or toe touches, just before sitting on the potty. If he has to go, if you do these exercises he'll relax those muscules before sitting on the toilet.

Another thing you can try is asking him how he feels when he poops in his pants. He should feel some embarrassment if he can't help it. If he's non-chalant and doesnt' seem bothered, then, he probably is being stubborn.

I hope this helps!

When my oldest was younger and had some constipation I would sit in bathroom with him.. and we had a specaial potty story ..about something he woudl go do fun all by himself as a big boy..
just to relax him about it and it helped.

Over the years some other things I ahve learned to suggest
1. Giving him a multi vit and mineral to amke sure he is getting emough Magnesium (which helps moves bowels)
and lots of water (Esp if he is drinking lots of milk)
2. Next.. after bath and after meals (when new foods is working down the colon and naturally puishing the l;ast food) massage his feet on bottom to help the accupressuire points for colon

3. there is the ileocecail value and Hoston value .. which help controal the urge" I first heard about this years ago when a friends daughter also had not going issues and had to be relleived
Look up some web sites onthese and some on Energy Medicine tech.(Donna Eden) or one sample (http://ezinearticles.com/?How-to-Massage-Your-Colon-for-C...

so to massage these points.. below the belly button ,
from teh sides inward stroke forward to center with palms and pull outward with fingers pushing inward..
small circles in arae can help to with stuck matter.
the massage is suppose to help unstick teh value .. and if is teh problem help reset it.

4.a thought At his age.. about 1/2 -1 hr hour after meal masasge his feet , value and have him drink some water ..have some exercise play .. (My kids move easier after movement) and tehn ask him just to go set on potty (With the story if desired ) . If no movement after 15 minutues. excuse him .. but keep trying this with out to see if natural sensation will come back for him . at only 4 he might be confusing teh sensation when busy.

As a nurse you may or may not ahve gone over these alternative approaches.. and with one own child .
I hope you can get him off Miralax so he can build life long haelthy habits. Thats where the powdered magnesium could help during the change over time.It's hard to get enough in food .
Hope thsi helps

Hi J.,
Same problem with my grandson at 5 and even sometimes even now at 6. So, now there is "potty time" everyday at a certain time until he poops. Doesn't take long so my daughter tells me, it's just the need to remind him. Funny thing is, if there is a weekend where their schedule is hectic and she forgets to have him sit on the pot, by Monday he poops in his pants or becomes constipated. She did everything you've done. Her pediatrician told her to do this about an hour after dinner every night. It works very well. Don't stress out, I guess this is just part of being a "little" man....you know how guys are with their daily constititional! Good luck

my son was about 4 also, i never pushed him i started putting him to bed without a diaper, and told him he was a big boy now, and he just seemed to pick it up on his own

i went through this many many years ago with my daughter. I believe it takes a long time to get the sensations back. she did the same, told me after the fact etc. I believe she didnt know until it was too late. you need to keep her on a pottie schedule. pay attention to when she goes and then start taking her before that and sit with her. it is hard work to get them back to where they should be. i dont thing stubborness has anything to do with it....there is another thread about this situation on this site. below is an answer i gave to another woman experiencing this problem, if you care to read it. thanks

Hi Nicole,
First of all if your doctor says this is just a fear and he will get over it...ask again..and again. If you still get that response, get a new doctor. Or at the least, a second opinion. I went through the same thing with my daughter. She is now 22! I dont know if there is any connection but I too breastfed till later than most. It started at a very early age and progressed till she was 4, with some side effects till even 6. She would fight having a bowel moverment. Potty training seemed to go well and all of a sudden she was terrified to go. And yet sometimes she would soil her underwear or "leak" a little. We would be up at 3 AM with her on the toilet...crying and holding her stomach saying "no mommy, please dont make me, its hurts!" She would literally scream, cry and wiggle trying to stop it from coming out. Talk about breaking your heart. Meanwhile I would fluctuate between praying, crying and getting mad. (not really proud of some of those moments). Finally after a second opinion we found out she had Encopresis, a condition in children. My suggestion would be just to have him checked for this before doing anything such as "ignoring it till it passes". I tried this at first and am so happy I decided to take my little girl elsewhere. It was one of the most trying times of my life! I had 2 little boys just a little older than her, and with the teasing from them that i was constantly trying to stop, the lack of sleep i was getting, frustration, I was extremely stressed. All the while people making me feel like it was my fault, that I was doing or did something wrong potty training. Everyone had their 2 cents! Finally after the diagnosis, she was admitted to Rainbow Babies Hospital in Cleveland overnight (I stayed with her) and she was "cleaned out", (IV liquids, diahrea, etc.No pain) The blockage taken care of I could start over. She then needed daily enemas, strict fiber diet, bathroom time consistancy,daily mineral oil (after the fact) and lots of patience! And the whole "yay!" treatment again when she would go. It took a while. I am not telling you this to scare you simply check it out as an option. It can be dangerous if ignored. And it can develop from a situation such as yours.If everyone says Miralax works then I would try it. I would imagine if they had it 20 years ago I would have used it. Because they didnt it progressed to a blockage. They informed me to add fiber etc. but that is not always a good thing if you dont go. It was contributing to the blockage. She got to the point where she couldnt go and no longer got the "urge". To this day I still remember all those late nights and tears and feeling terrible in the bathroom with her! Try the Miralax but I always still suggest checking for the blockage. If you lived through it you would suggest that to everyone! Encopresis is not uncommon and it can develop from this situation. Unfortunately...at 25 and 27 her brothers still feel the need to tease her! ;) Hope things get better soon. check out this website

Hope this helps...G.

Hi J.,
I'm sorry to hear what you're going through. It can be stressful, not to mention frustrating when your family is going through this. I say that because we've been there. Here are some of the things that helped our son.
* Keep him hydrated...this was so important for our son because he was holding because it hurt to go.
* Feed him a healthy diet consisting of fruits, veggies & whole grains. Oatmeal is a great food for moving the bowels.
* Stay away from sugars, empty calories and cheese.
* Have him sit (on the toilet) 15-20 minutes after each meal. This helped our son to get into a regular pattern of sitting shortly after eating and descreased the soiling.
* Avoid any punishment or shaming when he soils.

Does your son have any sensory issues? I only ask because our son has mild sensory issues. It's highly possible that he doesn't have any but I belong to a family support group consisting of 5 other families for children with Sensory Issues. We were all surprised to learn that all of us have dealt with or a dealing with chronic constipation & soiling issues. It's one of those topics that no one wants to discuss but others are going through the same thing.

I hope you find these suggestions helpful. You can email me off line if you want. I can send you some links to for chronic constipation & encopresis, if you're interested.

Hugs to you and your family.

you could always try just having him sit on the potty very frequently. maybe if he accidentally makes it in the potty he will start to understand what it feels like before he goes. i would try to take a weekend that you are just hanging out at the house and try him on the potty every 15 to twenty min. until he can go in the potty.

How about trying something for the constipation that's more natural like putting a few tablespoons of prune juice in some apple juice? An oldie, but a goodie. I have had great success with just that (after doctor's prescribed suppositories and medication that were harsh and artificial!)

Constipation aside, I am familiar with the pooping problem. My oldest son, now 10, still has issues on occasion. He has ADHD (NOT behavioral issues- he's a great kid, just attention issues) and his doctor told us it is a fairly normal symptom. They don't pay attention to a lot of things, from social cues from peers to physical sensations like having to use the bathroom until it's an emergency. Not to say your son has the same issue, but I had heard a lot about ADHD before my son's diagnosis and never heard of that!

Good luck!!!

I am a mother of two and one on the way. When we were potty training my daughter she had a hard time going number two on the potty chair also. She was fine with number one, but kept having poopy accidents in her pants. I knew she was smart enough it was more of a control thing for her. So, I explained to her that if she was going to "choose" to go poopy in her pants she is choosing the consequence. I would wash her off in the bath tub with cool water (not cold, but not really warm either. and I had her stand up not submerged in it). I got this advice from another friend of mine, and it works. She had one accident after that, and it has been fine ever since. I know it sounds harsh, but it works. The whole time she was in the tub I would tell her that I didn't like it either and I hope she makes a better choice next time. She is a strong willed child and she needed something to change her behavior. You could try this to see if it is him just being stubborn, if it doesn't stop than take him back to the doctor. Good luck!

I'm not sure why he was constipated (diet or otherwise) but he may be scared of sitting on the potty since he had such a hard time in the past. My niece and my son both have dietary issues that cause constipation. They both have an "allergy" to dairy products ... including all milk proteins as casein, whey, etc. Once we changed their diets, they were able to poop without pain and with much softer stools. Not sure if this would be a possibility at all for your son. If this isn't the case, your consistency in rewarding him and/or putting him on the potty will eventually pay off. I know it must be frustrating.

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