B.S. asks from Norristown, PA on June 27, 2011
Potty Training Problem - Norristown,PA
My 3 year old (turned 3 in April) officially started peeing in the toilet in March. She has had only a few accidents since then. The problem is with the pooping. She has always had issues with constipation. In January of this year, the doctor suggested Miralax, which completely helped with her large and difficult to pass stools. She even started going every day (instead of once a week). Her routine was that she would go during nap time. Well, we have tried desperately to get her to poop in the toilet. At first she said she was scared that it would hurt. We understood, so we just kept trying. She finally did it (a few times) and then decided that she didn't like it anymore. We took her off of the Miralax because it seemed too easy for her to just go in her pull up. Once I took her off, she went in the toilet almost every single day for a week. So we bought her a little prize at the end of the week. Now, she is upset about it again. She will freeze in her spot and start to cry because she's afraid of pooping in her pants. So I will rush her to the bathroom. As soon as she sits, she says, "I don't have to go anymore". Then she holds it in until nap time. We are trying to be patient and not get angry, but I feel like I'm going to lose it one of these days. I did not have problems potty training my son, so I am completely lost. Anyone have any suggestion??
Edit - I should add that we changed her diet and added more fiber a few months ago. Also, her current stools are soft (without the Miralax) and she doesn't seem to be in pain when passing them.
T.K. answers from Dallas on June 27, 2011
Could it be more painful for her without the Miralax? Now that she is off of it, maybe one of her last bms on the potty was painful? Kids bms can be scheduled, just like an adults. Have you tried not giving her the Miralax until after naptime? And maybe giving her a little less?
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K.B. answers from Philadelphia on June 27, 2011
One of my triplets had this horrid problem. We tried different things. The Miralax helped but also made a mess. So we tried several different things that didn't work. The one thing that did help some which got him to poop from once every 7-14 days down to once every 3 days was PediaSure. We bought the Walmart brand which was cheaper and got the vanilla with extra fiber. We did that for a long time until my SIL pointed out the obvious to which this day I feel foolish not thinking about. She suggested changing his diet.
So I looked online for ideas for diet change to help with hard stools and what I found was that at his age rather that giving him 3 cups of milk a day (8oz, one with each meal) he only needed 2 cups a day so he gets milk with his cereal every morning (Multi-Grain Cheerios has higher fiber) and milk with dinner. Less dairy loosens the stools. Any extra dairy comes through cheese with foods he eats. He's not lacking.
He gets straight juice for morning snack, lunch and afternoon snack. Straight juice rather than mixed with water will help loosen stools.
We are a meat eating society. When you look at just how much meat a child really needs it's much less than what they're eating. Meat has replaced vegetable eating. Chicken nuggets and fish sticks for lunch fulfills their protein intake, and also peanut butter in sandwiches. So I cut back on the large portion of meat at dinner and gave him two heaping spoon fulls of veggies rather than the meat. And adding veggies on the side for lunch rather than chips or crackers helped as well. (he got plenty of grains at breakfast and snacks)
For snacks I gave fresh fruits with a cup of juice. Sliced apples, pears, oranges, canned mandarin oranges. Any of these fruits can be dessert after dinner as well. In the summer I've been making fruit salad. Every pay day I buy a container of strawberries, blueberries and bananas and add them with oranges. I slice them all up in a bowl and when I slice the whole oranges in quarters I squeeze a bit of the juice into the bowl on top of the other fruits. Stir them up and it makes for a nice snack or dessert for dinner. My kids love it, especially if they get to help make it!
Your best bet is to slowly increase the amount of veggies on the plate and reduce the amount of meat.
It may take up to a couple weeks to start seeing softer stools. Keep in mind that when young children have this problem the withholding becomes as much of a problem as the hard stools themselves. It becomes a vicious cycle. The stools are hard so they hold it in. Then the stools compact and get harder so they withhold and so on. Until you can get the stools softer and she feels that they are softer and gradually begins to let it go it'll get better. But explain to her how these new foods are going to help her poops get softer and talk to her and relaxing and letting it out. I've had to sit with my son during this transition and hold and rub his hands and talk to him to let it out even though it may hurt a bit. After the stools started softening with the new diet and he saw that it was getting a bit better he started letting it out a bit more. He still has monster large poops but are not rock hard like clay and goes every few days at least. He used to rock himself on the floor on his bottom to keep that poop in! I'd catch him in his room and send him right in to get it out before he got it back up and then it was worse if I didn't catch him in time. He hasn't rocked since last year! LOL He's 6 now. I wish I would have thought years earlier about an obvious diet change. We stopped the PediaSure after we changed his diet. Saved us money too.
mom to 5 including triplets
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P.M. answers from Portland on June 27, 2011
Pooping successfully requires a certain amount of physical relaxation, so the colon's automatic action can take over. Emotional tension can easily override the natural peristalsis that makes pooping happen, just as emotional tension can make us tighten our diaphragm instead of breathing naturally and unconsciously.
There's a very good chance that your daughter is feeling not only tension about the discomfort she may experience while she poops, but she may also be sensing your tension and frustration about her pottying problems. If she's too involved with your feelings, she won't have nearly as good a chance to allow and connect with her own.
Many parents who have reached this impasse (and it is common) have realized they have to change their basic relationship with the 'training' process. What I have seen work with a number of families I know is to allow a diaper for pooping until the process becomes easier and more automatic again. They have assured their children that they WILL be able to do this just as soon as they are ready, and they express every confidence that that will be a happy time for the child (never mind the grownup). They have asked their children to make whatever suggestions they can about what would make it easier or safer for them.
In your daughter's situation, she may well be experiencing difficult and even painful poops. Miralax seemed to help her, but did not help you meet the goal you set for her, which is, plain and simple, pooping in the toilet, and not her pull-up. I hope you will reconsider this – her health and comfort should be a higher priority here. Children who have trouble with pooping for physical and/or emotional issues often begin withholding, and can develop a much more serious problem called encopresis, in which a large ball of stool hardens in the lower colon, stretches it out until numbness occurs, and then fresh stool continuously forces itself past the blockage and causes soiling. This is a difficult situation that usually requires the guidance of a pediatrician and months of consistent treatment, usually with Miralax.
Many, many children are allowed to poop in diapers until they are ready to use the toilet. They all come to it in their own, unique ways. Positive, supportive (but not pushy) messages from parents are helpful. A diaper for pooping does not generally cause regression if peeing in the potty is handled as a positive behavior with happy results. Some parents have successfully started a transition to pooping in the potty by having the child sit, diapered, on the potty while pooping. After several successes, they cut a hole in the diaper so the poop goes directly into the toilet. After several more successes, the diaper can come off.
Pooping is commonly a separate stage of training. Some kids actually accomplish this first, but for the majority, it will come later. Sometimes many months later. If you can relax and accept this simple fact, make all your potty messages calm and encouraging, I'll bet your daughter will have an easier time finding her own way to success. And ultimately, potty success is defined by the child being in charge of the choices.
Wishing you well.
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E.F. answers from Pittsburgh on June 28, 2011
We're right there with you. I've gone back to diapers-- he'll get out of them when he's ready. I'd put her back in diapers, and just let it go. When she is comfortable going in her diaper, you can start telling her that it is ok to poop in her diaper, but she needs to go stand in the bathroom to do it (b/c the bathroom is for poop, not her room). When she does that reliably, and without fuss, tell her that it is ok to poop in her diaper, but she needs to be sitting on the potty (with the lid closed) to poop. When she does that reliably, have her sit on the potty with the lid open (but still in the diaper). Again, when she's good with that, you can try without the diaper. She will eventually get this, so don't despair! (Which I keep telling myself, too!)
V.F. answers from Scranton on June 28, 2011
Try a natural laxative, raisins, popcorn, sliced apples all these things will help ease her bowl movements. It sounds to me like she is not getting enough fiber. Even a bowl of raisin bran a few times a week can do wonders for her digestive system.