My Grandaughter Is 4 Years Old and Refuses to Go to the Bathroom.

Updated on February 28, 2019
D.R. asks from Pine Bush, NY
9 answers

She hides and holds it in. It is a nightmare. She is seeing a therapist. Any suggestion appreciated. Thanks.

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So What Happened?

Thank you for all advice. She is seeing a therapist because it has been going on for over a year and a half. She has been to the gastro doctor, no problems. The doctor suggested the therapist. We have done all the things suggested, if you think of anything else, please post. Thank you all again. It is just heartbreaking. The therapist agrees that it is a control thing. Her parents are doing everything they can, it is really exhausting. She has been diagnosed with encopresis. She goes to pre k with underwear and hardly has ever had an accident. When she comes home, it is another story. She is back in pull ups. When she leaks stool, it burns her skin and takes 3 of us to hold her down to clean her. So far, we have done everything you guys suggest, still hoping for something we haven't tried yet. Thank you all so much.

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H.M.

answers from Dallas on

Sounds like it very well could be a control thing. That is one thing she's in control of. Glad she is seeing a therapist. Hopefully her parents follow what the therapist says to do!

3 moms found this helpful

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G.♣.

answers from Springfield on

Try to keep in mind that 4 years old might be a little late, but it's not crazy. You mention that the parents are doing everything they can. Maybe the best thing they can do right now is absolutely nothing. Leave her alone. Don't talk about it at all. Just continue putting her in diapers and changing them when she needs them changed. Once she realizes that there is no one talking about it and no one putting pressure on her, that's when she might decide that she wants to begin using the toilet.

Don't ask her to use the toilet or even suggest it. Don't try to persuade her in any way. Just act that wearing diapers in normal. She will come to a place when she decides for herself that using the toilet is something that big girls do. But she's not going to do it unless it's her idea.

6 moms found this helpful
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M.G.

answers from Portland on

I have a child with mild anxiety - not about that, but in general. When children are afraid of something, just acknowledging that they don't feel ok about it and making it 'fun' or 'safe' for them is key. They can't rationalize it (the fears don't make sense so there's no logic to it - just like there isn't in adult anxieties) so just being the adult and making it seem manageable worked for my kiddo best.

I would say let her take whatever she wants into the washroom - whether that be a toy stuffy, her favorite book, even an iPad at this point - to get her over being afraid and sit with her. Don't make it a big deal - do the opposite.

I had a friend who used to set up a fort each time for her son. I thought it was unusual but her kid needed that for a year - and didn't need it once he went to school.

You do what you have to do :)

* I have been stressed out over my kid's anxiety - and at times, I have to remind myself that that I can't really help them get over it - I can just be patient and try to distract and find ways they can deal. Hopefully the therapist will have really good suggestions.

ETA Saw your SWH. That's a long time and sounds like potty training may have been too intense and/or she wasn't ready developmentally. She's telling you she's not ready/interested. I would really back off and let her take the lead. She's old enough now to at least communicate if she'd rather be in a pull up or try the washroom with stuffies etc. Go with what she would prefer at this point.

4 moms found this helpful

S.T.

answers from Washington DC on

well, the advice of the pediatrician and therapist are probably more useful than that of strangers on the internet.

all i can suggest is that a child this age with this much self control has been pushed to the limit by something. so i'd work on figuring out what has stressed her this badly and try to alleviate it.

i'd also be heartened, in a weird way, by a kid with this sort of iron will. i'd try to find appropriate ways for her to develop that strength. redirect it toward something positive.

khairete
S.

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D.B.

answers from Boston on

It's a very typical phase and really frustrating. A lot of toddlers and recently-toilet-trained kids go through it - they don't want to lose "part of themselves" or they're afraid of the actual toilet - irrational as that may be. My stepdaughter went through it later, at age 8 or so. She went a week and then there was a horrible scene with screaming when she couldn't hold it in any longer.

Assuming your granddaughter doesn't have any intestinal abnormality that is affecting this (low motility, a kink in the bowel, etc.) which I am assuming her parents ruled out, then it's likely a combination of control and diet.

I don't know if she needs therapy or not. I'm hoping they tried other things first, or that the therapy is based on other factors and problems as well. It wouldn't be my first step for a kid just holding in her poop but maybe there's much more going on.

One thing the parents can do is to change up the diet so it's kind of impossible to hold it in. Also, the longer she holds it, the harder the stool is and the more painful it is to pass (which is what happened to my stepdaughter). So I would use a combination of stool softeners (talk to the pediatrician and/or senior pharmacist aware of your granddaughter's medical history) along with high fiber, high liquid foods to keep her stool soft and to keep her fluid levels up. It's just harder to hold in her stool when her body is working harder to get rid of it.

So, hiding fiber in her favorite foods is important, and easy. I made chicken nuggets with wheat germ coating and fried in olive oil or coconut oil, I added flax seed and bran to the crumb coating I put on mac & cheese, made sweet potato oven "fries" in a healthy oil, added wheat germ and bran and flax and oatmeal to pancakes, and so on. Smoothies with fruit and even the tops of strawberries (etc.) add fiber and liquid. Watermelon and other watery fruits are good. Bananas and rice are terrible and she should not eat those until this problem is resolved. Try quinoa instead. No cheese. Make meals fun - put fruit chunks on little skewers or make a face out of a pancake or a pizza (tiny amount of cheese on top, puree spinach and other veggies including beans into the sauce). These are healthier meal choices anyway, so it's a good idea to wean her off any problem foods and any processed things which are high on salt and preservatives and low on nutrition. Make cookies and muffins and granola bars with whole ingredients and add in flax, oats, wheat germ and bran at every turn. Water/water/water and no junk juices. Orange slices instead of orange juice, apples instead of apple juice, and so on.

3 moms found this helpful
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G.K.

answers from Norfolk on

Oh my word, I remember the frustration. Here's a good explanation of encopresis. My son had it too. Therapy was not effective for my son. He grew out of it eventually, but it was a long road:

https://www.summitmedicalgroup.com/library/pediatric_heal...

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R.L.

answers from Chicago on

I would also suggest backing way off. Let her wear diapers if that is what she prefers, and change them matter of factly. Trust that unless there is a medical or severe developmental issue, she will learn in time.

Sounds like this started before she was 3, which is early for many children. For a while, I wouldn’t talk about it at all except to maybe say “you don’t need to hide sweetie, I know you’ll use the potty someday when you’re ready.” Once she is no longer hiding, then you could try asking her when she thinks she might be ready. Would she like to wear underwear with Spiderman or Frozen characters on it? Would she like to use the potty when she’s 5? Listen to her ideas. Let her make a plan. If she continues to hide, be patient.

If she’s not attending preschool, you could also consider enrolling her. Sometimes peer pressure can be an effective tool.

1 mom found this helpful
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D..

answers from Miami on

I absolutely agree with Gidget. Read her post to her parents.

1 mom found this helpful
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M.P.

answers from Portland on

If not pooping is a control thing, give her as many age appropriate choices as you can. Do you want to wear these clothes or those clothes? Would you like to help set the table? Do you want to wear panties or a pull up?Asking takes longer but it also gives children some control.

My grandson wouldn't poop in the toilet because it always hurt. He was chronically constipated. His mother changed his diet to include more fiber. Doctor said to remove cheese and dairy products. As Diane B said feed fresh fruits instead of apple juice and applesauce. Doctor said to give him Miralax daily.

It took a year or so for him to consistently have soft stools. I wonder if it was as much about his age as a beneficial diet.

A friend took her 3 year old into the bathroom when she, the Mother, peed and pooped. She kept a potty chair in the living room and took it into the bathroom. The 3 year old was potty trained in 2-3 weeks. In time for preschool. Her mother had not tried to train her before. Her body was ready for it when she started.

With both my grandson and friends daughter getting them to use the potty was low key. Moms praised when they used the potty and didn't react when they didn't.

For my grandson the pain was severe. When he was at his aunts he screamed for 5-10 minutes and she called an ambulance. I'm very sympathetic to the situation.

As Diane B suggested make going into the bathroom fun. At first don't mention using the toilet. Get her used to be in the bathroom without mentioning using the toilet. We read, sang songs to the older girl when she was on the toilet.

My daughter is now training her baby who is close to being 3, She put a potty chair in the bathroom and showed her how to "flush" a feature of the potty chair. At first, she sat on it with her diaper on. My daughter is very low key. Her daughter now pees in the toilet but doesn't yet poop there.

My daughter bought a kids toilet seat that includes an adult seat to use by lifting the kids seat. It has a clear lid. The multi seat is attached to the toilet. I hadn't seen this combination before. It's very convenient. The kindergarten sibling uses the kids size on her own.

In your situation, I'd start over. Put diapers back on so she is able to poop in them if she wants. Babies bodies mature at their own pace. It's not uncommon to not being ready for training until 4 or 5. I suggest that if adults are relaxed, the child will have an easier time learning.

1 mom found this helpful
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