potty trained 4 yr old soiling her underpants

[DNBarbosa]

My daughter is 4 1/2 and was potty trained at 2 1/2. She was very quick to adjust and has not had problems until recently. She has been speaking since very early. She is extremely bright. Most people think she is 6 because of this and because of her height. She is the only child in the house except for her brother of 20. She is a very happy child and has been a delight in comparison to the other kids. My wife has been a stay at home Mom since she was born up until this past February. She has been attending a school that has only 9 kids in her class and she is well behaved. She did have some seperation anxiety when she started going to the school, but she adjusted quickly. She has recently started soiling her pants during school and at home. Sometimes repeatedly - 5 times in an hour. We have found soiled underpants hidden in her room. She cleans and changes herself and doesn't tell us. When asked why, she says that her tummy hurts or that she couldn't make it to the toilet in time. We're stumped. Is it for attention? Does she want to stay home with Mom? I saw a comment posted by someone suggesting to not allow her to do certain "big girl" things that she enjoys doing until she uses the toilet. Do we see a psychologist? Thanks for your help.

[Kevin Kennedy, Ph.D.]

The first thing to do is to arrange an appointment with her pediatrician. It is likely this has no psychological basis but, rather, a medical basis. Far and away the most frequent cause for such encopresis is constipation/impacted bowels. Your daughter's comments indicate this might well be the case. If so, the doctor will institute a regimen of stool softener and laxative which will remedy the problem.  As a rule of thumb, it's pretty reliable to rule out any physical cause for symptoms before turning to alternative (including psychological or emotional) factors or contributors.

[jdtm]

I belong to a support group for teachers and parents of children who suffer from anxiety (I like to define "anxiety" as intense distress which can reach toxic levels").  This issue is very common with our children - constipation, inability to use public washrooms (many of our children are unable to use the toilet at all during a full school day), feeling/reading "the need to go correctly", and often "accidents" occur.  Extreme cases within our group have led to bladder infection.  

The fact that your daughter claims "her tummy hurts" makes me suspect your child is suffering from anxiety.  Children suffering from anxiety often do not show outward signs - your description of your daughter reminds me very much of our grandson who said "it just comes out too fast to get to the toilet".  Please, first have your child examined by a medical professional but I suspect when the anxiety lessens, you will find this problem will also lessen.  The difficult task - "how to lessen the anxiety?" should be your next step.  You wil need to discuss this issue with the teacher and perhaps decide on some ways of dealing with this issue (perhaps some form of intervention).  I wish you the best -

jdtm

[JayRob303]

I have a 4 1/2 year old boy...and he's been potty trained for roughly 2 years.  Recently he's been having 'smudges' in his underwear.  He tells us that he had an accident and didn't make it to the potty in time...but this happens at least twice a day.  It drives me crazy...he knows that he has to go, because he's been doin' it for 2 years now...and all of a sudden he's starting to do this.  I just don't understand.  

We've tried praising him when he doesn't have an accident, punishing him when he does.  He cleans himself up, changes his clothes, and much like the original poster's child...hides dirty clothing in his bedroom.  As far as punishing him, we've grouned him from the television, video games, playing outside, time-out, no deserts...pretty much everything that we can think of without spanking him, and to tell you the truth, it's getting to that point.  We even brought him to doctor thinking that it might be medical...he has no medical conditions.  The current punishment is that he is back in a diaper...he lost his 'big boy' underwear priveleges...  He is embarassed by the diaper, knows it's wrong go poop in his pants, apologizes after he does it...but still does it...

The only thing that has changed recently to his environment is that I went to day shift with his mother, and he stay's with his grandparents until we get off work.  I thought maybe it was something psychological...maybe looking for attention or something...but it's absolutely negative attention...

At this point, I'm willing to try almost anything...
I am absolutely at a loss as to what I should do...

Any useful suggestions would be appreciated...

[jj's parents]

My 6 1/2 yr old son (almost 7 yrs) has had the same condition since he was 5 1/2.  It started with staining his underwear then progressed to having accidents sometimes 2-3x per day. He was found to be constipated and given laxatives.  It continued  and he said he couldn't get to the bathroom on time. We did everything that the previous e-mail said and he also was very embarrassed and angry that we were bothering him and not believing that he could not help it.  Last summer we took him to a pediatric gastroenterologist who diagnosed him with encopresis.  He was put on more laxatives and instructed to sit and "push" on the toilet after supper in order to tighten his colon.  Is in counseling for his anger which is better.  We recently went to Boston's Childrens Hosp as his colon is so stretched out he can't feel anything. He still hasn't been able to "go on the potty" sucessfully. This is just so frustrating for all of us and it never seems to end. Heart breaks for these poor kids. Thank God for my stay at home hubby who takes care of him. This is a combination physical and emotional problem.
Does anyone know of a on-line support group to help us parents and our kids?? We need to help each other help our kids!!!

[Little Darling]

If you suspect that the child is constipated, cut low fiber foods from her diet like ice cream, milk, cheese, meat, chips, pizza, and instant mashed potatoes or already-prepared frozen dinners.

Add high fiber foods to your  child's diet like fruits, vegetables, whole grains, like oatmeal, pears, raisins, and broccoli.

Make sure she drinks lots of fluid like water and juice. Don't allow her to have soda, she shouldn't drink caffine (not to mention all that sugar).

Exercise helps constipation too.

Also, take her to the bathroom often and have her stay there and read a book, play a video game or something at the time that she normally poops.

Be sure and take her to a doctor. She seems to be having some physical trouble. If she was doing it for attention, why is she cleaning herself up, hiding the evidence, and not telling you what happened? If this is involuntary, punishment/reward system isnt a good idea. It will only embarrass her and stress her out and possibly add to her already upset tummy.

They have a nice article about older children having problems with soiling their pants at:
http://www.keepkidshealthy.com/welcome/conditions/encopresis.html

and at:
http://kidshealth.org/parent/emotions/behavior/encopresis.html

Good Luck!

[lovemygirlsmhlh]

My future step daughter (4 and a half) is going through a terrible time using the potty for having a bowel movement.  She knows she should, but needs and asks for a pullup to do the deed.  Her ability to urinate on the toilet has improved; but she is still resistant often, but we've progress is progress.

She had many problems as an infant, and is still very prone to constipation.  She has a wonderful diet and loves all of the things that make kids poop, but still the problem persists.

She was diagnossed with Sensory Integration Disorder, and has significant problems with her vestibular development (this is the part of our body which understands our space and movements within that space.  Her SID goes much further than that, and manifests itself in many other areas, but this is the one that may be a key to working through the others.  If you don't feel comfortable in your own space, trust becomes a huge issue.  She goes to an OT once a week, and many things have been identified, and the process is slow and taxing, although she loves her OT and looks forward to going - Thank God!

The biggest problem is not that she won't go on the toilet; she doesn't seem to care either way - going in pull ups doesn't bother her one bit.  The biggest problem isn't all of the things she is going to need to work through to understand herself.  

The biggest problem is ME; there is a feeling of failure, a feeling of humiliation, and many other feelings which arise because the child I'm helping to raise does not do what other children her age do.  This is not my child's problem, frankly she is quite happy, and enjoys her days.  She especially enjoys them when we don't talk about the potty or anything to do with the potty.  As a parent we want our children to be normal, whatever that might be, and it is funny that I can get myself so wrapped up and frustrated over this issue, when so many other areas of her life are beautiful and amazing - she's reading at almost a first grade level, she's doing three digit adding, learning plurals.  She is an amazing girl, and I am selfish, because I get tired of watching my wife and others around us have to deal with potty issues.  I wonder sometimes who really has the issue?

[sweettweet]

My step son will be 6 next month, dont feel bad hes been potty trained for 2 1/2 years. Untill 3 mths ago he would poop logs that clogged the toilet. Recently hes been going in his pants. Weve tried every thing he has his bed and cloths only in his room. His pediatrician says that there is nothing physically wrong. If we sit him on the toilet 10 min every hour he is still covered with feces. So i guess I sympathize with all you parents. I know what you are going through If we can find a good psycologist and they help Ill leave you a update. For now all I can say is try to have patience, but sometinmes it dosent work.

[xmsrlong]

You have a very healthy attitude and that little girl is lucky to have you in her life.  We are all so often trying to fit children into what is considered "normal" that we often miss what is extraordinary about them.  Parents need to spend less time stressing over trivial little developmental "issues" and just enjoy their child for who she/he is.