My four year won't poo in the toilet

[Cazbar74]

My son has just turned four and has been able to pee in the toilet just fine for ages. My problem is that I cannot get him to poo in the toilet! He has "skidmarks"in his undies throughout the day and every time I ask him "Did you feel your poo's coming out?", he says yes. Then I ask where poos go, he says "in the toilet". At the start of everyday we say "You need to keep your undies clean ALL DAY, ok?", he agrees. About a year ago he did manage to do a poo twice in  the toilet, so we praised him and made a huge deal out of it. But there has been nothing since. I have tried rewards and/or punishment (taking away toys, etc), nothing helps. After his shower at night, we put a diaper on him, which is when he does his "main" poo. If I don't do this, he will just hold it which I don't want to do either. He has been constipated in the past. Has this affected him in some way? I have also talked to a pediatrician who said that I should maybe not make it so much of a battle, because often children will dig there heels in and it will delay the progress. Everyone seems to say "it will happen, just give him time". I'm a my wits end now because I have explored so many options. Has anyone got any advice for me? Am I just involved in a power battle with my son? Could there be a physical reason why he is not pooing in the toilet?

[AnnieBrooke]

Encopresis is impacted stool in the lower intestine, bowel or colon, around which some more liquid stool can seep, and it does cause those 'skid marks' you mentioned in the underwear, plus the feeling in the child that he does not know for sure when the poop might come (because the bowel is losing its ability to contract).  You really, really don't want that to be happening, it's not a matter of the child being stubborn, it's a medical issue.  As specialmom says, get him onto a diet that softens the stool, it is so much better to prevent this problem than it is to have to deal with it once the bowel is getting disfunctional.  Don't treat it as your son being stubborn and you "giving in" if you keep him in a nappy.  At least he's pooping!  I am here to tell you from experience that whether a child is in a pullup (or nappy) or not, he will learn to potty train when it is time.  The old canard about how if you make it too easy, he will never learn, is simply not true.  Even a nappy (despite the "stay dry" liner) is not ultimately as comfortable for a kid as clean underwear are.  In your shoes, I'd leave him in the nappies and up the fiber and grape juice, staying ever vigilant if his poops become less than once a day especially.  If he associates pooping with pain or trauma, he may start to "hold" it, and that is not good if you are in a borderline situation.  Far better to be in nappies for a while more.  Good luck!

[specialmom]

Hi.  I want to tell you that my son has had constipation and it really wasn't like what I pictured constipation to be.  It kind of hurt him to go as his stool was hard and he at times had a hard time judging when he was REALLY going to go.  As time went on, this is interesting to what Anniebrooke said, he was going number 2 regularly but still was constipated and having issues.  We have been to the hospital ER for impacted stool!  It worked like a bowel blockage and became an emergency.  And he WAS going daily at that point.

Here are things that worked for us------------  whether you think it is constipation at this point or not, I'd try it.  Up the fruit intake.  Fresh fruit is great and just keep it coming.  Grape juice.  This came from the hospital for my son as a great way to get things 'moving' more smoothly.  Buy baby food prunes, put them in another bowl so he doesn't see the baby food jar, tell him it is purple pudding (and it does taste pretty good).  Make smoothies using frozen fruit, fruit juice (I use strawberries with apple juice, sugar and cinnoman and a banana and sometimes throw in chopped spinach and store bought carrot juice----  kids have no idea and all LOVE it.  Another recipe is frozen mango and orange juice with a bit of sugar and a banana.)  

Old remedy is a bit of corn syrup in their milk.  And fiber is always good.  Cereal or cereal bars and I buy the grape juice with fiber in it.

Believe it or not, I took care of these problems this way.  My son at 4 was like your son------------  and he was constipated.  good luck

[margypops]

Congrats on the new baby and yes I think he has regressed because hes sees his little sibling wearing them and getting plenty of attention.See I think the only way to potty train is to remove diapers and pullups , especially during the day as it is enabling them to do it in their pants. Get him into big boy underwear, punishment wont work in fact it makes anxiety which exacerbates the problem.It sis possible that because of the baby arriving you may have to be patient, I agree with the pediatrician about making more of it, back off for a short while then introduce big boy pants and be firm .Lots of attention so he still feels special, get Dad involved .  

[Cazbar74]

Thanks Annie. Unfortunately my son will not wear pull-ups, not even with his favourite Cars theme on it. He seems to very attached to his nappies, as a matter of fact he just said "I LOVE my nappies"and when I asked why,  he said "because I can push (his word for doing poos) in them." The other night he gave his nappy a cuddle! I was thinking it might have to do with the fact that I just had a baby and that he may be regressing a bit but this issue has been going on way before that.

[AnnieBrooke]

Please read up on encopresis just to rule it out.  If he has had constipation issues before, it is a possibility you really want to take seriously and try to avoid, even if it means putting him into pullups for a while.  I'd rather have a 4-year-old with pullups than a 7-year-old with encopresis, and always erred on the low-key side when my son was potty training just because of the long-term nature of the issue if one pushes it.