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My son is 4 and he is a little slow with speech/understanding.
About a month ago we took a week long trip. The day after we came back he had an experience where he was "very busy" playing a computer game and ignored his need to have a bowel movement. This resulted in him having an accident...very messy and he was horrified. I tried to let him know that it was ok...but he was very upset. Since he learned to have bowel movements in the toilet he insisted on privacy and wiping himself...only occasionally have I needed to help. It dawned on me about seven days ago that I haven't noticed him "seclude himself" in the bathroom. He started complaining that he "was so sick in his tummy". I explained that sometimes a tummy ache means that his body needs to go poop. He vehemently denied he had to go to the bathroom. He has no other symptoms. I have tried: Oral stool softeners, increasing fiber, increasing liquids, (specifically water...) Still no progress. I am concerned about the recommendation of giving mineral oil. (I don't want to force it...)
I don't want to make this a big deal, and scar him for life. I don't want to do an enema or suppository unless it becomes really necessary. What I would like to do is teach him...and how do I do that if he won't even allow me to talk about it?
Background: He has typically gone a week before having a bowel movement (since birth!), and it is always an issue of straining. I have tried to improve his diet...but he refuses to eat vegtables. I am very overwhelmed with his eating and bowel issues right now. Any advice welcome.
In Reply to: 4 yr old withholding stool.... posted by Susie Durham on March 10, 2002 at 16:00:25:
Hi Susie -
What a sad situation to be in! Since you said he typically has bowel movements about every seven days, apparently his body has gotten used to this amount of time.
You can put mineral oil in orange juice, and he won't even know it's there.
Also, you could get the book that kmd told us about (the post is in the archives now), called "I Know Where My Food Goes" by Jaqui Maynard. My daughter thought my 3-year-old granddaughter would be too young for it, but it helped Kathy's little 6-year-old understand that this is what is supposed to happen and that cured him of his withholding stool. It might be just what your son needs to help him. They might have a copy of it at your library - I got my book at Barnes & Noble, so that you could read it and see what you think. Good luck! Raisa
In Reply to: 4 yr old withholding stool.... posted by Susie Durham on March 10, 2002 at 16:00:25:
Hi, Susie.
First of all, you are not going to talk him out of this. The only solution is to make his stools bulky enough and soft enough that he has no choice but to soil himself OR be reasonable and go to the toilet. That means the constipation protocol for witholding. The longer you let this go on the longer it will take to resolve it.
Whatever makes you think that a 4 year old knows enough to decide what he will eat???
If you only offer him vegetables and only at mealtime (restrict mealtime to 30-60 minutes 3 times a day) he may be stubborn enough to resist a week but will start eating vegies voraciously by them IF you are firm. This cannot do him any harm but your continuing to expect a 4 year old to know what is good for him will CERTAINLY cause him harm now and in the future.
Walt
In Reply to: 4 yr old withholding stool.... posted by Susie Durham on March 10, 2002 at 16:00:25:
Sounds like me when I was a kid. I dreaded going to the bathroom because I hated the feeling of straining. OK a little too much info about me but I can assure you that it is something you grow out of. I would follow Dr. Strolls suggestions and add as much fiber into his diet as possible. Once he begins to feel that pooping is not a painful activity, the issue will dissapear. Also there are certain fruits that taste good like kiwi and strawberries that soften stools. I would try those as well for him.
Good luck
In Reply to: Re: 4 yr old withholding stool.... posted by mike on March 11, 2002 at 11:32:43:
Not too much info at all! It's so helpful to actually hear from someone first-hand what was going on in your mind when you were that way. Thank you.
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Walt Stoll on March 11, 2002 at 10:12:24:
Apparently you didn't understand me. Soiling himself was what made him afraid to go in the first place. It wasn't the straining. I will not put him in that position. As for the eating...I put his dinner before him, he either eats it or goes hungry.
I do understand that you have a remedy that works, but this came across as a very condecending post...I hope you didn't mean it to be.
Susie
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Susie Durham on March 11, 2002 at 20:36:22:
Hi, Susie.
I uhderstood, perfectly, what started his problem. Ultimately we all learn to place our wastes in the toilet because it is less messy, less stinky and so much more socially acceptable. HE is going to have to finally realize that. There are other options that other people on this BB have found to be helpful and they are all archived.
If I did not care for people I would not be donating at least 4 hours a day to the internet. I have just learned that sooner or later SOMEONE has to stop beating around the bush and say it as it is.
Are you telling me that you only offer him whole (and wholesome) foods and still he will not eat vegetables??? How much other stuff do you offer him that he does not need to eat his vegetables?
He is controlling the family already. What do you think he will do when he is a teenager?
Walt
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Walt Stoll on March 12, 2002 at 10:37:57:
Hi, Susie -
Of course, Dr. Stoll is right about the diet. But, you and I both know that it's easier said than done, and especially if your little boy is, as you said, "slightly slow in learning and speech". I can relate to what you said about his being embarrassed by the 'accident' he had and therefore decided not to poop anymore. Recently, my 3 1/2
year old granddaughter, who had been going on the potty to pee (mostly when asked), had an accident, and the floor got all wet and she was embarrassed. ( Her mommy refuses to put the pull-ups on her because she says that then the child just thinks of that as a diaper.) Most of her little friends have been potty-trained since they were two years old. Well, after that, she decided that she was not going to pee during the day and started refusing to drink anything because she had figured out that that made her pee.
But, of course, that didn't last long. One day, when her mommy told her that SHE needed to use the potty, my granddaughter went in with her and said, "mommy, how do you know that you need to pee-pee?" So, apparently, her bladder is not ready yet and the way she knows is when it starts to come out. Sometimes she makes it to the potty and sometimes not. She wears pull-ups at night and is always soaked in the morning, which I have always understood means that their bladder isn't ready.
The only comparison here with your little boy is that he, too, was embarrassed at the mess he made, as you said, so maybe if you tell him a story about how you once had an accident or something like, would that help?
One question I have is: How do you know he is straining if he doesn't ever let you watch him in the bathroom.? Does he flush the toilet when he's finished, or can you see what the stools look like? Does he wipe himself? My grandson needed help at 4-years-old to wipe him. How about his daddy, could he help in this dilemma?
Sorry this is so long. I just thought maybe hearing another's experience might help. Raisa
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Walt Stoll on March 12, 2002 at 10:37:57:
I didn't say you don't care about people! It is obvious you do...I have seen you post on many topics here. What I am saying is I have difficulty enough without people "blaming" me for what my child will or will not eat. I put the food in front of him...tonight it was fish, mashed potatoes, green beans, carrot sticks and milk. What is wrong with that? If he doesn't eat his meal he doesn't get anything else...and this is a serious question...do you expect me to shove it in his mouth? Do I cut out everything except vegtables? How (HONESTLY!) do I deal with this without making it a psycological issue later in his life?
As for control, yes I do believe he is trying to control something...he has control of nothing. He has difficulty getting his point across, and I for one know how frustrating that can be!
I think that is part of the problem...and I am really searching for answers.
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Raisa on March 12, 2002 at 12:05:42:
I know he isn't straining or in pain because I do check on him while he is in there...he is four and not very coordinated...I have to check things out sometimes!
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Raisa on March 12, 2002 at 12:05:42:
Thanks, Raisa.
You are a voice of sanity in the wilderness!
Every child is different and any parent needs to use what works.
Namaste`
Walt
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Susie Durham on March 13, 2002 at 00:56:17:
I wasn't criticizing you, Susie - please know that. I understand very well how difficult it is to guide our children and yet not give them complexes, etc. That's why I told you about my granddaughter's recent experience - to let you know that others go through these things, too. As you said, it was after the week-long trip you took that this happened when things had been perfectly fine before that, except that he didn't usually poop more than every 7 days.
I was just trying to help you. I'm very happy for you that things are back to normal now. Please do try the mineral oil in orange juice - my granddaughter had no idea it was in the juice, and it really did help her - that plus the Fiber Choice tablets and/or Metamucil.
Raisa
In Reply to: Re: 4 yr old withholding stool.... (Archive in pediatrics.) posted by Susie Durham on March 13, 2002 at 00:54:43:
Thanks, Susie.
I think this is perfectly reasonable (especially if the potatoes still have their peelings on). No more than 2% fat milk.
So long as he is not getting snacks at other times, he will have to eat his vegetables eventually. Unless he gets seconds of his "peeled" mashed potatoes or milk, which kids like this will tend to fill up on.........
Kids this age are trapped inside a growing body and hunger will eventually get them past this kind of controlling behavior. When mealtime is over you simply must not care if there are any left-overs. I know this is hard but it is MUCH healthier for him. If he succeeds at this age, in controlling you, think how things will be as he gets older.
This is typical controlling behavior at this age and you simply must not let him see how important it is to you for him to eat. If you stick to it, he sill soon find some other controlling behavior to "push your button" with.
Hope this helps.
Walt
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