The Child That Just Won't Go

If you've ever had to deal with potty training, you know how hard it is: the tears, the fears (80's readers..... anyone?), the frustrations, the begging, and that's only what we parents go through! Try putting yourself in your toddler's pull-ups. Imagine how scary it is to hear "okay, well you're done crapping on yourself, you must now hover over this gigantic hole and let loose." That's a scary thing for them to process. But with time, patience, and a healthy stash of alcohol, they will succeed. But what happens when your child only gets it "half-right?"

I'm talking about an all too common problem: Refusal to poop on the potty. This happens to many children for a slew of different reasons, but the common theme in all these reasons is simply: fear. These children are actually afraid of dropping a deuce into the toilet, and it's something us adults have a hard time understanding. For a lot of these children, it is purely psychological: The thought of something inside of their body suddenly "falling out" is scary to them. They feel like they are losing a part of their body.

Then there are some children, like my daughter, who are fully potty trained (pee and poop), then suddenly become constipated. Now all of a sudden they have to deal with stomach cramps, multiple trips to the bathroom with nothing to show for it, and then, when they finally do poop, it is very large, very hard, and very painful. This ends up having a traumatic affect on the child, and the next time they have to poop, they are going to think "Well if I poop, it's going to hurt again, so I'm just not going to poop."

If caught early, this behavior can be fixed with the help of stool softeners (Miralax is a very common one for kids). Soon the child will be able to poop pain-free and won't hold it in anymore. However, if left untreated, constipation can lead to a serious condition of impacted stool, and this is what my daughter has had to deal with for over a year.

Impacted stool happens when a person does not empty their bowels regularly. The stool backs up into the colon, eventually hardening into a large mass. The colon will then stretch (like a balloon) to accommodate the mass, which continues to grow as new stool enters the colon. When the person eventually does poop, it is still large and very painful. Eventually, the person can lose the sensation to poop, meaning they won't know when they have to go! Not only that, but all new poop that enters the colon will actually leak around the mass to be expelled, but since the person cannot feel the urge, they soil themselves without even knowing it. This is called Encopresis. The worst was towards the end when the daycare was sending 3-4 pairs of my daughter's soiled underwear home EVERY DAY.

Pretty gross, huh? Sorry, but let's be real: parenting is gross. If you can't handle the shit, parenting will be tough for you. Anyway, for over a year my daughter has been dealing with this, and yes, we've taken her to see her pediatrician numerous times, who at first suggested Miralax every day (this was before we knew the extent of her condition). When that wasn't working and an X-ray confirmed the large mass of stool in her colon, the only option to treat this was a full-on Colon Cleanse. I know adults who have done this in preparation for a Colonoscopy who couldn't handle that, imagine having to do it to a child. But that was what she had to do. The cleanse is:

*1 32oz Gatorade

*7 capfulls of Miralax

*drink it all within 4-6 hours

*1/2 chocolate Ex-Lax square at bedtime

I'll spare you the details of the aftermath, but will tell you that getting her to drink the whole thing was the worst part. Fighting, pleading, begging, bribing her to finish it was awful, and I felt so bad for her. I'll also say that the cleanse did technically work, because she pooped A LOT, but after all was said and done (and cleaned up), we found out a few months later that it didn't clear the mass. So her doctor said to try it again. Umm...what? But he's the doctor, right? So we did it again. Went through all of that stress...again. You wanna know what happened? IT STILL DID NOT WORK!

So when her doctor suggested to try it a 3rd time, I said "Absolutely not. Find me a specialist." Saw a pediatric gastroenterologist, and you'll never guess what he said we had to do? That's right: ANOTHER cleanse. But this one was a little different, and a little more aggressive. It also WORKED! An X-ray the following week showed an empty colon, and a much happier girl. Now, this cleanse is not an overnight fix. Turns out, it could take MONTHS for a person to start gaining that sensation of having to go back. We were also instructed to do a daily regimen of Miralax and Ex-Lax, and she has to sit on the toilet after Breakfast, Lunch, and Dinner, for about 10-15 minutes, or until she poops. It's really a lot of work! And even though she still soils herself (she still hasn't regained full sensation yet), instead of 4 or 5 pairs, I'm only bringing home 1 pair of dirty underwear, and even more recently, NONE! We are also struggling with her having to go after every meal, because she gets bored and doesn't want to all the time, but the important part is: she is having regular, healthy bowel movements every day (sometimes more than once per day!), and as long as she continues that, she will never have to go through this again.

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TIPS AND TRICKS FOR HELPING YOUR CHILD POOP ON THE POTTY:

*Make sure your child gets plenty of fiber in their diet to keep them regular.

*Do not pressure your child to sit on the potty to poop. This will ultimately lead to a power struggle, which will continue to delay their progress.

*Try a more gradual approach: 1) Let them wear their diaper (or pull-up), but when they need to poop, take them into the bathroom. Let them know that this is where poop goes. Have them help you empty the poop in the potty and let them flush it. 2) After a few weeks, still with the diaper on, have them sit on the potty to poop. This allows them to understand that we need to sit on the potty to poop but still have the "safety net" of the diaper. 3) After a few more weeks of this, cut a hole into the diaper, so that the poop falls into the potty. 4) Finally, after they are comfortable enough, ditch the diapers for underwear.

*PRAISE, PRAISE, PRAISE! Praise your child every time they sit on the potty to poop, no matter how little comes out or even if nothing comes out at all! Children thrive on praise from their parents, grandparents, teachers, etc. so get everyone in on the praise! Jump around, yell out, sing, dance, do whatever it takes! Trust me, your child will love seeing how happy you are, and knowing they did something to make you that happy will build up their confidence to keep doing it.

*If you think your child may be constipated, call their doctor sooner rather than later.