Need help with poop PTing
mommyof4boys
member
Chris decided last week to potty train himself! This was after he saw Jon and Matthew going....he pushed a stool up to the toilet and went after I had him undressed for tubby. He's completely pee trained *helps since he doesn't like the sensory aspect of wet and we were going through tons of diapers*! I am not pushing the poop part since the other boys were all pee trained before poop trained HOWEVER he refuses to sit at all on the toilet. He keeps saying "fall" when we put him on even with the potty seat and he will not sit on a potty chair. Is this something we will need to wait for? *Again, I am just thrilled that he's going pee on the toilet period! Jon and Matthew weren't able to be trained until this time LAST year when they were 3.5!* And how do we get over the sensory aspect of him feeling like he's going to fall?
Next...Matthew has low muscle tone. Matthew is going a week or so without going poop then having accidents. I've talked about this before. We were told to do Miralax but after talking to a pharmacist, decided to use Pedilax first. DH gave him the entire max dose the first time and it worked TO WELL 
Now Matthew is afraid to try it again and who can blame him? Is there anything else I can do to help them with this? It was suggested that his accidents could be a direct result of the low muscle tone as well since he's getting so consitipated that it is so few and far between.
Re: Need help with poop PTing
I am the expert at all things wrong in this area, so don't take this too seriously
DS had 'toddlers diarreah' until we put him on daily fiber (Benefiber to be exact) at the instruction of the GI we took him to. They told me it would help regulate whether he was constipated or having diarreah. First line of defense if you haven't already tried it... it's at least worth a conversation with the pedi. I'm feeling like you've probably already been that route though. I hope it gets better.
On poop training.... Since he seems to have some potty readiness my son does not, I wonder if he had something he prefers (a book, music, an electronic gadget) that would bait him into sitting & I wonder if just sitting on it w/o the added pressure of actually going would help him work through his fear.
My own DS actually doesn't mind sitting on the potty. He independantly ran to the potty and we found him naked sitting on it this afternoon (this is a first) and he was trying SO hard to go poop. I had to hold back from rewarding, even as much as I wanted to, so that I dont give him the idea that he can go and pretend to do his thing and then get rewards. It was awful hard to not really celebrate hard on that one
THAT would be my fear with the above suggestion, but it all depends on how you think your DS would react.
Not sure about Matthew and if he has any other delays aside from his low tone (that could be attributing or impacting his ability to understand this horrible cycle), but my daughter has encopresis and it is horrible- both for the child and the parent. As Auntie said, it can take years to overcome, so its best to start treatment right away. Miralax is a major part of the treatment as well as specific behavioral pieces/strategies.
We work with our pedi, a GI dr and a child psychologist. The medical drs have added their piece, which was extremely helpful in the beginning with getting her on the right laxative dose, looking at her diet, ruling out any physical reasons etc... but in the end the psychologist is what helped the most with my dd- helped to address why she was withholding bms rather than just cleaning her out with laxatives. But, I'm sure different approaches work differently for different families.
If you have any questions, feel free to ask and best of luck.
Has your developmental pedi said anything about the poop issues?
I ask because it sounds like it will difficult to determine the causes of the symptoms. Ex- is it low tone or has he lost sensation because of the stretching out and the constant urge to go (like how you eventually tune out a humming refrigerator). Or things like anxiety, control, diet, can all play a role.
For us, it was control issues and anxiety that caused my dd to withhold, after she had an anal fissure. We also see control and anxiety in other areas of her life as well.
The biggest piece has been using miralax on a daily basis to keep the bm soft and unable to hold it in. You also then have practice sits 2-3 times per day (without the expectation of him going) to start having positive toilet associations. We rewarded her in the beginning for practice sits and then for every 3 sits, 5 sits etc... We tracked all of her bms- when, consistency etc... and eventually we started seeing a pattern as to when she'd go. Then we based her practice sit times around those times to catch the bm on the toilet and reward that etc... My dd has been in treatment for 14 months and she is now going on the toilet everyday , only on the tiniest bit of miralax, no more withholding and this week began initiating the need to go- so her sensation is back
It may take a long time and be a long road- but hang in there- it will get better!!!
Also, try not make a big deal about it- clean it up without getting upset, making comments etc... Just very matter of With kids who are capable, having them help to clean up can help to. I know this isn't easy- believe me, its horrible!!!
Talk to the dr about doing a cleanout (some use large doses of miralax, others use enemas etc.. depending how old the poop is thats in there and where it is) but its important to know he is empty before starting with daily doses of miralax.
Good luck!
Unfortunately the clean out phase is not fun
For my dd they put her on a LARGE dose of miralax for three days in order to get the residual poop out. You'd be amazed at how much can be in there. Unfortunately it takes it to be basically liquid for it to get all out. So during that you have to be prepared for some accidents. Then you do a maintanence dose each day- varies from child to child. Good thing with miralax is that there is no taste, grit etc... so you can mix it in his drink and he won't even notice. My dd knows she gets her "juice med" to help her poop but bc it doesn't taste bad and doesn't work instantaneously she has never equated miralax with diarrhea. You have to find the right dose so its not liquid but its not solid enough to hold. My GI had said if she went 2 days without going to up the miralax.
When he skips the week and then has accidents... is it all diarrhea accidents or does he eventually have a large formed stool that passes? Just curious as to how much could be in there. I almost fell over when they did an xray on my daughter and I saw how much stool was backed up! yikes!
For him, it probably started as withholding due to being afraid that it would hurt. And then it just sort of becomes second nature to hold it. To the point where they aren't even aware that they are holding it in. My dd used to sit and push and push with all of her might but just could not make herself go. Its heartbreaking to hear your kid so upset over such a "normal bodily function" especially when they get so upset about the accidents and so down on themselves. I'm sorry that you are going through this right now
I would start with either your pedi or dev pedi (whomever your more comf with) and then probably a GI dr to see what is going on with him. Hang in there....
IDK if he would have a reaction to them, but can you try those Cottonelle wipes? I'm just thinking they the cleanup would require much less wiping and maybe less flare up from the irritation? Baby wipes aren't flushable so those are a pain but that could work too. Otherwise, maybe starting with wet washcloths. Something to show him that wiping doesn't have to hurt to take away that negative association...