Saturday, July 2, 2011

Pooping on the Potty - Don't Make Me Go!

“Currently, our toddler is practicing willful control of her bowels - in a bad way. Potty training was going well for awhile, but suddenly she's refusing to let herself have a BM. (We made no changes to routine, diet, etc.) She's just flat out clenching and fighting for all she's worth to not have a BM, even when we add high fiber foods. After 3-4 days of a grumpy, constipated child, we finally pull out some PediaLax products, which then seems to *make* her go 1-2 days later. Then she'll be regular for 2-3 days, but after that, the cycle starts all over again. Any advice for me and/or your blog readers?”

Going poop in the potty is a common issue for toddlers.... something about pooping into that bowl really bothers some kids.  So they end up holding it in and get constipated.  Then it hurts to go because they are constipated, and they are even more afraid to go next time... so they hold it in.  Then they get more constipated... and so on.  It’s a painful cycle for your toddler and can throw a monkey wrench in what had been successful potty training efforts.

So... here's what to try if it happens to your toddler or child.  Buy some Miralax (an over the counter stool softener - very safe for kids, can use up to a year if you had to).  Other stool softeners can work, but often result in more cramping and cannot be used for long periods of time. Give 1 capful a day (17g) of Miralax mixed in liquid (if the stools are too soft, cut back a little).  But do this for at least two months - even if the stools are normal.  Stop pushing potty training temporarily while you do this.  She needs to forget that pooping hurts. 

Her colon needs to get used to normal-sized, soft stools for several months.  When constipation occurs, the colon gets stretched out of shape (think of how a woman’s belly gets all stretched after being pregnant – it takes time to get back to normal) (although I think mine will never get back to normal!).  The stretch of the colon sends a signal to our brain to tell us that we need to go.  If your colon is stretched out already, it takes even more stool to send that signal to your brain.  So, it’s important to give your child's colon time to shrink back to normal size before you stop the Miralax.  

It is very important to change your child's diet.  Avoid constipating foods (bananas, rice, applesauce, toast (white bread), cheese).  Give more fiber (oatmeal, bran, fresh fruits, vegetables), prune juice (if she'll drink it), prunes, and water.  For some children, too much milk or dairy can be constipating.  Toddlers need around 16-20 oz of milk to get enough calcium, but more than that can result in constipation and anemia (too much calcium can interfere with iron absorption which then leads to anemia or low red blood cells).  

Then in about two months, start trying to potty train again.  Don't remind her that she used to do it... just start from scratch... stickers, rewards, etc. 

Don't worry – there are very few kindergarteners still wearing diapers to poop or pee... so everyone gets it eventually!  Refusing to poop in the potty is very common and very normal toddler behavior.

If she hasn't poop in five days, has vomiting, has blood with stools, or severe stomach pain, call your doctor for help.  Do not use Miralax in infants.  If your baby is constipated, consult your child's doctor.

Hope this helps!  Thanks for reading and Happy 4th of July!