Toilet Training a 4 year old with NO poop successes

[ESD]

Hi guys,

I'm new to this forum and I was hoping that you guys might have some insight or helpful suggestions. Here is a little bit about what I've encountered:

I am currently toilet training a normally developing 4 year old boy how to poop in the toilet. I've had this little guy in my care for just over 3 months now with zero success on poop. When he first came into my care he wasn't toilet trained at all and the other care provider didn't attempt to train him whatsoever. He holds his poop ALL day every day and every now and then little bits at a time will come out because he can only hold it for so long. This could happen up to 5-8 times per day (little poop slips and skid marks in his underwear).

I suggested prune juice to his mom so we tried that out hoping that if he could no longer hold it we would have more successful trips to the bathroom. He is a very smart boy and knows when he has to go but just won't.

We've tried a sticker chart, candy rewards, even a new toy but he will say things like, "that's Ok I don't want those things" and we also tried another approach with him watching his peers successfully using the bathroom and telling him if he wants to go to big boy school that he has to poop on the toilet like his friends. The school he is registered for in September requires all children to be fully toilet trained before they are allowed to attend.

His mom has taken him to the doctor several times but they keep telling her that his systems are all normal.

I should also mention that his parents are separated so he's with mom half of the time and dad the other half. I explained to them both that we all need to be consistent with what we are doing and not scold his accidents. I've also recently broke him of his soother (while here in care) too along with his "special" pillow. He has a lot of attachments and I'm wondering if poop may be another?

His parents and I just don't know where to go from here!

Has anyone else been in this sort of situation? His parents are really worried that he won't be allowed to go to school come the fall.

TIA for all suggestions and tips ladies!!

[JennJubie]

The holding and small amounts of soiling concern me. When my son was doing this very thing, we were told that he had encopresis. Encopresis may end up resulting in a "clean out" in the hospital if it becomes severe enough. It can also damage nerves, and then children have difficulty with soiling themselves because they honestly can't feel it happen sometimes.

http://en.wikipedia.org/wiki/Encopresis

[giraffe]

What I would suggest is to have him sit on the toilet for a set amount of time every day at the same time every day. After a meal works well. Have him stay there for 10-15 min. If he produces great and if he doesnt, thats ok too. after a while (could be days or weeks) the childs body will usually start to become trained to poop at that time. Make sure that its a non-pressure situation, what we are trying to do is to get the childs body to relax. It does take time but it will work.

[sunnydays]

I would be concerned about him holding it as well. I had a 3 year old dcb who started to do this when he was toilet training and we had to put him back in pull-ups and let him poop in them because it is very unhealthy for them to be holding it and can lead to problems such as Jennjubie mentioned. It sounds like it is a security issue (my 2.5 year is also unable to poop on the toilet so far, so I have to keep her in pull-ups) and more pressure may just make it worse. Personally, while I agree that he is way too old for this and should be trained...I would put him back in a pull-up for now before he ends up with bowel damage from holding it.

[sunnydays]

Hmmm...I may try this with my daughter and see if it works. I agree with the lack of pressure as the more pressure the child feels, the less likely they are to be able to relax enough to do it. I may try a potty in front of a movie or something.

What I would suggest is to have him sit on the toilet for a set amount of time every day at the same time every day. After a meal works well. Have him stay there for 10-15 min. If he produces great and if he doesnt, thats ok too. after a while (could be days or weeks) the childs body will usually start to become trained to poop at that time. Make sure that its a non-pressure situation, what we are trying to do is to get the childs body to relax. It does take time but it will work.

[JennJubie]

If you can, try making him a schedule, visual works well, and make going #2 part of the routine. This really helped for us, because instead of being stressful for my son, it just became part of his day.

[ESD]

Thanks guys! He's been to the hospital and has had several tests (including X-rays and other similar tests) and all came back normal.

I will definitely take you guys up on the schedule (visual schedule as well) and give both parents the same so we are all on the same page.

He actually had his first success here today just hours after I posted this. He had an entire poop! I was so happy that I even called his mom at work!! lol its been a very busy 3 months with this little guy and he has come sooo far from when he first started care with me.

I will try the scheduling thing and have his mom bring up the nerve damage possibility with the doctor as a concern to see what they have to say. She has already scheduled an appointment

Do you guys allow children to do things while on the toilet? Read? Should I be distracting him from the thought of pooping so he can relax?

Thanks again!

[Crayola kiddies]

If I was this child's mother I would be getting him up early in the am and inserting a suppository and then waiting a few minutes (5-10) and put him on the toilet and telling him to stay there till he goes. That way he's all cleaned out before he comes to daycare. This child is using it as a control issue. There are things in his life that he can't control such as his parents separation for one and it could be causing him stress but his bowels are something he can control so he is. He's choosing not to use the toilet.

[Momof4]

I have to agree with Crayola here, the mother should be finding the solution to the problem, not you or even the old caregiver who didn't help out. Ultimately it's the parents responsibility to solve problems and health issues and we are the secondary caregivers who are supposed to take the parent's lead and help out on a daily basis. But the onus has to be on the parents. I give it my all when a child is doing well at home, don't misunderstand me, but it's not my job to set up the reward system or anything else.