Constipation in a preschooler

[AmyRI]

Ugh. It's been a couple of months since DS last had a poop accident, but here we are - he had 1 big one and one small one yesterday, and is obviously in need of pooping today but he starts to poop in his underpants, but tries to hold it in and won't go when we sit him on the potty. He is holding it in on purpose. (We can tell and he admits it.) Now he can tell it's big and knows it'll hurt when it comes out, so he's holding it in harder. 

We had him drink a big glass of prune juice before bed and we're hoping that plus all the fruit he's been eating helps... but if it doesn't, do we call the pedi about an enema? How long do you wait? Would you let him poop in a pull up to clear out his system if necessary and then address potty training all over again? 

And any advice on how to convince him to go to the potty instead of holding it in? Rationalizing and talking about why he needs to go regularly and in the potty is not helping. Do we start taking away his favorite toys and books? Or would you go back to a reward system for when he does go on the potty? 

Sorry if this is incoherent. I'm tired and frustrated. 

[turtlegirl]

DS1 got constipated when we were first potty training and he was afraid to go in the potty.

Our pedi recommend medimucil mixed in his water. Up to 6 grams of fiber a day, but I think we only ever had to do 3 or 4. Just a small tsp mixed into a big glass of water.

It made to poop softer and easier to pass. It got to the point where he couldn't hold it in anymore, but not like it was diarrhea. He had an accident when we were out to eat and I think the humiliation and annoyance of daddy having to take him in his poppy clothes out to the car to get cleaned up and changed freaked him out enough to go in the potty.

[faith194]

I have been there, and am no longer fighting the poop battle- he gets to poop in a pull up, no pressure. I would give him a pull up. Tell him that the poop's job is to come out. Do not take anything away. I made that mistake, and DS was holding his poop for over a week with leaking, etc. I am on my iPad, and others will chime in, but don't make it into a huge deal. However you can get the poop out, do it(if Pull Ups are the answer, perfect). Hugs.


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[rootbeerfloat]

Have you tried Miralax? I would try that for a few days before an enema. Also, keep in mind that if the constipation continues, you should keep up the Miralax until he's going regularly. The longer they go without going, the more the muscles get stretched, which compounds the problem.

When we struggled with DD, we let her go in a pull-up. She is stubborn, and the alternative was that she wouldn't go at all and end up constipated. Then we would encourage, praise and reward.

[pupcake]

I would give him some miralax. It might take a couple days for it to work. When dd1 suffered from constipation we were told to make sure she was drinking an extra 20 oz of fluid a day. The first place your body will take water from is your poop making it harder to go. Keeping her hydrated made a big difference for dd1 on making it easier to go.

[fortmyersbride]

DD has chronic constipation issues and we give her a half-full cap of miralax everyday. She also gets senna syrup every night, but I think the miralax would be a good starting point.

I give her glycerin suppositories when she gets really blocked up. The suppository makes her go right away, but now that she's getting older it's certainly not a pleasant experience for either one of us.

[AmyRI]

Ok I'll call the pedi about miralax dosage tomorrow.
I'll also try the pull up, but he was trying to hold it in last night before bed even when wearing one. Can't hurt, though.

DS is in love with his water bottle so he drinks a lot of fluids.

Thanks for all the advice. It's helpful to know this isn't uncommon.

[Redpoppy]

DS had a strep infection on his bottom a month before Kindergarten started and was holding poop in until he had an accident. It was not constipation related but it hurt going before he started antibiotics to clear it up. It was bad and a total power struggle. We talked with the pedi who agreed. I was so close to asking for a psychologist referral. We did take away things based on our pedi's advice and DS almost egged it on, flat out saying "I don't care I'm not pooping on the potty and my teachers will just clean me up." Rewards were useless. We stopped calling them accidents and he had to help clean them up.

The thing that finally turned it was me crying in the car at daycare after he went again in his underwear. I was quiet at first til I noticed him watching and played it up. He asked why I was crying and I told him because he kept pooping his underwear and he said he'd stop doing it if I stopped crying. We went home and he pooped, no problem. He had one more refusal the next day and I faked tearing up and he quickly went. That was the end of it. Little shit.

[jena]

Do not make it a power struggle. Nothing good will come from punishing him.

When they've had constipation, I tell my kids that the poop has to come out our it will make them sick. (But they were pt'd already) I hold their hands and talk softly and encourage them to relax and let it out. And then there was the time that ds was screaming in pain with poop halfway out and I had to help it out. ::puke::

In your situation I would feed my kid a ton of apple juice, a handful of prunes (whole prunes work better than juice for us), and put a pull up on them in a heartbeat.