Q: Our daughter is almost four and she is potty trained for the most part, however she seems to have a very hard time learning how to poop in the toilet. She can hold it all day or for as long as five days, however she seems to have terrible cramping and a very hard time most evenings due to her abdominal pain. We tried I believe everything that we know and it seems to be of no support.
Is our child normal? Please help us!
Michael and Denise
New York, NY
A: Michael and Denise,
I definitely believe your daughter is normal, and learning how to go poo in the toilet can be a big deal to many children especially as they get older. From your question I understand your daughter's age, the fact that she is not using the toilet regularly to eliminate her stools and I also understand your frustration and most likely worry.
I would have loved to know for how long this is been going on, and what are some measure you have already taken. In my profession as a professional potty trainer and parenting coach I have come across cases like your daughter's and after we ruled out a few things, we came to believe we were dealing with something called encopresis.
Encopresis affects one to four percent of children, and it may be undetected unless a doctor or potty training professionals directly asks about habits during potty training or toileting. It can very well be confused or misdiagnosed for constipation only and treated as such when in fact we are dealing with a child who may be emotionally upset, a child with a poor diet, a child lacking in physical activity, and more.
We work with children and parents who find themselves in this situation, create a custom plan and take it from all angles by developing a strategy to educate the parents, child and all involved in the child's life.
What we suggest for your daughter is to contact your pediatrician, get her checked and read all you can on encopresis, constipation and withholding.
Before you visit with your pediatrician I suggest you keep a daily journal of your daughter's food intake, liquid intake, activities, rest and potty breaks for at least three days. Your child's doctor will be able to have a proper diagnosis if he knows what your child's life is like.
At home or school have your daughter sit on the toilet at least twice a day for at least ten minutes each, preferably shortly after a meal. Think on how you can make this time pleasant; do not scold or criticize her if she is unable to have a bowel movement. Until the intestine and rectum regain their muscle tone, she may still have "accidents" and soil her underwear on occasion once the doctor prescribed the right care. If she is in pre-school or kindergarten she may be able to wear a disposable training pant until she regains bowel control.
Taking a change of underwear and/or pants to school can help minimize her embarrassment and improve her self-esteem as bowel control improves.
If you would like to learn more about encopresis and steps you can take this may be a great resource.
One of our contributing writers, Dimity Tefler is an encopresis survivor and she has great information and support to offer.
You may want to read:
Adriana Vermillion is the Founder and CEO of P.O.T.T."Y" Generation®, The Potty Whisperer™, a Lead Trainer and Parenting Coach with over sixteen years of experience in potty training special needs children and coaching parents. Adriana is an Author, Freelance Writer, and a frequent Motivational Speaker available for your event at www.adrianavermillion.com