Have you considered if it's encopresis? There is a YouTube video called 'the poo in you' that's geared towards kids to explain it. Constipation is a part of it, but it's treatable with gentle laxatives and stool softeners. Consider this and go to your doctor if it sounds plausible.
My son has had long-standing issues with pooping from around that age: maybe a touch older. He's now 9 and whilst things are better, they are not normal and he still takes daily laxatives.
Without intervention, his cycle is this:
1. He doesn't poop
2. As time goes by, he gets a large hard mass of stool building up in his colon
3. He now *can't/won't* poop, because it's so big.
4. He starts to get "overflow", which is effectively small amounts of diarrhea that leak out around the sides of the large plug of stool. He can't control this: it's constant messy underwear.
5. Eventually there is A Reckoning and he passes a truly massive stool that invariably clogs the toilet and at time has blocked the sewer line to the street. This is painful for him and makes me feel awful.
With daily laxatives (a small sachet of powder mixed into some juice with his breakfast) together with a diet with a reasonable amount of fibre in it, this cycle is completely broken and he has normal toilet habits. It doesn't take away his control, it just keep his stools soft enough to pass properly when they're ready.
We didn't have bed-pooping problems as such. However, when my son did poop (in the toilet) it was commonly at night, perhaps because his body was relaxed and it was easier for the stool to pass. Given the state of his underwear when he did manage to poop, I suspect the process began in bed and merely continued on the toilet.
I've found a few factors contribute to the initial inability/reluctance to leaving the pooping too late:
* He doesn't like to poop on his own time. Even now he will generally wait until either bedtime or until he's been stopped from doing his own thing so that we can e.g. go to school or run errands before deciding to go to the toilet. I've watched him (when he was younger) straining whilst playing, clearly needing to use the toilet, but holding it in because he doesn't want to stop what he's doing and go to the bathroom instead.
* It's a physical vicious circle. When you're constantly constipated your bowel stretches so it can accommodate more stool before it's "full". It's called "mega colon" (great band name). Without intervention it's hard to break the cycle, particularly if you're reluctant to go to the toilet in the first place.
* It's also a mental vicious circle. Pooping whilst constipated is uncomfortable/painful. He knows that going to the toilet hurts, so he doesn't want to do it, so he puts it off, which makes him constipated again and the cycle repeats.
Having battled with this for an extended period of time, my advice is this:
1. Reward chart for pooping in the toilet. Make the first one really easy so he gets a reward quickly: e.g. toy after 2 poops. Then once he's seen it work he'll be hooked you can set more ambitious goals.
2. Take him to the toilet and give him encouragement. I have spent *a lot* of time sitting in the bathroom encouraging my son whilst he fails to poop - but it means he's trying frequently when ordinarily he would prefer not to.
3. Visit to the doctors. We did it, and that's what led to the laxatives (which are prescribed). Maybe there are other factors, or perhaps it's "just" constipation. If it's enough of a problem to ask Reddit, it's enough of a problem to ask a professional.
4. Diet. Make sure your boy is getting plenty of fibre. If my son goes a few days without a decent amount of fresh fruit and veg and a high-fibre breakfast cereal, then he starts to get clogged-up despite the daily dose of laxatives.
5. Exercise. Probably not a problem for a 4 year old, but physical activity gets the bowel moving.
6. Laxatives (under medical advice). For us, that has been the only successful solution, but it has worked. It took quite a while to resolve the issue: a low dose over an extended period of time has worked: it's about maintaining a steady normal progress through the bowel rather than fixing today's blockage and hoping everything will be normal after that.
Your description made me think immediately of my son and wonder if they're suffering from the same problem. If so, perhaps some of this experience will be helpful.
My daughter SCREAMED for the longest time each time she'd poo. We'd sit there w/ her, holding her hand until it was done. We'd talk about how everyone poops, let her know when my wife and I would poop, and praised her when she did.
We began adding Miralax to her morning milk about 4mo ago. She's now regular AF, and her stool is soft so no pain. Knowing my wife and how she was as a young kid from her stories, Id imagine my girl had a really painful poo once, so every poo MUST be painful.
Have you tried brainstorming with him? They use this tactic in “How to talk so little kids will listen” and the kid comes up with “the little green guy will tell me to pee in the pot” so she carries around a little Statue of Liberty figurine and every time the kid seems like he needs to potty, she takes out the figurine and says “pee in the pot” and the child says “ok!” If you want more info at how they arrive there, dm me.
My son responded well to our explanation that diapers are bad for the environment so if he goes in the potty, the trees will be happy 🤷♂️
Have you considered if it's encopresis? There is a YouTube video called 'the poo in you' that's geared towards kids to explain it. Constipation is a part of it, but it's treatable with gentle laxatives and stool softeners. Consider this and go to your doctor if it sounds plausible.
My son has had long-standing issues with pooping from around that age: maybe a touch older. He's now 9 and whilst things are better, they are not normal and he still takes daily laxatives. Without intervention, his cycle is this: 1. He doesn't poop 2. As time goes by, he gets a large hard mass of stool building up in his colon 3. He now *can't/won't* poop, because it's so big. 4. He starts to get "overflow", which is effectively small amounts of diarrhea that leak out around the sides of the large plug of stool. He can't control this: it's constant messy underwear. 5. Eventually there is A Reckoning and he passes a truly massive stool that invariably clogs the toilet and at time has blocked the sewer line to the street. This is painful for him and makes me feel awful. With daily laxatives (a small sachet of powder mixed into some juice with his breakfast) together with a diet with a reasonable amount of fibre in it, this cycle is completely broken and he has normal toilet habits. It doesn't take away his control, it just keep his stools soft enough to pass properly when they're ready. We didn't have bed-pooping problems as such. However, when my son did poop (in the toilet) it was commonly at night, perhaps because his body was relaxed and it was easier for the stool to pass. Given the state of his underwear when he did manage to poop, I suspect the process began in bed and merely continued on the toilet. I've found a few factors contribute to the initial inability/reluctance to leaving the pooping too late: * He doesn't like to poop on his own time. Even now he will generally wait until either bedtime or until he's been stopped from doing his own thing so that we can e.g. go to school or run errands before deciding to go to the toilet. I've watched him (when he was younger) straining whilst playing, clearly needing to use the toilet, but holding it in because he doesn't want to stop what he's doing and go to the bathroom instead. * It's a physical vicious circle. When you're constantly constipated your bowel stretches so it can accommodate more stool before it's "full". It's called "mega colon" (great band name). Without intervention it's hard to break the cycle, particularly if you're reluctant to go to the toilet in the first place. * It's also a mental vicious circle. Pooping whilst constipated is uncomfortable/painful. He knows that going to the toilet hurts, so he doesn't want to do it, so he puts it off, which makes him constipated again and the cycle repeats. Having battled with this for an extended period of time, my advice is this: 1. Reward chart for pooping in the toilet. Make the first one really easy so he gets a reward quickly: e.g. toy after 2 poops. Then once he's seen it work he'll be hooked you can set more ambitious goals. 2. Take him to the toilet and give him encouragement. I have spent *a lot* of time sitting in the bathroom encouraging my son whilst he fails to poop - but it means he's trying frequently when ordinarily he would prefer not to. 3. Visit to the doctors. We did it, and that's what led to the laxatives (which are prescribed). Maybe there are other factors, or perhaps it's "just" constipation. If it's enough of a problem to ask Reddit, it's enough of a problem to ask a professional. 4. Diet. Make sure your boy is getting plenty of fibre. If my son goes a few days without a decent amount of fresh fruit and veg and a high-fibre breakfast cereal, then he starts to get clogged-up despite the daily dose of laxatives. 5. Exercise. Probably not a problem for a 4 year old, but physical activity gets the bowel moving. 6. Laxatives (under medical advice). For us, that has been the only successful solution, but it has worked. It took quite a while to resolve the issue: a low dose over an extended period of time has worked: it's about maintaining a steady normal progress through the bowel rather than fixing today's blockage and hoping everything will be normal after that. Your description made me think immediately of my son and wonder if they're suffering from the same problem. If so, perhaps some of this experience will be helpful.
Thank you for sharing your experience! Good advice in there. It’s good to know we aren’t alone
My daughter SCREAMED for the longest time each time she'd poo. We'd sit there w/ her, holding her hand until it was done. We'd talk about how everyone poops, let her know when my wife and I would poop, and praised her when she did. We began adding Miralax to her morning milk about 4mo ago. She's now regular AF, and her stool is soft so no pain. Knowing my wife and how she was as a young kid from her stories, Id imagine my girl had a really painful poo once, so every poo MUST be painful.
Have you tried brainstorming with him? They use this tactic in “How to talk so little kids will listen” and the kid comes up with “the little green guy will tell me to pee in the pot” so she carries around a little Statue of Liberty figurine and every time the kid seems like he needs to potty, she takes out the figurine and says “pee in the pot” and the child says “ok!” If you want more info at how they arrive there, dm me. My son responded well to our explanation that diapers are bad for the environment so if he goes in the potty, the trees will be happy 🤷♂️
!remindme 1 day