About a month ago, our 4-year old decided to stop pooping. He didn’t stop pooping in the potty, but he decided to stop going at all. I didn’t know this was humanly possible, but as we’ve recently seen, the determination of some children is nothing short of astounding.
The first week, I wasn’t too worried. I thought, “Certainly it will find its way out somehow. It’s not possible to keep it in.” Oh, was I wrong! By keeping it in, he has caused himself an immense amount of pain and discomfort. His tummy has started dictating our daily schedule and meal choices, limiting play dates, causing late camp drop-offs in the morning, and creating an enormous amount of anxiety (not to mention laundry) for me and my husband.
This post covers everything I wish I’d known, and wish I had done, on day one of the pooping problem. Actually, I wish I’d known this before the problem began, so I could have prepared for it; perhaps I could have prevented it from occurring at all.
The technical term for what my son is experiencing is “stool withholding”. It’s almost always caused by constipation and/or experiencing a painful bowel movement with hard stool. The child is so fearful of having another painful experience in the bathroom that they become expert in holding their poop in. So much so that it causes severe abdominal pain and eventually bowel movements that leak out bit by bit, or ones that come out en masse, at the moment you (and your child) least expect it.
Constipation in children is often caused by (1) dehydration, (2) a diet too low in fiber, and (3) anxiety-inducing changes such as moving or starting at a new school. At the time this issue began for us, my son was experiencing all three. We’d just spent a week on vacation in 100+ degree temperatures, where it was next to impossible to stay adequately hydrated. While we were away, our usually steadfast requirement to “eat your veggies” had become lax, and too much vacation food (pasta, pizza, and cheese) seeped into his diet. And, he was set to start at a new summer camp the Monday after we returned home. In hindsight, I should have known this problem was destined to occur, even before it did.
I wish I’d known to keep an attentive eye to what came out of his bottom, how frequently, and with what level of (dis)stress. I also wish I’d known that Mirlax, the overwhelmingly recommended remedy, is safe to give to children*, and is available over the counter. Hindsight (ha!) is 20/20, but if I’d had a bottle of Mirlax on hand, I could have given it to him the moment I noticed a difficult pooping experience or hard stools.
Dairy is a huge culprit in our story, too. Among the “Worst Foods for Constipation”, Web MD lists dairy products as #1. Lesson learned: pay close attention to how many servings of dairy he is consuming each day, being mindful of hidden dairy like the butter used to cook our morning pancakes.
As an endurance athlete, I think carefully about my own hydration, but I need to give the same level of attention to his. Water isn’t just good for your body; it’s a necessity! Without enough, poop becomes dry and compacted, thus harder to push out, which causes more back-up. It’s an awful cycle.
This is a topic so complex, I could write a book on it. Lucky for me, someone else already has. Here are three resources that we’ve found very helpful:
- Stool Withholding: What To Do When Your Child Won’t Poop! Sophia J Ferguson, 2015
- It Hurts When I Poop! A Story for Children Who Are Scared to Use the Potty Howard J Bennet, MD, 2007
- Video: The Poo in You GI Kids, 2013
We are barely a month into our experience with stool withholding, and I’ve since connected with other moms whose children have struggled for months, even over a year! Early intervention is really key here. If you’re noticing any signs or risk factors, take it seriously, look into early precautionary steps, and perhaps even place a call to your pediatrician.
Finally, keep giving your little one lots of love and understanding. This is an incredibly scary and traumatic time for them. At first, I thought our son was doing this as part of a power struggle; now I realize just how real this struggle is for him, and how much he needs our love and support.
*Always consult with your pediatrician before giving your child any medicines, whether prescription or OTC.