Potty Training Regression (Again!)

Hi! Yes, do call the pediatrician's office! You're on the right track. If they don't take you seriously consider a second opinion. There is a condition called Encopresis. Sometimes when a child is constipated, they begin to hold it to avoid voiding. This in turn sets up a situation in which they begin to have difficulty controlling their ability to void. It is a physical problem that often leads to huge power struggles as Mary Sheedy Kurcinka writes in "Kids, Parents and Power Struggles". She also mentions in the epilogue a resource for dealing with this issue, "Childhood Constipation and Soiling" by Dr. Judith Owens-Stively.

I totally agree with the other responses I had a chance to quickly read. A friendly attitude is a must in power struggles. You don't want to get hooked in because, darn it, kids are smarter and more persistent than us and they do win every time. :) Even if winning looks like us getting exasperated. I take a lot of deep breaths and need to take especially good care of myself when working through an issue so I have the patience to not let my buttons get pushed. I've been working on power issues with my four year old and since I've been working really hard at maintaining a friendly attitude, side-stepping power issues, and giving him lots of choices and teaching him self-sufficiency, It's like a have new, delightful kid!
It took a few weeks to turn the boat around, but it was worth the effort and things are easier as my new attitude has become second nature too. Also, when you start to work to improve misbehavior, sometimes it gets a worse before it gets better as they pull out all the stops. Just know that if that happens, it means the change for good is just around the corner and hang in there. Best wishes!

If there is nothing physically wrong with her (and it doesn't sound like there is), then you need to give her consequences for her actions. If she poops her pants, then she takes them off, she dumps the poop in the toilet, she rinses the undies out, she cleans herself up, and she gets herself new clothes. Same if she wets herself. She cleans everything up and gets herself new clothes. When she has an accident, show no emotion, just say 'go clean yourself up' and walk away. When she realizes the control battle is over and she has lost, that mom isn't giving in and that its much easier and faster to just use the toilet, it won't happen anymore. If she can't get a rise out of you, then it won't happen anymore. And since she's a girl, the grossout factor of cleaning up her potty mess may make the process a little faster.

Constipation and holding can cause urine leakage and accidents. I'm surprised your pediatrician hasn't mentioned this. Both of my boys went through the holding stage and what actually worked best for us was to back off and just be positive and encouraging. We had a reward system for pooping in the potty. In your case it sounds like she will poop in the potty, just not often enough. Try to encourage her to go more often. We had a rule that our younger son had to try to poop after meals and before bed. My younger son's situation was a little more serious and he was actually on Miralax for quite some time. It is now an over the counter product and our pediatrician assured us it was very safe, but I've since heard mixed things about it so if you decide to go that route you might want to talk to her doctor first. The first few days can be nasty as they get "cleaned out" and you adjust the dosage. I know it can be very frustrating because I've been there, but I would try to stay positive, not pressure her and know that a lot of kids go through the holding stage at her age. If you get that taken care of the urine accidents may resolve also. Good luck.

She is taking "genuine pleasure" in your frustration. There is very likely nothing physically wrong with your daughter. This has become a power struggle and she is winning. Be calm about this and:

Are there other stressful things going on in the household? This can add to the need for your daughter to "be in control" of at least one aspect of her life. Can you give her more control over other small decisions in her life? Can you reassure her about other things that may be stressful? Can you give her one-on-one positive attention during the day?

My daughter refused to go to poop in the toilet, she chose to control her poop by holding it in. It took her a year of frustrating horrible screaming, giant poops, suppositories, laxatives, bribery, letting her wear pull ups, whatever it took to poop. We ended up having to go to the hospital after one horrible bout of holding it in for 10 days. She was given an xray to rule out blockage, and was given mineral oil enema and clogged a hospital toilet with her poop and then we embarked on poop training with miralax and sitting on the toilet after each meal. The thing that worked for us was a book called It hurts when I poop. I will link to that article here so you can read the whole story and a link to the book.
http://momlifestyle.com/?p=199
Good luck, and you are not alone in the frustrating, poop refusal stage, in my ECFE group there were 3 of 10 parents experiencing this as well.

While there could be a medical reason for the problem, it could also be pyschological in the respect that she is getting much attention from you and she sees that she has enough power over you to get you very frustrated. I would try reverse pyschology. Be cool, calm, and nonchalant AT ALL TIMES, and tell her that it is perfectly okay with you if she wants to stink and FEEL uncomfortable and unclean, but she has to change her own wet or soiled clothes herself (provide her with a plastic bag or bucket to put the soiled clothes in for washing). Say, "Maybe NEXT YEAR when you start school you'll want to feel better by having clean underwear, etc.". If this isn't a medical issue then at age 4 it is definitely a power struggle between her and you, and she is winning because she knows there is nothing you can do about it.

I would bring her to a chiropractor. If she is out of allignment she may not be able to FEEL the urge to go..... This has worked for a friends son and some others I know. Make sure to specify that's why you are having her adjusted so they make sure to work "extra" on that problem.

Can't hurt and just may be what can help her. Good luck.