Withholding Behavior Issue

Try giving her a diet that is rich in foods that make it hard to be constipated: prunes, raisins, fresh fruits--blueberries, strawberries--lots of liquids and soups. Then, put one of those little potties on the floor and walk away from the potty training. (go outside and yell and cry).

Warning: This is going to get graphic. And you may not like this. I've been through it personally twice:

It may very well NOT be a behavior issue, but a physical one.

In our family about one child in four is born with near adult sized intestines. You can imagine how painful it is to eliminate with adultish intestines and a childsized rectum because you had a child. Honest to god, birthing my son hurt about the same amount as many (not all, but many) of my bm's as a child. I was actually surprised that it didn't hurt more to have a baby (given all the fuss)...and was actually able to use many of the "tricks" I'd learned as a child pooping.

Laxitives only made the situation worse...the intestines were too big...laxatives just made them fill up that much faster, cause cramping, and panic. I remember withholding, and "marking" my underwear...but still withholding because i was deathly afraid of the pain AND how angry my mum got at me (i was the only on of her children who had this issue).

To parallel, yet again, if you were afraid of the pain of childbirth (and we get babies out of that pain!!! And it only happens at most twice a YEAR, not twice a week!!!), look closely at your daughter...and see if you see yourself then in her now.

My son also has this problem. Since he was a year old (and started eating solids as his primary nutrition source), I've spent hours and hours rocking him in my lap while he cried from the fear and pain, applauding his efforts, reminding him that as he gets older it hurts less and less, telling him how brave he is, "admiring" his handiwork (ugh), and holding his hand (literally).

At nearly 7, he doesn't need me to hold his hand, or the constant support...but he's had years in which to learn to build his courage, face his fear, and accept that (even severe) pain is sometimes a fact of life. And he IS very brave. Can you even imagine going into labor once a week, much less 3 or 4 times???

My mum lost her patience with the whole thing when I was probably about the same age of your daughter. The next four years were misery for me. Force fed laxitives, milk of magnesia (the smell STILL makes me want to vomit), shoved enemas into me, in general acted like I was doing "this" to make her life difficult. I was slapped, spanked, all of my "friends" (toys) taken away from me, punished every which way from Sunday. All for something that I couldn't control. Fear.

I remember crying myself to sleep at night, knowing that she hated me, no matter how often she said otherwise. I remember knowing that I must have been stupid, to not understand something she thought was so simple, and there must have been something wrong with me. Seriously wrong with me, because no matter how hard I tried I couldn't get something so simple "right". Failure. Disappointment. Better off dead and out of her life.

Can you imagine? A six year old who had everything in the world (loving family, great friends, an interesting life)...who had never even heard of suicide thinking those thoughts and feeling that way??? My mum had built a brilliant foundation based on love and trust, she was everything wonderful in the world...so I knew for her to "hate" me so much it had to be something intrinsically flawed with ME. And believe me...4 years of disdain, anger, punishment, and frustration over something even as trivial as POOP..if it happens twho, three, four times a week...can have that effect. It can destroy a child's self worth, and a parent's relationship with that child for YEARS...no matter HOW WONDERFUL my mum was the rest of the time.

Eventually children's rectums get bigger and it doesn't feel like childbirth anymore. For most of the people I know this happens around age 8, although it continues to hurt (a lot) until we're actually adult sized.

My mum (obviously) used fear and shame and punishment...and I remember swearing to myself that I would never be like that to my own kids. My cousin had the same problem, but my Aunt is rather the polar opposite of my mum, so my cousin was never in fear of punishment as well as pain. So the way we've handled our son is a combo of both what I'd WISHED my mum had done for me, and what my aunt actually did for my cousin:

A few tricks:

- The opposite of fear/punishment/shame: Constant support and praise. He's the one in pain, not me, so I figure I owe it to him to both let him know how brave he is, and that I'm proud of him for it. Bravery is not having no fear, bravery is being afraid and doing the right thing anyway.

- Allowing him to poop in a pull-up until he was 4.5 (The way we sit on western toilets is actually not the easiest physical position. The squat that toddlers do in diapers, or that EVERYONE uses in Asian style toilets is actually way easier).

- A LOW fiber diet

- Tylenol 20 minutes beforehand (rarely)...you know what I mean. You frequently know HOURS beforehand, and from their face/eyes you can tell if it's going to be a bad one.

- Let them take a dab of vaseline with their own finger and dab their own bum (not only does that let them feel more in control...but if it's big it means they're less likely to tear, and if it's acid...the vaseline keeps it from burning).

- Lamaze or other kind of focused breathing (works wonders!!!)

- Other relaxation under stress techniques. For my cousin, it was being able to read a book. For others, it's privacy, or meditation, or music, or rocking, or math problems.

The good news: All of us grew out of it, and none of us hate our mums (as adults). But whatever you do, my strongest possible recommendation, is to be gentle with your little one. She's learning some hard lessons right now.

My grandson was chronically constipated during his toddler years. He too would frequently scream in pain trying to have a bowel movement. I suppose he withheld at least part of the time. I'd withhold too if I were having so much pain and I'm an adult. His aunt called 911 once time when he wouldn't stop screaming. The EMT knew immediately what was the problem and inserted a lubricated gloved finger into his rectom to help get it out. I remember my mother doing a similar thing with one of my brothers when he was a baby. Chronic constipation is no one's fault. And withholding when constipated is not a behavior issue.

My daughter took her son to the doctor about this issue more than once. We tried various things that the doctor recommended including Miralx. We stopped giving him milk and dairy products, bananas, and ??? because they can be constipating.
We tried giving him more fiber, prune juice in his diet and increasing his intake of fluid. Sometimes he could pass a "normal" bm but it was stll too firm for comfort.

We sympathized with him. We sat on the tub across from him and read or talked while he waited for it to eventually come out. He took toys in with him. Anything to keep his mind off the pain he knew was coming.

Has your daughter been seen by a pediatrician about this problem? If not please take her. As Zoe said, one reason could be that the intestines can be too large. There are other medical causes that might not be found with just one or two visits that are medical issues. I searched th Internet and found a couple that are serious enough that they require medical intervention.

It sounds like you're equating withholding as something that a child does on purpose as a part of a power struggle because that's almost the only thing a child that age has much control over. If and I say IF your daughter is purposely withholding the way that you have treated her would result in continued and more serious withholding to the point she no longer had control of her bm any more. It's possible this started as a power struggle but has now evolved into a physical condition.

Power struggles happen when the parent decides that the child will do something her way or else. Punishment such as taking away her toys, shaming her by putting her back into a diaper, removing priveleges reinforces the lack of co-operation. And, from my own experience I can tell you that when I've had to withhold because of where I'm at or what I'm doing it takes me a couple of days before it'll come out. And no one is making me anxious by insisting that I do it now.

The best way to handle "withholding" no matter the cause is to be compassionate and understanding.

My grandson still has difficulty at times with constipation. Actually, I think he is nearly always constipated because his bm consists of small round individual balls. But he goes regularly and doesn't complain.

So yes, this too shall pass, if you can find a way to relax about it and give your daughter loving support instead of angry and frustrated insistence that she do it. In time her body will mature and be able to function more normally. I think my grandson had serious difficulty until he was very near 5.

My cousin's son was still having difficulty some of the time when he was 10 or so. He tried to keep a stick hidden so that he could dig it out. I don't know the history and so can only guess about the cause.

I think I may understand some of your frustration. You do want to be doing this right so she won't have a life long problem. Perhaps someone has taught you that if a child her age isn't poop trained that you must be doing something wrong. I'm glad that you wrote in to ask for a better way.

As with Zoe's mother, you are a great mother in other ways but this one stumps you. That's OK. We all do the best that we can with the information we have at the time. Both you and your daughter will be doing better as you learn to be together without judgement of yourself or the other.

Hello A.:

I know that potty training can be frustrating but believe me it feel 10 times worse for you daughter. Going #2 on the potty can be a VERY scary thing for little ones as they feel they are losing a part of themselves. On top of that she has constipation which would stop anyone from wanting to use the potty. First suggestion would be to give her Aloe Vera juice, which is much less demanding on her little body. You can find it at New Seasons or any whole foods store. Speak with the employee in that department and ask them how much to give her. My second suggestions is to give her back her things and never punish for potty training. This can lead to bedwetting and what you have now. I suggest you stop the whole process and go back to diapers all the time and do not mention it anymore. Just ask occassionally if she wants to use the potty and then leave it alone. I can guarantee she will become more relaxed and want to use it. Of course when this happens you make a huge deal of the accomplishment and move on. Hang in there as this happens alot and you are not alone. The important thing to remember is that she will get it. As my Pediatrician told me, "your daughter will not be President of the United States and still wearing a diaper. It will take care of itself". Good luck and take some deap breaths.

Hi A.,
I have a son that has had and is still dealing with this problem. I, like you took all his video games, favorite toys etc away to try to get him to "want" to poop on the potty. Then when I took him to a peditrician that specialized in "pooping" problems :-), I felt HORRIBLE, because I found out it was not my son's fault, it was a physical problem we had to address. So to save you from the "Mom" guilt, don't take things away because of this problem. I also did the mirelax (which did not work, so they increased the amount and then he had diarrea all the time, we never found a happy medium). This is what my son went throuh. He would get really constipated, so much that we would have to give him dispositories to clear him out. Then he would only poop about every 4-7 days, very unhealthy. So we took him in and found out some very interesting stuff. First of all the doctor told me that he needed to retrain his body to get use to pooping each day, but...that not every child poops every day so we needed to figure out his healthy schedule. He said what happens is that they get so constipated that when they new poop comes in the old poop won't let it get around it and some "leaks" out which is why they get a little in thier pants. Then it all builds up so much in there, when it does come out it si so big that it really hurts. Your muscules that are used to squeeze the poop out get outstretched and then can't work properly. So we had to get everything working again the right way. We made a chart (which we had to take in to the doctor's office so my son could show him his progress, helped with my son feeling involved). So we set up a poop chart. Now this is what we're told to do and I would go to see the doctor to figure out what is best for your daughter. He had to have emema's the first day or two to clear him out, then we started on mineral oil treatment (it helps the poop slide out). We started with 2 tablespoons a day and had to increase as needed up to 1/4 cup a day. Now in the beginning it was kind of messy because until you find out the right amount for them they will poop out mineral oil (and it comes out orange and will stain clothes), but ..... my son would go poop because he figured out that it helped and it would just slide out with little or no pain. This is a LONG process and you need to just deal with it and stick to it. It took us about 4 months to get everything where we wanted it. It might of took a little less, but we got a little lazy and knocked ourselves back about a month. But my son is a much happier kid and so is his Mom and Dad! He still has to take about two teaspoons of mineral oil about once or twice a week and he only poops every 2-3 days, but that seems to be his body's cycle. He doesn't hold it any more and isn't afraid to poop anymore.
The good thing is this to will pass once you have figured it all out. It just takes time and patience and lots of love, for everyone! :-) Good luck and let us know how things work out.
By the way, I too asked this question on here and that's how I heard about how others dealt with it, and took my son in and now we are a much happier family! I love this board!

My daughter also has had withholding issues and was born 11/05. Must have been something in the stars as it seems many people have posted with similar situations and ages. For us, there were also some physical issues and I think it's important to figure out if it's a physical issue that has led to a behavioral. Your pediatrician can help lead you in the right direction there. Ignoring it helped some, but diet was huge and also, lately we have agreed on "pooping day" and get really excited about pooping day and it has done wonders. When everyone in the family has had their poop (mom, dad, her and her sister) we celebrate with a song and dance. For whatever reason that really helps with her. And on days that are not pooping day we look forward to the next day in hopes that it is.

Good luck!

If it were me, I wouldn't put her in a diaper. (how do you even find them big enough?) Unless she has medical issues, there's no reason for her not to use the toilet like the rest of us. If you're a SAHM and she's out of school, it's a perfect opportunity to let her run around commando! If you don't want her who-ha showing, have her wear a dress, although a dress somewhat hinders toileting. When she goes, and she will go, and it's on the floor, she cleans it up. But don't make a huge issue of the mess, like how disgusting it is (or that she's a filthy, rotten pig, LOL!) or anything. Just matter-of-factly give her the supplies and tell she has to clean it up. Another thing you could try is let her wear the panties (like you and daddy and her teacher and all her friends) and when she soils them, and she will soil them, she cleans herself up and throws the panties away. Hopefully, it will be her favorite pair. But but again, don't make a big deal out of it. Don't tell her she pooped on Cinderalla or Barbie, but that she pooped in her Cinderella panties...if anything even needs to be said. Her soiling herself, the house and the discomfort of it HAS to affect her and not you. Then when she does poop on the toilet (like mommy and daddy...)don't make a huge deal out of it, rather tell her that you knew she could do it, she must be so proud of herself! (remember, it's about her, not you. Don't say right off the bat how proud you are, but if she asks you respond with "Yes, aren't you"-always keeping it about her)
If you are not a SAHM, start it first thing in the morning on your next day off. If she is in the habit of withholding, she probably doesn't go every day, so don't expect immediate results, but start anyway.
Good luck! ~Mary~

Have you talked to her pediatrican yet? My SIL went through the same thing with her oldest, she was under the assumption that it was a control issue for him,, as weill. Unfortunately after lots of xrays and scans they found that he had some underlying physical issues with his bowels, as well, He had lots of emotional issues resulting from the pain of having a BM.

I know how frustrating it is when you are dealing with toilet issus, but hang in there and spend some (more?) time talking with doctors to see if there are any underlying causes.

Good luck !

Hi A.! I feel for you. We have a son who was born December of '05 that we have been having the same problem with. He had always had constipation problems as a baby and we had been dealing with it by having him take a tsp of mineral oil every night. That seemed to help and a few months ago we quit using it because it seemed that he had finally passed that phase. Then a few weeks ago, he had a hard stool that was painful for him and from that point on, he started withholding. So frustrating!! His Dr. had us use Miralax also, but told us to use it continually at a full dose every day until he completely cleaned out. (She had his stomach x-rayed and said it was amazing how packed he was and that things were starting to stretch out in there so we needed to get him cleaned out soon!) Then we went to a half dose, and currently we are at a 1/4 dose and she would like us to keep at this dose for probably close to a year to ensure that he doesn't have much if any memory of pooping ever being painful. Long process!!

Talk to your Dr. about what to do for a long term fix rather than just fixing the immediate problem. We had to take out son in because he had been witholding for so long (almost 2 weeks) that he couldn't eat much and was throwing up pretty regularly.

Currently we are trying to make the experience fun. So, lots of books when he's on the toilet. We read with him and have him push every page or two. He tends to get results when he pushes, but doesn't think to do it on his own and we have to constantly remind him. The other thing that has been working well is letting him occasionally watch a movie on our laptop while he is pooping. He gets so engrossed in the movie that he forgets to hold and afterwards we'll talk about how it doesn't hurt to poop and it makes his tummy and bottom feel better. He is much happier the last couple weeks.

Sorry this is so long! Good luck, and let me know if you have any questions. Maybe there is something specific I can help answer. =)

B. Ace =)

Go to a naturopath and check for food allergies. Food allergies can cause all kinds of bowel trouble. My daughter had the same thing and was diagnosed with Celiac disease. However, because her markers were low, an MD would have said, she wasn't celiac, but according to a naturopath she was celiac. I trust their tests more.

A.,

My son was the same way (12/2005 b-day). He still is not going poop in the potty. He's on and off. And he was constipated and always holding it until last summer I started mixing his milk with water, about 60/40, to help him go. It really helped. Because it didn't take so long, he didn't mind it so much. Now he asks for water in his milk. I think he might like the taste of it better. It can be a control issue too. I would just take her in there, give her the chance to go, and then move on. It sounds like there's a lot of pressure on her about this. It's just another stage, albiet a tough one on the parents, but she'll get through it -- and so will we! My son is still in pull ups because he just doesn't want to go in the potty, usually at home. At daycare, he's fine. But in his comfort zone at home, he'd rather go in the pullup. He'll move on and so will your little one. Hang in there and good luck.

R.

Hi A.,

It looks like you have a received a lot of feedback. One thing that I recommend that hasn't been mentioned in the previous posts is having your daughter sit on the potty after meals. Since food is going in, it is natural that the body wants to eliminate.

My son had significant issues with constipation (due to chemotherapy and pain medications in his toddler years). Under the guidance of psychologist who specializes in encopresis we used diet, Miralax and behavior modification methods to finally get him pooping regularly and in the potty (as opposed to his pants). Even with the constipation issues well behind him, he still sits on the potty after dinner everyday. He produces 80% of the time.

Don’t be afraid to use bribery to encourage the sitting behavior. We used stickers, extra tv time, and a little treat bucket to reward J for sitting when we asked. It eventually became a reward for producing.

Another thing to add is this is not a quick fix. It took our son 4 months of regularly using Miralax, eating high fiber foods, consuming lots of water, and diligently doing the sit program for everything to come together.

Good luck!

Wow, you have gotten some great information on this post -- I have learned a lot myself -- wish I had known to do these things with my son, now age 9, who has had withholding issues since he was almost 4.

The thing is, he was fine until then, he pooped 3 times a day cuz I would give him an m&m as a reward. Then when his sister was born, I think that stressed him and he got into the habit.And think perhaps, based on some things I've read here, that caused his intestine to stretch, causing him to be able to pack a lot, causing it to be painful when he finally pooped. because for the last several years his poops have been larger than adult sized.

I think I might try the mineral oil or the miralax.

Anyway, based on my six years experience, I want to urge you to take a LONG TERM view. Don't expect you can solve this overnight. Be patient, but also be on top of it. There was a period where we just ignored it and said its his problem but that didn't make the problem go away.

Where we are at right now, it that we have a rule he needs to do 3 poops a week in order to be able to play the Wii. If he misses a week, then the next week he can't do the Wii until he gets his three poops in. I know it's kind of ridiculous, but the thing is, either he lost the ability to recognize when he needed to go, or he pushed back so much that his body stopped trying to go or whatever, but left to his own devices he will wait 10 days to do and then invariably clog the toilet! So this seems to motivate him to go.

It's not a perfect solution but its where we're at right now. I sure wish I'd had Zoe and the other mom's perspectives 6 years ago! I'm going to read these to my son and see what he thinks.

Have you spoken with the doctor? if not, you should. also, you can't make a child go to the bathroom in the potty. They have to want to do it. She may just be having a little set back. try to be patient and don't make a big deal out of her accidents. Eventually she will get it. But i would definitely want to rule out any medical reason for all this. good luck.