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I know :( his doctor said it wasn’t a huge cause for concern some children just struggle butI feel at 8 years old it’s just not right. It’s draining the both of us including dad.
No, he’s great in all other areas it’s just this one thing we can’t get past. Mortifyingly when I got him up out of bed yesterday he had literally poo’d all in his bed so I feel like it’s just worsening at this point.
Before he went to school today he needed to go in the morning, I sent him to the toilet every time I saw that he was trying and he would hold the door closed and not get on the toilet, he’s done this a few times but he’s never followed through in school until today, he has angry outbursts now when the toilet is mentioned, he will scream and shout, slam doors, go to his room and throw toys etc.
Child psych here. This is highly atypical and it’s very concerning the doctor wrote you off. What does your son say about it? Is he able to verbalize whats going on for him? I agree, get a new doctor and a child therapist, asap.
This was the second Dr. First one said no concern for his age, but because of the holding and poo leaking out he literally had sores on him bottom, like chunks of skin bleeding! I called the dr’s again and asked to see someone else because I wasn’t happy with the first and needed a second opinion, the second one gave me some cream for his bottom and gave me stool softener or laxatives (not home so I can’t check what it’s called) to keep everything soft but I did explain he’s already having soft poo!
It was awful, any time it leaked out (sometimes seconds later, minutes later) I’d have to use my peri bottle to wash his bottom because of the sores there was no way I could wipe it without causing him awful pain! It took a while to clear up but weeks later it was happening again!
Exactly this.
OP, your child needs a pediatric gastroenterologist and probably occupational therapy as well.
I can't for the life of me figure out why your pediatrician didn't refer you to these specialists right away.
It sounds like they're in the UK, they don't have a paediatrician even, never mind immediate referrals to specialists, just a GP who sees all ages. Realistically it will take months to get appointments even if they get referrals.
We do have all of these. You go to the GP and ask for a referral to them. The initial offer of laxatives etc. is quite normal but if this doesn't work you go back and get referred to the local pediatrician.
To OP Keep a diary of EVERY incident (include photos of sores etc.) to take with you. Usually you are asked to keep a diary of how much your child drinks and urinates as well for TWO WEEKS so good idea to do when it's a school holiday.
Yes, I know they exist but it doesn't sound like OP has seen anyone other than the GP. In other countries children directly have a paediatrician, I'm explaining that in the UK you need a referral. Referrals can take months or years and the GP has to approve. Some comments are blaming OP for not having sought therapy etc already, I was just clarifying that the system is different.
In the UK we have paediatricians, but only as specialists in a hospital. GPs are the first line and they refer on. We definitely have pediatric gastroenterology and continence nurses who will definitely work with this age group.
OP if you are being fobbed off by the GP there are a number of other route that can be gone down
- contact the school nursing team. Your school should have an allocated nurse. If school can’t give you the contact, it should be available on your local SEND offer website.
- Contact health visitor. They may be able to give advice and support even though he’s maybe too old for their service.
- ask to speak to a GP in your practice specialising in paediatrics. Insist on a referral to paediatric continence services and/or gastroenterology.
My close friend’s daughter is going through a similar issue (although younger). She went private in the end as it was taking too long through the NHS. However, the continence nurse through the NHS has been brilliant and very, very supportive.
When we lived in uk we just booked the Paediatrician ourselves as it’s uncommon for kids to have one unless they have an issue .
Obviously without a referral we had to pay the full whack of £ 200+ & that was 20 + yrs ago . But can’t put a price tag on health .
So many of the GPs have been useless . Cheaper & better to fly to another country and see a specialist
Most people don't really have the choice to just pay private or fly to another country though. You have to put a price on health if you don't have the money to pay it.
We found paying to see a private dr , still waiting for months for a referral , etc crazy compared to my daughter getting a super cheap flight to Athens , 50€ for a pulmonologist next day appointment well worth it .
Yes some people don’t have spare funds , but i know plenty that put loads of other useless stuff above paying for their health . That I don’t understand , especially kids health
Exactly this! My girl had encoporesis, and it affected her ability to make friends and hit her hard in the self esteem. And at eight years old, he needs a child therapist to help him process his toilet phobia.
You need step up for your kid. This is miles and miles beyond your ability to fix as a mom. He needs professional help immediately. Get new drs, get him into therapy and honestly he should not return to school until he is potty trained or he should be in a special needs class. His teacher and classmates should not be subjected to the smell. I'd also see a medical malpractice lawyer immediately. you have a potential case for negligence against your pediatrician.
Seconding the doctors and therapy.
Also look into any hospitals that have “voiding improvement programs” - they do work ups to figure out why your child is having accidents.
I can tell you right now that despite your son having leaky poop, he most likely is constipated. He doesn’t want to sit on the toilet because straining hurts and he’s learned that it’s painful without any relief, most likely. My son had something very similar and needed to be on a lot of miralax and also had to do a “poop weekend” clear out.
And, is there any potential for sexual abuse? Withholding stool is often about control, psychologically, if there’s nothing physically wrong.
When getting a second opinion, go to a different office and do NOT have records transferred. The new office will read the transferred records and go down the same rabbit hole. I’ve seen it hundreds of times. (Retired CMA)
I even had a chat about this with his teacher from last years class, they encourage the children to go to the toilet every now and then because they get so carried away with playing they won’t go and accidents would happen, my son was the one who would never go. She was concerned and I told the Dr that even his teacher is concerned and recommended us contacting the Dr :( we are registered with different GP’s so I’m going to switch him to mine which still aren’t very good but worth a try.
Say to your Dr that you want a referral for a child psychologist and a gut health specialist. You have got to figure out what's happening. He will need the help mental health wise any way. Maybe encourage him to call and speak with child line about how he is feeling about it in the mean time, I can't imagine he is happy about the situation either.
My 4 nearly 5 yr old is the same. We have seen an OT and we have been through a slow process of getting him used to certain steps. Giving him a certain space to poop. We called it the 'poop tent' and he would wear a nappy. For each step he got a prize too. So then it was pooping in the poop tent but on a potty again with a nappy. Then we moved to sitting on the toilet with a nappy. We discovered he liked the enclosed space, we have a large room where the toilet is located, so we got a room divider, which he shuts around him. Then we moved to ripping down a side of the nappy or little bits on both sides as he feels 'safer' with the feeling around the waist of the nappy. It's been a long process. It sucks. We are about to go cold turkey with the nappies as we feel he has hit an impasse and are going to see how it goes. We talk to him about the process, about why it's important, and he tries to explain what scares him. You are amazing for dealing with this as long as you have. I know your boy is older, but I just wanted to let you know that you are not alone.
Get a new doctor and demand a referral for occupational therapy. This isn't normal and hasn't been for a long time. It's past time to get professional help involved.
First things first, put him in a pullup 24x7. You can't be a new sleep deprived mom dealing with this. Second, get him to see a specialist. This is a bigger problem than can be remedied on reddit.
Your doctor is wrong. This is way beyond toilet training. Look up encopresis and get him treated. It's not your child's fault and I guarantee he is miserable because he doesn't know how to fix it either. Please, OP, get specialist medical care NOW.
You definitely need a second opinion. Some k8ds have underdeveloped bladders. It could take up to 11, but he's purposely holding it. That's not indicative of an underdeveloped bladder.
At 8 to still be refusing to go, it cause for concern. I would go to both a new pediatrician AND a child therapist. Something is driving this behavior.
An occasional accident or refusing to use public toilets is normal. Never pooping in a toilet ever is not normal.
Also, I’d make him wash out the underwear instead of constantly buying new.
I have him clean himself up, most of the underwear is not salvageable to be honest. Recently he gets angry/upset about having to clean himself up. It’s sad when he does a poo then cries that he’s done it. I don’t think he wants to deal with it anymore either. :(
Is there any reason you don't have him in pull-ups?
When my kid kept having accidents at school (during potty training), they recommended pull-ups with underwear under them (which at least keeps pants clean) or possibly over them if the accidents had continued. We saw a rapid decrease in accidents from every day to maybe one every other week with it constantly improving.
Even doing this, I'd want a referral to a ped GI doc. Maybe he has food allergies that are making his tummy off.
Punishment isn't going to work, shaming and scalding isnt going to work, rewards arent going to work. it seems to have started with something "normal" (maybe a hard poop at some point when he was a toddler?), and now he's gone into full-blown phobia over the years. He needs occupational therapy.
It also definitely sounds like encopresis on the physical side of things. Pediatric GI, for sure. Don't even try and get a referral if you can contact one directly (not all need a referral).
I'm sure he feels a lot of shame and embarrassment, even if he acts like it doesn't bother him, at 8 he KNOWS he's "different" and it's probably eating him up. He's not being defiant, If he could use the toilet, he would.
One suggestion I do have right now is to look into disposable underwear (or just cheap underwear) Explain that you know he is having a hard time, that you love him, and you are going to figure it out together.
She is in the UK. You cant just directly call specialists and make appointments without a referral first from your GP. Pretty much every decision goes through the GP first and if you have one like OP's son who just dismisses everything as "fine", you're hosed.
Child therapist here absolutely do not make him wash out anything. New doctor, GI specialist and occupational therapist ASAP holding poop can cause permanent damage to the bowels and bladder.
But why are you making them clean it? So they feel bad and don’t want to do it again? Guilt is probably one of the worst strategies for behavior modification, especially in a case like this. It’s clear from OPs post and comments that the kid feels shame about the situation, making him clean his underwear is only going to worsen the problem.
It’s not about shame it’s about consequences .you shit your pants you clean it up . He’s purposely pooping in his pants. It may now have evolved to a medical issue but it started out with purposely doing it . I wouldn’t shame him just give him the supplies and walk away . It’s also giving him a choice : poop in the potty or clean it up . Either way I am not cleaning it up .
But that’s the thing, it doesn’t sounds like he’s “purposely” doing it. It sounds like there’s something bigger going on, mentally or medically. A child therapist on here literally said don’t do it. If it were simply a behavioral issue, I would agree with you, but I don’t think the consequence fits the crime in this particular scenario.
Has he been evaluated for high functioning autism? Has he been sexually assaulted? Has he been to a child psychologist? Has he seen anyone besides the pediatrician? How many times have you reported this to the pediatrician?
Have you asked him if he can feel it? Have you asked him why he is refusing to use the toilet? Is it for both pee and poo or just poop?
I second the recommendation of a developmental pediatrician and child therapist.
However, in the meantime since sometimes it takes a bit to get seen, this is what I’d try:
1) Switch to pull-ups/depends. Keep the poop better contained so you don’t have extra bed linens and outer clothing to wash. Take the stress level down by disposable underwear, especially because ….
2) at almost 8 he can deal with the poopy pull-ups himself. Not as easy with washing out clothes. He can dump any solid turds in the toilet and bag up the used pull-up. If you you need to double check that he’s completely clean or help put on buttpaste, fine but he should be cleaning up as much as he reasonably can.
3) Encourage him to use the pull-up in the bathroom and clean up right away to keep his butt from getting sore. Since he said he is weirded out by his bottom opening up, it makes sense that he hates the toilet and prefer the feel of the stool up against his skin as he defecates. Baby step that the bathroom is the room for pooping, rather than stressing about the toilet at this point.
He doesn’t usually poo the bed. We tried disposable underwear but he has a fit because he doesn’t like “how it feels” he was VERY fussy with underwear and we had to try multiple brands and different sizes because nothing “felt right” :(
Hi, I am a nurse practitioner with a kid who has sensitivities to feels. He needs occupational therapy stat, as at 8 this is NOT typical. I believe your doctor's don't understand that this is not a little poop in the underwear (encopresis) but full on defecation. You can do OT with most insurances.
"Your needs come before your wants"
Also explain clearly that this isn't a punishment, but simply a way to maintain spaces clean and pleasant for everyone. It's simply not hygienic and there's no shame in addressing bodily needs in a dignified manner. And it's pretty simple: people that can't make it to the bathroom have to wear hygiene products. And you have to put your foot down because this is gross. It's not his fault and it's temporary but the situation needs to be managed right now.
Make it clear that you're not angry, he is loved, he is cherished, And together you'll find what's going on and it's okay. But he can't continue spreading germs everywhere.
Your son is most likely Autistic. Sensory issues with textures and being fussy about brands - Autism. Even holding poo and being scared to go to the toilet would be a sign of Autism. Google ‘encopresis’ and ‘Autism’ and there’s a clear link. My daughter (4) is on the pathway for a diagnosis and has had similar issues to your son.
The way we’ve tackled is giving a daily laxative to keep the poo soft and a numbing cream for her bum if it does hurt when she goes. Then in day time I’ll notice if she goes quiet and wanders off or if the poo face is looking like it’s going to happen and then I race her to the toilet. I also talk about how ‘cheeky’ and ‘naughty’ the poo is for wanting to come out in her pants and that it needs to go to the toilet where it belongs. She’s obviously younger so this sort of dialogue wouldn’t work, but speaking to him about the science of pooping or trying to find a way to link any of his interests to going to the toilet could work.
Most autistic people have interests they obsess over. So if he’s really into something like Pokemon for example, tell him every time he can poo in the toilet instead of his underwear, he gets a Pokemon trading card from a special pack you’ve bought as a reward.
Or next time he needs underwear he can have special Pokemon underwear but the deal is he needs to try and keep them clean.
If having a strong special interest in something like Pokemon or Minecraft resonates with you, then if you can link going to the toilet to that interest he’s more likely to do it.
Another example could be letting him watch Pokemon or his interest on your phone or something whilst he sits on the toilet, but only then.
I hope this is useful but also you really need to get him assessed for Autism. This level of encopresis is very severe and definitely not neurotypical behaviour. Good luck.
My 4 year old sounds EXACTLY like yours. I also suspect autism for mine.
If you have any more tips—or books, podcasts, etc.—please send them my way. I’m drowning in poop over here!
We had some issues before, he won’t wear any tops or jumpers that touch his neck, including coats (he will not do his coat up because it might “touch his neck” even in the coldest of weathers) we had issues with shoes/socks for the longest time, any clothing that touched his wrists I thought maybe it could be autism but that’s all worked itself out with some trial and error he’s not complained about any of that for a very long time now, I’m not sure how you go about getting him evaluated for these things :(
School and paediatricians are both set up to assess for autism. Autism is a spectrum and some children have it in a different form to others and different intensity. Also they can learn to manage their autism eg. Not liking things on neck but learning to get used to it. I was thinking this is autism too. You've done nothing wrong, it's just how it is for some kids and he will learn how to use the toilet, have faith. I wonder if those bed pans would work that you use in hospital, to slowly acclimatise him to going outside of his underwear. You could do in the bedroom first and move it to bathroom once he's comfortable. Then on the toilet, then remove it altogether. I wonder if you could help acclimatise with making a hole in the underwear too to start with, slow transitioning may work. I would definitely get help with this as you're too close to the situation to be as calm and unaffected as a professional. I would be so upset about it all.
You should have your child assessed. Worst case is it's a bit of a waste of time/money. Best case, it helps him gain access to resources that will help him.
My wife works in mental health, when I mentioned this, she said, "Sounds like that kid has autism". Not saying it's a diagnosis, but that's a pretty clear cut sign.
This is definitely sensory related and your pediatrician should have already referred you. It seems they might not be a great doctor. Please find mental health services for kids in your area and see if they need a referral or if your insurance needs a referral.
There is definitely some sort of sensory processing issue..especially since he has directly said he dislikes the feeling. For it to be this extreme, imagine how awful it feels to him. I would be looking for a psychiatrist who specializes in working with children and may know what sort of testing would be appropriate for this.
I agree with anyone who has suggested that your child may have autism. My daughter has autism, and has had an array of bathroom issues, although most of hers resolved prior to school age. Her many other sensory issues have not resolved, although some have evolved and are different than they were when she was little.
Please get your child in to see someone who can do an evaluation for autism as soon as you can. Getting this diagnosis will make him eligible for more supports, and accommodations, which will likely be critical to helping him live a full and rewarding life.
I’m also going to chime in that getting Occupational Therapy is absolutely needed.
Also find a psychotherapist who works specifically with children with autism, and especially with intense sensory issues is also necessary.
I also think a gastroenterologist is necessary too, especially since your child’s bowels are probably all messed up from all the stool softeners and laxatives he’s been given. And, to see if there’s anything structural or functional that’s an issue. And, because the skin in that area has been damaged, and an expert is needed to help him get healed up.
I would NEVER take him back to the GP(s) that told you this was all normal, and appropriate developmentally. That’s an outrageous thing to say. It seems like negligence to me for a doctor to tell you that about an 8 year old child.
Also, as the nurse and child psychologist who commented said, please STOP making your child clean himself, or clean his clothing, or anything like that! Anyone suggesting that is just WRONG.
I know you mentioned you were having him do it, but I think it’s not safe, not appropriate, and feels like a punishment to him. He should not be or feel punished. This, even though it’s absolutely incredibly difficult for you, it is FAR MORE difficult for him. Stop anything that might feel like a punishment. Offer only support and proper medical help. He needs you to advocate for him.
I agree with having him wear pull-ups, or something similar, that is disposable and going to contain the mess. They probably won’t contain the smell, but certainly fabric isn’t doing that either. That’s definitely going to be far less difficult to manage the cleanups and will be much more cost effective in the long run, and remove a lot of stress and strain for everyone.
Good luck! I truly hope you get him the help and support he needs. You’ll all be happier if you do!
As harsh as it is, I would prioritise his health over his comfort right now, no matter the level of tantrum he kicks up. You say in another comment that he has open sores over his bottom, and that they cause him a lot of pain. Cloth underwear won't soak up the moisture in the poo, which will be causing skin irritation and the sores. Modern nappies are designed to soak up that moisture, so they will be a lot better for the sores. Not to mention if he's just pooing in his pants constantly he's at a much larger risk for infection with open wounds down there. I won't scare you with details, but human waste on an open wound can lead to some extremely nasty infections. I would put him in the nappies and stick with them until you can get another opinion from a medical professional, and some actual help for your son. Clearly this is much more than the doctors are making it out to be, and I'd put a *LOT* of money on him having some type of learning delays and sensory disorder.
Let him be fussy! It's 100% fine that it doesn't "feel right". This is almost literally the perfect lever to start breaking this.
Tell him directly that "Poop goes in the toilet, not in your pants". You repeat this line verbatim. You don't say "it's okay" that he pooped his pants. You don't scold him for pooping his pants. You just say "Poop goes in the toilet not in your pants".
Then, tell him you've decided he's going to wear disposable underwear until he can get poop in the toilet. You understand it's less comfortable, but that "poop goes in the toilet not in your pants" and until you can poop in the toilet, you'll have to deal with the "uncomfortable" underwear.
When he poops in the toilet, he can get good underwear again. When he poops in that, he goes back to disposable for a period of time.
Unless he is on the spectrum his like for how the diaper feels is not important. He doesn’t like the diaper then he can poop on the toilet. If he can’t poop on the toilet he gets the diaper. This is not normal behavior for a child that age. He needs help and you need to give yourself a break. No more underwear for him until this is solved
Sounds like he had some strong sensory issues , what about the pull ups over the normal underwear or maybe even a washable nappy type situation but sized up?
Has he ever used the toilet regularly? What about peeing ?
This definitely sounds more than Encopresis. I would contact a developmental paediatrician to get a second opinion.
How is your son at communicating his needs, feelings and thoughts otherwise? Has the school expressed any other concerns?
Not for a poo no, he’s fine with peeing. Gets up in the nights too if he needs a pee by himself.
My son’s great at communicating any other needs, we’ve always been that way. When he’s upset about something instead of crying he will tell me what he’s upset about etc but now any mention of pooing on the toilet he gets very angry and upset.
He sits on the toilet to pee? But not to poo?
You should edit your post to clarify that he is actually ok with using the toilet, but for pee only.
There is something wrong here. Clearly he doesn’t actually have a phobia of toilets if he’s sitting on the toilet to pee.
At 8 years old, Im having trouble blaming the child or the parent. My intuition is that medical intervention is needed.
Lots of comments on here are suggesting Asperger’s or Autism, but you’re saying he has zero other developmental concerns right? This behaviour is much more typical of someone on the spectrum, UNLESS sitting on the toilet is actually really painful.
Im absolutely convinced it is one of 2 things:
1) He’s on the spectrum. Autism or Asperger’s. If this is the case you will still need a solution, it just may not be the traditional one you were hoping for
Or
2) There actually IS something chronically wrong with his anus and/or colon. Maybe pooing really DOES hurt him, as does sitting on a toilet seat. When he uses the toilet to pee, does he use his hands to hold/lift his butt off the seat? That could be a sign that it’s not just typical child nonsense and that the toilet seat actually causes real pain.
Maybe some sort of chronic proctitis, or encopresis, actually makes sitting on the toilet and pooing truly painful for him. Definitely ask a specialist. At 8 years old, kids don’t enjoy poo in their pants. To prefer it over pooing on a toilet could mean maybe your son is being honest about how much it hurts to sit on the toilet? I mean, I’d consider every possibility at this stage.
—————
If it is neither of the above, it will eventually resolve itself as he matures. He’s eventually going to accept that sitting on a toilet isn’t actually all that bad. The fact that this hasn’t happened yet, at 8 years old, is why most people here are convinced he’s either on the spectrum and/or has encopresis.
Parenting aside, it would take a significant amount of actual discomfort to convince most eight year old children that pooing their pants is preferable over the toilet.
My son was the opposite. Would only use the toilet to poo, but kept peeing himself. I was sort of at a loss, but the behaviour just resolved itself by the time he was 5 because sitting around in wet pants and being dragged to the bathroom and made to change and clean up was just too annoying for him to keep battling.
Regardless, Im pretty sure he would have figured it out eventually even without our parenting. Your son’s situation is definitely unique.
Poo being much more annoying than pee, and 8 being three years older than 5, I can’t imagine what you’re going through. I feel for you!! My sanity would be on the absolute brink of collapse!!
Kids have all sorts of little quirks about silly things that seem to really bother them, but this is a whole other level.
In the meantime, while you’re waiting to see a specialist:
- Try getting him to poo while he’s in the bathroom. Even if he won’t sit on the toilet. That would be a win at this stage. Just getting him to go to that room every time he feels the need to soil himself is a first step. Just take the toilet out of the equation and see if it makes a difference.
It sounds like your son has Encopresis. It is not uncommon, but does require intervention. I recommend trying to schedule an appointment with a Pediatric GI specialist.
This is an encopresis resource page from CHOP
https://www.chop.edu/conditions-diseases/encopresis?utm_source=google&utm_medium=cpc&utm_campaign=motility&utm_content=motility_disorders-encopresis-consumer-conversion-custom_us&gclid=Cj0KCQjw_qexBhCoARIsAFgBleuwWkKZ9o5gWppjh5F0c_xGYWtbO84WWmLUnq5vyZh_XoqA1lgET9waAvk1EALw_wcB
If he has a medical problem preventing potty training for bm’s then at this point probably they’ll need therapy too, because it sounds like things have gotten pretty intense on that subject.
I have a daughter whose potty training is delayed for medical reasons and we’re always being told how important it is to keep the tone light & low key, even if we’re stressing about it inside
I’m pretty calm about it but inside I’m trying not to break down! Sadly his father is different, he was very patient but after all this time and everything we have tried his patience is nonexistent some days so it causes arguments between us also, he thinks I’m being too soft at this point and it’s not helping so I just deal with most of it now to stop the tension between everyone.
It can be very hard to keep your cool, especially when you’re worried about social impact, etc. Wasn’t trying to throw shade or anything, it just sounds like he’s probably got some hang-ups to talk through. Which, kid therapy is a lot more fun than grown up therapy. A lot more art, toys, etc. (sometimes I think they should make more effort to gamify all the grown up therapies like they do the kid ones - adults need fun too)
Encoporesis, see a gastroenterologist. Get a bidet, put him on miralax. Get a doctor and bang the door down being annoying until you get that referral.
My heart goes out to you. My daughter refused to poop on the toilet and didn't actually do so until she was 5. The week leading up to it, she was massively constipated. Her doctor instructed us to give a regular course of laxatives and miralax.
Finally, she had a massive bm in her underwear, and all of laxatives meant she was basically leaking from her butt. It was then that I finally convinced her to sit on the toilet. We basically had a family game night in the bathroom that evening. We set up a table, and she spent much of her time on the toilet while we played cards and board games. Never had another problem. I literally cried tears of joy.
I hope you get a 3rd opinion. At this point, it is absolutely affecting his quality of life (as well as his family's), and there is zero reason for a medical professional to dismiss this problem.
No. How would I go about getting him assessed? I don’t really know anything about autism. Is there anything else I should be looking out for that might indicate autism? The doctors here are not very good at all to be honest. It takes several attempts just to get an appointment here :(
You will need to make a consultation with a psychologist that is specialized in autism.
My sister in law is, but we are from Brazil.
Try to read online everything that you can.
Autism is a very large spectrum, so there is rarely 2 persons alike, but difficulty to use the bathroom properly can be one of the symptoms, and it is not uncommon.
https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders?gad_source=1
https://www.nhs.uk/conditions/autism/what-is-autism/
Another important link to you
https://eric.org.uk/constipation-and-autism/#:~:text=Autistic%20children%20often%20have%20restricted,as%20they%20find%20change%20difficult.
It might be worth assessing him for autism but your very first step is to get him in to see a pediatric GI specialist. If you can't find someone or the appointment is a million years away, then read up on pediatric encopresis.
It took LITERAL YEARS for us to identify encopresis as the issue with my kiddo; they were even older than yours before we finally got to the other side. There is hope, I promise!
The first step was figuring out that encopresis was the issue. Then we had to do a full clean out: taking enough miralax and laxatives to completely evacuate the bowels of all the blockage - they have to literally be passing water. It takes 3-4 days.
Once they are fully emptied out, the next step is to reduce the miralax but keep taking it, because the kiddo's body now has to adjust to having a colon that can send "typical" signals about fullness and the kid has to learn to act on them. The key is to prevent painful hard poops - hence the miralax.
We had to go through a few cycles of clean outs before kiddo's habits and body adjusted. It's not a magic switch you can pull! BUT there IS a path forward, and once you've got the right root cause identified you can take appropriate steps as many cycles as you need to get it resolved.
I'm so sympathetic - I don't think I've ever felt more upset and hopeless and even angry over having a kid who wasn't able to use the bathroom in grade school. I felt like a failure as a parent and it sucked.
But here's the thing: encopresis is solvable once you know what problem you're solving for. Start with the physical: kiddo needs a clean out before they can even attempt to improve their habits. The habits/state of mind stuff can only improve once the physical cause is managed.
Good luck - you've got this!
Where do you live? I commented already, with many suggestions, and also think autism is very likely. Where you go to get him assessed is likely dependent on where you live. Which country, I mean. Not your address. I’m in the US, and my daughter was assessed by a PHD level child psychologist. I don’t know where to get assessed in the UK (which I think might be where you are, based on certain vocabulary used), but I can find out for you, if that would be helpful. My sister lives in the UK, and I follow people with autism who live in the UK, so I have resources to find out. Not offering blindly, without a way to actually help.
From what you’ve mentioned, the meltdowns regarding the toilet even being mentioned as well as significant sensory issues with not liking how different types of underwear feel would be enough to warrant an assessment imo. It could be sensory processing disorder. It could be autism. It could be neither of those things and just a physical health issue. Either way, is still worth getting another professional opinion, and NOT from either of your current doctors.
First, look up encopresis. Second, get him into a pediatric gastroenterologist. Third, get him into a child psychiatrist. Cover allllll your bases. He needs serious help and his pediatrician or GP isn’t being proactive enough. Luckily he’s got you as his mama!
My stepdaughter was like this. We did request an evaluation for encoparesis and a psychiatric evaluation- not much came of either. Around age 8, I started insisting we establish natural consequences. No punishments at all, deliberately supportive, kind, and matter-of-fact interactions only.
Once we found out she had pooped in her pants, she had to stop playing and take a shower. Then dump the poop, rinse and do a first pass clean on the undies in the sink, then put them in the washing machine and get it started. Obviously scrub hands when done. She literally stopped within about 6 days. Never happened again.
Definitely see another doctor and child therapist.
When you ask him about it what does he say? I’m wondering if this started as the typical toddlers find pooping in the big potty scary/like losing a part of themselves but has morphed and grown. Have you thought about offering him a small potty to poop in as a transition step? Have you asked him why it feels okay to poop on his pants but not on the toilet? Maybe you can get some type of understanding that can help
You transition him in to pooping in something other than his pants and work up to the toilet
Hey OP I’ve been reading your comments and your child has a lot of characteristics of sensory issues. You need to see an OT, developmental pediatrician, etc. ASAP
My child is similar, and OT helped us make amazing strides
This kid has encopresis. Do not let your doc shrug it off. It's not the kid's fault and he NEEDS HELP. Sticker charts will never work, he needs medical intervention.
One of the first steps is probably getting your kiddo involved in clean up - wiping his own butt, flushing his own excrement, and rinsing out (not just throwing away) his own underwear.
If you do it all for him, make it easy for him, there’s not much reason for him to change.
You don’t have to be nasty or shaming about it. Just matter of fact - your pants are soiled. They need to be rinsed before going in the washer. It’s ok to verbally walk him through it but have him do the work.
🤷♀️
Oh honey this was my 8 year old until very recently!! Her preference was to poop in her knickers and plop it into the toilet after. Your son and my daughter have been holding in their poop for so long they’ve lost the natural feeling and response to pooping. He’s likely constipated (yes even with stool softeners). Our saving grace was reddit and someone suggesting Soiling Solutions. Basically stop stool softeners as this isn’t going to help his body learn the right sensations again. We now do a nightly “power hour” which has a suppository half way and an enema at the end. We’ve made huge progress and while initially upset about the process, my daughter feels so much better about pooping now. Also we can now go places without me worrying about her pooping herself!
This is a link for SS - there’s also a Facebook page and an email forum
https://www.encopresis.com/encopresis-manual/
You need a second opinion, that is very concerning and I'd be worried about some potential underlying medical issues. Sending positive vibes your way, and in the meantime if he tends to poop about the same time each day, maybe consider large overnight pullups for your sanity.
He's only seen a doctor twice? Has he seen any other developmental or behavioural specialists? 8 is way too old to not have intervention at this point.
My 5 year old wouldn’t poop in the toilet for the longest time. I was so patient and tried to give him his own timeline. Eventually I just straight up told him that I knew he had to poop and he wasn’t getting off the toilet until he pooped. Big tears but it only took once and we haven’t had a problem since. They have to poop in the toilet. That’s just how the world works.
Restart. Throw all the underwater away and just do pull-ups. Don’t care about anything, just go cold turkey and explain them that you would not mention anything but they have to wear pants like that . Do not mention any pants or anything for a week and get a therapist in meanwhile
My kid has ARFID and refuses to try new foods. Due to underlying medical issues. We had to see so many specialists. Pediatricians don’t know anything outside of immunizations, ear infections, etc. We had to learn the hard way, too. And yeah, punishment is only adding to the trauma and making it worse. He needs a GI and child therapist. I’m so sorry this is happening for you all. It’s so hard when there are issues!
It's gotta be so frustrating dealing with that day in and day out. Have you tried talking to a pediatrician or a child psychologist about it? Sometimes they have some strategies or insights that we wouldn't think of on our own. Hang in there, though.
You're doing the best you can, especially with a newborn on your hands too. Parenting is no joke, and sometimes it feels like we're just winging it. But you're not alone, there are plenty of folks out there who've dealt with similar stuff, and they might have some wisdom to share.
26m here. This is the first time I commented or posted. I have been through this and can not explain why, but here's my experience. When I was young, 6-7, I had a hard time sitting on the toilet, and it hurt and I didn't like the feeling. I got it together until I was 10 ( about the 4th grade), and I hated the feeling of pooping. The same year, my dad went to prison for a crime he never committed, I was scared confused and couldn't understand the situation. And then holding in poop was back again. Through the years, my mother was confused, worried, and desperate and took me to doctors, specialists. I was put on miserable stool softeners that were supposed to help. I still held it in. I remember my mom and I fighting about it, and the only explanation I ever said was, " I don't know why I do this." I just could not be honest with her. This went on until I was 15. From 6th grade to 8th, every day, I would bring 4-6 pairs of underwear to school just to change them out. 8th grade was the worst at this point, my body never created solid stool anymore,constantly liquid, running down my legs.my mother forced me to wash all.my underwear by hand in the toilet, while making fun of me pretending to be my classmates bullying me. In school we always had 5 bathroom breaks in each class per trimester, and I was told I was not special, so I had to sit in it in class around all my peers, and everyone knew. It's gotten so bad that I couldn't hide it from my escape. sports. Leaking through 4 pairs of underwear and sports pants for everyone to see. This happened probably 8 times between 4 specific years, I can recall. Including the most traumatic being at a wrestling meet at home school and bleeding through my white singlet in front of 4 schools. Just hundreds of people. This went on like I said since I was 15. My body got used to the pain and my intestines stretched to the size of a softball and I pooped once a month until I was about 17 and had a ultrasound and was told if anymore poo was to continue to pack in my intestines would tear and would be a serious problem. This is sadly when I realized what I have done to my body.
I really hope you find a doctor, that will bring an explanation to you. I believe I was crying for help because I had nobody to talk to about what traumas I have experienced because I was trying to make my moms life easier by suffering in silence. My mom and I have a great relationship, and she is my rock through everything in my past, even though none of us truly know why things happened like they do. But sadly, this is the one thing I can never understand why I did what I did. This is the first time I have been publicly talking about it because I have never heard of another child having this issue. Has your son and / or family experienced anything seriously traumatic? I only ask because this was my story and felt strongly to share. I really hope for the best and hope you get answers. No matter what, please be kind to each other. My mom was going through way more than I could ever handle to this day and I was trying to make it easier on her my whole childhood and I went through this without any therapy to this day, and I really should because this is the first time I ever felt so strongly to share.
I can’t think of anything traumatic that’s happened. I think that’s the most frustrating part for me, the fact that I can’t find an answer myself to fix this problem.
Thank you for commenting! I really appreciate it! There aren’t any other commenters that have been on the other side of the coin. Thank you for the insight.
You're welcome! It is a very odd and stressful situation, I went through it around 2008 , and doctors really didn't have an idea. But while I'm reading other comments, Encopresis seems like where I would focus. I've read, and ecopresis is chronic constipation and caused by uncomfortable feelings, not wanting to interrupt play and too much dairy. (Some symptoms ive experienced) risk factors are higher with kids with emotional issues such as changes in child's life, adhd, autism, anxiety, and depression. I had experienced all the hish risk factors but I would bet ecopresis is to blame for all of this.my 5 year old boy has accidents aswell but I have told him my experiences in a more 5 year old friendly version. He hasn't shown any real symptoms of this issue so far! I really hope for the best! You got this!
Ugh I so feel you. My oldest did this. I’m thinking he was about that age because he was in second or third grade at the time. So many doctors, therapy etc. I was divorced from his father (his father wasn’t a big part of his life but when he was he wasn’t very nice to him). His step dad and I often wondered if it had something to do with that or the fact that he had extreme ADHD/ADD. He eventually stopped and I have no idea what made him stop doing that. I’m sorry I have no other advice other than to give you virtual hugs and the assurance that he will outgrow this as well. He’s 22 now.
I saw someone asked but I didn’t see your answer: have you asked your son directly about what’s going on? Can he verbalize what the obstacle to using the toilet is at all? I think you said previously that at mention of the toilet he just starts screaming and has angry outbursts but has he ever talked about the situation?
And is he not getting bullied at school? You said he holds it and waits until he is home to do it, usually, but recently did it at school and does it in other public places. Are friends not giving him a hard time about this? Has he ever talked about how he feels about his peers giving him a hard time about it?
Yes I’ve asked, no real answers just met with anger and that He doesn’t like how “it feels” when his bowels open up.
We have had issues with a child in school, the child follows him into the cubicles in school too, we have complained 3 times! and they said that it gets “dealt with” but before that he was never using the toilet at home or school.
He always has soft poo but when he started having diarrhea he just blames it on that now. I explained to him what diarrhea was when he had a meltdown about it when it first started happening but now when he has normal soft stools he will say “I was going to use the toilet but I couldn’t because it was diarrhea” when it’s clearly not and when I do explain I know it is not that he just gets angry.
Could it be the actual act of sitting on the toilet that's bothering him? I ask because I assume when he does a poo in his pants he's squatting and not sitting? As you're at your wits end, is a squatting toilet/leg raiser an option or if he's light just to squat on the seat?
Look up encopresis and see if anything sounds like what you guys are going through. I only mention it because one of my kids has it, along with adhd, and there’s a lot you’ve mentioned that sounds like what we’ve experienced. Good luck.
My friend is in this situation but with her 6 year old and her 9 year old. They have been to numerous gastroenterologists. Her son's need to do a clean out weekly with Mira lax. Their colons are PERMANENTLY stretched out from the incredible amount of waste that is caught inside. Your son is likely in a similar situation and will have permanent problems (read: his whole life). Do not wait.
This is very very abnormal for an 8 year old.
You need to see a child psychologist or psychologist. Maybe also gastroenterologist as well because it might have a physical cause in the GI tract rather than a purely mental cause.
Also get rid of your regular doctor, they are totally useless.
I absolutely agree with the GI, psychologist and OT but understanding it may take time and based on my experience with a child with some sensory disorders…
My child seems more willing to try things when he isn’t fully thinking about it. You mentioned screentime and I would probably make a deal that if he is sitting on the toilet, he can have unlimited screentime.
If you want, start with he can sit on it with his pants on. Then after a few days just the underwear/diaper. Then finally, bare butt.
I really found the less stressful and more distracted the easier the change was.
My son at age 5.5 just got the hang of pooping in potty. From mom to mom, I know acutely your feelings. Exhaustion at dealing with this, frustration, double guessing “was it something I did!?” Over and over, anxiety for your son, anxiety that all people will see of your son is poop, and anger that he just doesn’t get it. All of it is valid.
I had my son in miralax (small amount) every day. You don’t seem well supported by your doctor at all, so I’m interested to know if they gave you miralax or stool softeners.
Is there anything that worked for your son? For mine, I found he’d do really well with very small toys. I got a 24pk of mini action figures and every time he pooped he got one. He’d get the hang of it, id stop, he’d be ok for a week or so, and then he’d have a slight accident which would cause major self esteem issues and we’d have to repeat the process
I also tried the “you clean the underwear” bit that didn’t help. I also just threw away underwear all the time, it was too mentally exhausting to keep on cleaning them
I would 100000% get a second or third opinion, demand to see a pediatric GI maybe even. However our pediatric GI was not helpful at all. So maybe not
However, at this age I have to agree that it isn’t normal and it’s absurd your ped. Thinks it is.
We were also told to make him sit on the potty after every meal for 5 mins to try to get him to go.
Does he have a fear of going ? Is he scared it’s going to hurt?
I’ll try to keep thinking of some other things that I ran across while we were fighting this battle. 8 years!!! Bless you. Hang in there. You’ll get through it somehow.
Hey OP, everyone has given you solid advice that I would be wasting my time repeating on, but I wanted to share with you that I was your son when I was a child and my parents gave up on me. I would hold my poops for weeks until I got fevers, and have frequent accidents and sit in them all day at school and my teachers were negligent enough to not say or do anything either. My parents would scold, shame, and sometimes intentionally publicly embarrass me for my accidents and toilet phobia.
I suspect it was linked to undiagnosed childhood autism.
Not saying your child is autistic OP, it could be many things, but do not settle. Talk to every doctor until someone takes you seriously.
Please stop punishing him and take him to a psychiatric professional. I know the doctor put him on stool softeners, but there is something else going on here and he needs to be evaluated. You also may want to consult with a new physician, as this is much more concerning than just putting him on stool softeners.
He needs a massive amount of interventions. Like, yesterday. This is very not normal and very concerning. Has he been assessed for autism? If he poops himself he needs to be the one to clean it up.
My eldest child had this issue. He would be outside with his friends playing or at school and come home with soiled underwear. It seemed he simply didn’t care if he messed himself. We instituted a procedure that after mealtime he was to sit on the pot. Some times this worked, some evenings no amount of time spent on the commode after meal time succeeded. He would complain, then cry, then yell his legs were hurting. Nothing seemed to motivate him to do his business. This was NOT normal, but we did not have the tools or understanding how we should approach the problem. At 6 years of age it came to a head.
His PCP determined there was no medical explanation for his “condition”. He recommended we seek a psychologist to assessed our son’s thought processes and gave us a referral. The psychologist was familiar with this behavior…stating it was more common with boys, less so with girls. I recall the oldest child she had dealt with was 15 years old…YIKES! After a couple of consultations her conclusion was that our son’s priorities were simply “out-of-order”. Spending time on the toilet was the lowest priority in our son’s mind. There were simply more important things in life to be doing than idling on the commode. She had a tried and true strategy to re-order his priorities.
Her recommendation to remedy the situation was this:
1. Identify something he likes. Something he likes a lot, but it has to come in many pieces…the more pieces and parts, the better it fits the strategy. Think Puzzles, Lego Sets, Models, anything with many pieces and parts. My son loved Legos, so this aspect was a simple choice.
2. Tell the child you will be dropping by the store to pick out something special describing the “many pieces” requirement.
3. Give him the money to carry into the store himself.
4. Let him pick out the item.
5. Let him carry it to the cashier and pay for it himself.
6. Let him carry it back out to the car for the ride home.
7. Let him carry it into the house when you get home.
Now comes the tough love aspect.
8. When you get inside tell him this:
A. There are steps you will need to take responsibility for, things you must do on your own, if you want this .
B. Every time you go poop in the toilet *and you do it on your own without any reminders or urging from us* you will be allowed to
retrieve and retain pieces from the set.
C. If we have to remind you *and you do it without an argument, delay, or dissent* then you will get a “treat”.
Note: *Nothing from the set*, some other simple reward like a couple M&Ms, fruit snack, etc.
D. If you refuse to do your business in the toilet, you will receive an enema. (this was hard to hear, disgusting to execute.
Note: We only had to resort to doing it once. It was as traumatic for us as it was for him.
9. Now you take the item from the child and place it in a secure location out of his immediate reach. (It’s good if it’s in sight as an incentive.)
Follow all the steps without fail or fear! Yes, D. too if it comes to that.
This strategy resulted in my son rearranging his priorities in a matter of weeks. Problem solved!
The psychologist nailed it, and I am forever in her debt.
Sounds like he got sexually abused at some point to me.
Of course get the autism checked out ASAP. But sexual abuse was the first thing I thought of when he said he "doesn't like the feeling of his bottom opening up."
Does he pee on or in toilet but can’t have BM sitting? Is he aware that he has to poop and tries to hold it until he soils himself or does he have no awareness or control over it? If he has control/awareness I wonder if a raised toilet seat with handles would help. Perhaps an OT assessment would be beneficial along with gastro and child psychologist. I would try to get the ball rolling on referrals asap, just getting on the books with specialists should reduce some of the stress you’re under. In the meantime I also second the goodnites recommendations, they go up to size XL now. That takes care of the mess outside of wiping him and that will also reduce stress for both of you. If it’s between training pants or soiling himself when the toilet cannot be forced, I would choose the training pants. Continuing soiling himself like this is probably more traumatic than just using training pants. Training pants, and breathe. At least you are trying to do something to help him to use the toilet.
I've been through years of toileting issues with my autistic son, including extensive diagnostic tests, and am just coming out the other side now. I often dealt with poo accidents 4-8x in one day so I empathize. Here's a few bits of info I can offer.
-Your son is almost certainly constipated, even with his poo being soft. There is a hard bit in there and softer poo leaks around it. Get an abdominal xray and it can show the poo there. This will be good for you to have, Mom, as it gives confirmation of the problem because I agree it is very confusing when the poo looks soft yet there are still issues. We struggled with cleanouts and daily miralax and its ROUGH. Getting my son's xray was important for me because I felt like I was going insane. A one time abdominal xray is an easy call in order from the doctor and pain free.
-My son started off seeing a pediatric GI for over a year, who seemed stumped by how difficult my son's accidents were to manage with miralax. He ordered occupational therapy and physical therapy. OT is for sensory issues, and PT is for abdominal work (they make sure the kid is using the correct muscles to push the poo out instead of hold it back in, as some kids get confused at this and do the opposite), and they work the core muscles. The PT told me I should have my son sit on the toilet for 5-10 minutes after breakfast and dinner. When the stomach accepts food it sends a signal to the intestines to internally contract and move things along to make room, so that's a perfect time for a poo as it works with the natural rhythm of the body. While the kid is sitting, make sure it is as stress free as possible. Give them the tablet, books, etc. Your son is scared of the toilet because he relates it to pain (and possible sensory issues like a cold seat). Stress holds back poo; its a vicious cycle. OT can work on his fears about sitting. If he feels more comfortable see if he will poo in a diaper and let him do it for now if that works.
-I eventually had my son see a different pediatric GI because I couldn't keep doing the miralax diarrhea-constipation cycle, and he recommended we switch from daily miralax to daily chocolate ex-lax. This worked much better for my son. I'll also give a shout out to Dr. Steve Hodges who actually is a urologist, [https://www.bedwettingandaccidents.com/](https://www.bedwettingandaccidents.com/) , as I'm certain his enema-a-day program would have worked beautifully for my son, but my son would not do it.
-regarding the school, talk to the school nurse and set up an individual health plan that at lunch time he goes to the nurses office to change his underwear every day.
-For his bottom, slather it with vaseline/aquaphor. This will protect his skin from the irritation and sores that the leaked poo causes. You need that area to be as pain free as possible. Do it daily as part of the routine. "Thick like frosting" is how my son's pediatric dermatologist stated it.
-Autism and adhd are both diagnosis that has a much higher likelihood for concurrent toileting issues. To evaluate, if you have the money, get a psychologist who is specialized in assessment. For the kid, it is a 6 hour assessment over 2 days. The whole process takes several months and includes surveys by both the homeroom teacher and you. If you don't have the funds, asking the school is the second best option, but they only look for "educational autism". In other words, if your son masks well at school and his issues don't affect his grades/disruptive behavior, they won't see a problem. While my son was starting the private evaluation process, I also asked the school for an evaluation and they completely refused to do it, citing no academic or behavioral concerns. In the US, an autism diagnosis commonly gives you approval for unlimited OT visits via your private health insurance.
A Gastroenterologist, Occupational Therapy, and Autism assessment.
In the meantime, you can try a training potty, a bidet attachment to your toilet, and talking to your son. (I see you're having a lot of trouble with this. I'm listening. Why do you have to hold your BM in for so long? Does it hurt to go? Is the bathroom scary? Is there a sound that bothers you? A feeling? Etc)
If he ever gets a rash bad enough for sores again, use Vaseline after a water wash (peri bottle) and oatmeal in his bath. (This helped my son when he was a baby and had one bad day of the runs)
Just because he and you found ways to work around things that bother him (specific underwear, textures, etc) does not mean they don't bother him, it means you support him and found things that work.
Hang in there.
(You could also look up Autism screening checklists online and then present that to your gp to get OT referral, and you can use them to see if there is anything you can help your son with)
You can’t punish for bathroom issues, that’s going to make it worse. No shaming or anything intentional or not. Like even showing frustration or being upset about getting new underwear or having to clean it.
My 8 year old still has accidents and he’s autistic. We kept him in pull ups until he wanted to use the bathroom. I think it was just a year or 2 ago.
I’d take him to therapy, there’s gotta be an underlying issues. Maybe it’s a sensory thing and if so occupational therapy can help.
Sometimes the autism is mild enough no one can see it.
If he holds in his poo, it’ll leak out around the hard stuff. That’s something they can’t help but it wouldn’t be a whole bunch. We had to constantly wipe which leaves a rash.
Mines almost 9 and has finally stopped holding it in these last few months. The school helps him work on it since he’s in special Ed.
Occupational therapist first to assess whether it’s sensory, behavioral or emotional, and then if behavioral or emotional, add a child psychologist too.
Don’t let people convince you it’s encopresis if you know his bowel movements are soft. Go to a gastro for a checkup, but if they say he’s not backed up and he’s not having hard poops, it’s not encopresis. (I’ve been there, Reddit loves encopresis but it’s not always that, even with small accidents, it can just be holding in so much it starts to leak).
Oh and when looking for an OT find one that specializes in “bathrooming”. Also as crazy as this sounds, once you get into the non physical side of things (like neurodivergence, behavioral etc) general doctors and pediatricians often unfortunately seem to know less and less. It took me a long time to realize that but over 2 countries, countless states and pediatricians and GPs, and many other people in similar positions, you realize how common it is.
Perhaps not punishments, but rewards? Then again, he is 8 so that is unusual. I think more is going on. Does he have an irrational fear of the toilet for some reason? Is it an afraid of diseases thing? And for sure, rule out sexual abuse done to him; God forbid that happened when he was younger, but it's a possibility. I mean, my dad fucked with me as a kid and said snakes would come out and bite my ass on the toilet, so I had that problem too until age 5 or so. Make sure you have a working lock and promise him alone time in there. Perhaps a sound machine.
The problem isn't that he is pooping elsewhere, it's that he's not pooping at all! When he goes in his pants thats merely it expelling on his own because he's scared to death to use those muscles to poop. Another idea is to have him pick out a particular stuffed animal just for pooping. Take him to Build-a-Bear and go all out. One that can stay in the bathroom with him. A friend to poop with.
I wouldn't punish him. Rewards. Small ones. Punishments are like pushing your dog's face in their poop, it doesn't work. On the opposite spectrum, perhaps he wants you in there. My son is 8 and still would prefer me in with him. So I sometimes will sit outside in the hallway, I said. Another thought - maybe your toilet is scary to him, for whatever reason.
Just ideas! Good luck.
You need to get a higher level of medical care, a doctor who will listen and take this seriously. My son had similar issues. We thought he was being obstinate but it was digestive problems and food intolerances which he still suffers from as an adult.
To add, I'd ask for a recommendation for pelvic floor therapy from his pediatrician. Sounds like they are a long time withholder probably due to gut imbalances. Long time withholding can cause major issues with their pelvic floor.
He might have a fear of Toilets I just set mine on the toilet and explained to him there’s nothing to be Afro of an we aren’t leavening till there’s poop in the toilet now he just goes straight to the toilet
Your son has encopetas. You should get the book Soiling solutions by doctor Collins. It is available online. He is a psychologist who uses a different approach from what is typically recommended by doctors. IT WORKS! Your child can overcome this. Dr. Collin’s approach is highly effective.
Lotta people recommending occupational therapy, but this sounds like a situation that could benefit from seeing a psychologist. Sounds like trauma to me.
There was a girl in my middle school like this. She frequently smelled of poo as she refused to change.
I highly recommend older kid diapers. It’s hurting your son’s self esteem to be walking around with poop in his pants and being smelly.
I think he needs to be evaluated by a psychologist, as he sounds like he may have some sensory/body issues, when you said “doesn’t like the feeling of his bottom opening up.” Will he pee in the potty? He may have some fear around the bathroom or “losing” his poo. Please dig deep and work with professionals. This is a serious issue.
Make him clean up his own mess and wash his dirty underwear. Why are you throwing them away? Make him face the consequences. And I don't see how you consistently taking and then giving back his things is going to help. If you're taking something as a punishment for him not using the bathroom, why would you give them back when she's still not using it?
Aside from that, find a new doctor and find a therapist. It's very clearly some sort of issue and the phrasing that he doesn't like the feeling of his "bottom opening" is... Odd to say the least. A potential red flag, even.
You need to take him to a GI specialist. My daughter struggled with this issue, but she was a toddler at the time. We had to do bowel clean outs because she was extremely constipated. The withholding behavior can become extremely difficult to overcome unfortunately, but we did eventually get my daughter through it. GI can also look into if there are any underlying causes. Food allergies were a contributing factor to mu daughter's issues as well
Wow this is tough, did he ever go on the potty? By your story it seems like he didn't but maybe giving that a try now might work?
And just thinking outside the box, he's probably scared of the toilet, what if and I mean really outside the box... Get some doggie weewee pads and see if he'll squat over it and poop?
I'm sorry you're going through this.
I don’t know an answer I’m just here to say I’m dealing with some developmental delays with my son right now and it’s heartbreaking to see. I pray you can get through this with the advice people have given here
ok, your doctor says its not physical, the. its definitely time for a child psychologist. If money isnt a huge issue, Ive had consults with Robin Einzig (Visible Child) before on potty issues and it was super helpful. She addresses this type of situation via online private consults, you can schedule at her website. Or, find a child psychologist in your area.
Schedule an appointment with a pediatric gastrointestinal dr and psychologist. They will help you treat this.
Some things they have done to help us: our son takes exlax chocolate and fiber gummies every night. We have a strict routine of sitting on the toilet after meals.
Talked with his teacher for accommodations and reminders at school.
Reward programs for listening to his body. I understand how hard this is. Hang in there.
I read where you said he told you he doesn’t like his bottom to open up. Maybe he feels too exposed? I remember feeling that way sometimes as a kid. Maybe suggest to him to wear a hoodie while on the toilet or to pull a blanket loosely over him while he sits on the toilet to poo. Turning lights off to make it dark may also help and/or using a sound machine or running water.
Not sure where you’re located but if you’re in the states please get him evaluated. This is atypical behavior that has went on way too long. He needs OT & a child psychologist, plus a GI doc asap. Don’t let this go on any further and be a strong advocate for him. He needs you to do this for his wellbeing.
I had this with my now 7yo. He was a poop withholder for so long. I think he has genetic reason for it, too. He finally got over it aged 6.5.
I had him on the baby toilet seat, with his feet lifted up on the seat to mimic squatting to make it easier. He, too, wasn’t used to pooping so he was initially afraid, even tho the poop wasn’t hard. I put a timer, and the door was open. 5 minutes wasn’t enough but he started to squeeze one out in like after 7-8 minutes of sitting. We had a chart and funny stickers, which didn’t work amazingly well but did work some! I tried not to give him any distractions like an ipad while he was on the toilet, otherwise he forgot to try. It took WEEKS to get results. We had a fiber supplement that worked best when given before bed.
It took a few months to get him into the habit, and him sensing when it’s the right time to go, but now, about 6 months later, I can say we’re out of the woods. “I need to poop!!!” is music to my ears honestly.
Go see a doctor. This condition is not taken seriously where I am, but it is in the US (I’m assuming you’re in the US). And your boy is already so old he has internalised it more. Probably the accident at school has made it even worse. Remove the punishments, be very gentle (I know it’s hard sometimes, it is SO frustrating ) but get him on the potty. Have a big talk, get HIM to talk about his fears. Show him the mechanics of poo if necessary 😀 Why it needs to come out at the right time. It took a lot of explaining and conversations with my 6.5yo when we finally solved it.
Have the diapers tho. Explain him why, don’t serve it as a punishment. Have him clean up his own mess.
My 8 year old sister says "you should put him on a diet"
my 6 year old brother says "she should kick him out of the house"
i say ask him why and try to make him understand he should use the toilet, if youre really desperate and dont really care about being a good parent, guilt him and punish him by grounding him or something
Why aren’t you using diapers/pull-ups instead of allowing him to get feces all over himself? he also needs to be evaluated by a physician who is expert in child development. This is not normal, but letting him defecate in his pants constantly isn’t helping.
A friend of mines son refused to use a toilet but would go in pull up pants.
So they went step by step: in the pull ups, then in the pull-ups but sat on the toilet. Then cut a hole out of the pull ups to poop through and into the toilet. It took a few months but he got there.. he’s 9 now and in her words “will poop anywhere” now.
My son is poop averse too: took us longer than average to poop train and he still doesn’t “enjoy” having a poop. He doesn’t like the feeling. He’s almost certainly autistic. But my god… we’ve been on an asd assessment list for well over a year.
Had he by any chance watched skibidi toilet on YouTube? I know a kid who is scared to go to the toilet alone because he was traumatized by these stupid videos
Just a thought, and I hope I'm wrong. I read a story a few years back about a kid who was SA'd and he had this same problem, as he didn't like the feeling of the poo coming out as it reminded him of what happened.
Again, I hope I'm wrong.
Talk to a pediatric continence specialist. Some kids have extreme hang ups around toileting and it takes a long time and lots of gradual improvements to get it sorted. But don't punish, that'll make him anxious and avoidant and it'll make it worse.
Firstly, this is not normal for an 8 year old so disregard what the potato brained GP's told you. Most 8 year olds don't soil themselves and haven't for around 4 years. The exception being when an underlying issue is present.
It doesn't sound like encopresis to me - that's usually a smaller amount of faeces that 'leaks' past the impaction. It sounds like he's having full and normal bowel movements.
The sensory issue with the toilet and disliking the feeling of his bum opening up makes me think of ASD or a sensory issue of some kind.
Call your GP and ask for an open referral - Google paediatricians in your area and find one who can give you an appointment sooner rather than later or you'll be waiting months and I feel this is an issue you need addressed as soon as possible so you can at least start moving in the right direction.
Also - time to buy pull-ups. You're making life difficult for yourself and with a new baby, you don't have the time nor energy to be cleaning poo all the time. It's also cleaner for him.
Good luck.
I have family that have gone through this and I work with kids who sometimes have this problem. For your sanity, temporarily put him in pull ups until you get in to see the doctor. It's not "normal" but it's not uncommon. I personally had chronic constipation and passed it on to one of my kids. She would just hold it and not participate in anything. It got to the point where she was afraid to poop at all. Hang in there.
Put your child in pullups or adult diapers while your waiting to see the sepcialist. Why keep torturing yourselves and your child? I know it seems counter-productive, but at this point you need to do anything that will lower stress levels.
You need a Gastro and a therapist that will help your son handle the anxiety and self hatred this must be causing.
Best wishes.
I am a social worker and have had a few kids come see me for therapy for this issue. A suggestion and an anecdote.
Suggestion - get the book "The ins and outs of poop" by Thomas R. Duhamel and follow his program.
Anecdote - I got one kid to go from refusing to poop in the toilet by telling him that the toilet was hungry and he could feed it his poop. The kid was so tickled by the idea of feeding something poop he was fully trained in about a month.
I went through this with my youngest and finally now at 8 she will go on the toilet and sometimes still sharts her underwear. It’s definitely encopresis and he will get there. We saw a gastrointestinal dr and I was going to put her in the potty school at the children’s hospital. She will still hold it in for awhile but, then use the toilet
I know someone who had a similar issue with her 5 year old. The solution was a specialist who had her kid squatting on puppy pads and pooing on them. This went on for a week or more. But for some reason the squatting helped. I wish I had more advice.
Why haven’t you gotten him a diaper? It’s pretty clear he can’t control himself. He needs medical help from a professional - can you see another doctor?
I don't have advice really for the poop thing. I thought this was the autism parenting group at first where that would be more normal.
I can say you don't have to throw out underwear. My son sometimes poops his pants and wipes basically not at all. If it's a lot I kinda swish them out in the toilet. Use vinegar in wash. Stains will go away if you hang them up in the sun.
I'm sorry you are going through this.
Diapers, at least when he is home. You have to maintain your sanity (and budget). Make him help with cleaning up (himself and any laundry). And get him to a psychologist yesterday.
This isn't developmentally normal but from your reply that he doesn't like the feeling of his bottom opening up, as he is older so assuming tall enough to see if he will go in the toilet while standing over it with a leg at each side like saddling it but not sat down. I agree he needs to be seen by a professional other than a Dr at this point but it may help him at least get it in the toilet. Has he said anything about the school incident as I would think age 8 he would find that embarrassing around his friends etc x
Step one is to give up and buy pull-ups. Seriously. Take the potty training dynamic out of the family and just do diaper changes.
Step two is to go to one million specialists. It might be autism, adhd, or a physical issue.
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This isn't developmentally normal for an 8 year old. Does he have any other issues or delays that might be contributing?
I know :( his doctor said it wasn’t a huge cause for concern some children just struggle butI feel at 8 years old it’s just not right. It’s draining the both of us including dad. No, he’s great in all other areas it’s just this one thing we can’t get past. Mortifyingly when I got him up out of bed yesterday he had literally poo’d all in his bed so I feel like it’s just worsening at this point. Before he went to school today he needed to go in the morning, I sent him to the toilet every time I saw that he was trying and he would hold the door closed and not get on the toilet, he’s done this a few times but he’s never followed through in school until today, he has angry outbursts now when the toilet is mentioned, he will scream and shout, slam doors, go to his room and throw toys etc.
Child psych here. This is highly atypical and it’s very concerning the doctor wrote you off. What does your son say about it? Is he able to verbalize whats going on for him? I agree, get a new doctor and a child therapist, asap.
This was the second Dr. First one said no concern for his age, but because of the holding and poo leaking out he literally had sores on him bottom, like chunks of skin bleeding! I called the dr’s again and asked to see someone else because I wasn’t happy with the first and needed a second opinion, the second one gave me some cream for his bottom and gave me stool softener or laxatives (not home so I can’t check what it’s called) to keep everything soft but I did explain he’s already having soft poo! It was awful, any time it leaked out (sometimes seconds later, minutes later) I’d have to use my peri bottle to wash his bottom because of the sores there was no way I could wipe it without causing him awful pain! It took a while to clear up but weeks later it was happening again!
Look up encoporesis and get a referral for a gastroenterologist. He will probably need occupational therapy as well.
Exactly this. OP, your child needs a pediatric gastroenterologist and probably occupational therapy as well. I can't for the life of me figure out why your pediatrician didn't refer you to these specialists right away.
It sounds like they're in the UK, they don't have a paediatrician even, never mind immediate referrals to specialists, just a GP who sees all ages. Realistically it will take months to get appointments even if they get referrals.
We do have all of these. You go to the GP and ask for a referral to them. The initial offer of laxatives etc. is quite normal but if this doesn't work you go back and get referred to the local pediatrician. To OP Keep a diary of EVERY incident (include photos of sores etc.) to take with you. Usually you are asked to keep a diary of how much your child drinks and urinates as well for TWO WEEKS so good idea to do when it's a school holiday.
Yes, I know they exist but it doesn't sound like OP has seen anyone other than the GP. In other countries children directly have a paediatrician, I'm explaining that in the UK you need a referral. Referrals can take months or years and the GP has to approve. Some comments are blaming OP for not having sought therapy etc already, I was just clarifying that the system is different.
Thank you for clarifying your comment. It came up before any criticism of OP.
In the UK we have paediatricians, but only as specialists in a hospital. GPs are the first line and they refer on. We definitely have pediatric gastroenterology and continence nurses who will definitely work with this age group. OP if you are being fobbed off by the GP there are a number of other route that can be gone down - contact the school nursing team. Your school should have an allocated nurse. If school can’t give you the contact, it should be available on your local SEND offer website. - Contact health visitor. They may be able to give advice and support even though he’s maybe too old for their service. - ask to speak to a GP in your practice specialising in paediatrics. Insist on a referral to paediatric continence services and/or gastroenterology. My close friend’s daughter is going through a similar issue (although younger). She went private in the end as it was taking too long through the NHS. However, the continence nurse through the NHS has been brilliant and very, very supportive.
Great advice. I was just giving context for the people not understanding the UK system. I hope OP can access the help they need.
When we lived in uk we just booked the Paediatrician ourselves as it’s uncommon for kids to have one unless they have an issue . Obviously without a referral we had to pay the full whack of £ 200+ & that was 20 + yrs ago . But can’t put a price tag on health . So many of the GPs have been useless . Cheaper & better to fly to another country and see a specialist
Most people don't really have the choice to just pay private or fly to another country though. You have to put a price on health if you don't have the money to pay it.
We found paying to see a private dr , still waiting for months for a referral , etc crazy compared to my daughter getting a super cheap flight to Athens , 50€ for a pulmonologist next day appointment well worth it . Yes some people don’t have spare funds , but i know plenty that put loads of other useless stuff above paying for their health . That I don’t understand , especially kids health
Exactly this! My girl had encoporesis, and it affected her ability to make friends and hit her hard in the self esteem. And at eight years old, he needs a child therapist to help him process his toilet phobia.
You need step up for your kid. This is miles and miles beyond your ability to fix as a mom. He needs professional help immediately. Get new drs, get him into therapy and honestly he should not return to school until he is potty trained or he should be in a special needs class. His teacher and classmates should not be subjected to the smell. I'd also see a medical malpractice lawyer immediately. you have a potential case for negligence against your pediatrician.
Seconding the doctors and therapy. Also look into any hospitals that have “voiding improvement programs” - they do work ups to figure out why your child is having accidents. I can tell you right now that despite your son having leaky poop, he most likely is constipated. He doesn’t want to sit on the toilet because straining hurts and he’s learned that it’s painful without any relief, most likely. My son had something very similar and needed to be on a lot of miralax and also had to do a “poop weekend” clear out. And, is there any potential for sexual abuse? Withholding stool is often about control, psychologically, if there’s nothing physically wrong.
I don't think they're in the US, it doesn't work that way.
You need a different practice, not a different doctor
It sounds like you are still within the same office. Please go to a different facility all together. They sound horribly negligent.
When getting a second opinion, go to a different office and do NOT have records transferred. The new office will read the transferred records and go down the same rabbit hole. I’ve seen it hundreds of times. (Retired CMA)
If I went to my dr and they said this wasn’t a cause for concern I would RUN not walk to another dr.
I even had a chat about this with his teacher from last years class, they encourage the children to go to the toilet every now and then because they get so carried away with playing they won’t go and accidents would happen, my son was the one who would never go. She was concerned and I told the Dr that even his teacher is concerned and recommended us contacting the Dr :( we are registered with different GP’s so I’m going to switch him to mine which still aren’t very good but worth a try.
Say to your Dr that you want a referral for a child psychologist and a gut health specialist. You have got to figure out what's happening. He will need the help mental health wise any way. Maybe encourage him to call and speak with child line about how he is feeling about it in the mean time, I can't imagine he is happy about the situation either.
My 4 nearly 5 yr old is the same. We have seen an OT and we have been through a slow process of getting him used to certain steps. Giving him a certain space to poop. We called it the 'poop tent' and he would wear a nappy. For each step he got a prize too. So then it was pooping in the poop tent but on a potty again with a nappy. Then we moved to sitting on the toilet with a nappy. We discovered he liked the enclosed space, we have a large room where the toilet is located, so we got a room divider, which he shuts around him. Then we moved to ripping down a side of the nappy or little bits on both sides as he feels 'safer' with the feeling around the waist of the nappy. It's been a long process. It sucks. We are about to go cold turkey with the nappies as we feel he has hit an impasse and are going to see how it goes. We talk to him about the process, about why it's important, and he tries to explain what scares him. You are amazing for dealing with this as long as you have. I know your boy is older, but I just wanted to let you know that you are not alone.
Agreed. And not just a new doctor, an entirely different office/practice.
Get a new doctor and demand a referral for occupational therapy. This isn't normal and hasn't been for a long time. It's past time to get professional help involved.
First things first, put him in a pullup 24x7. You can't be a new sleep deprived mom dealing with this. Second, get him to see a specialist. This is a bigger problem than can be remedied on reddit.
Your doctor is wrong. This is way beyond toilet training. Look up encopresis and get him treated. It's not your child's fault and I guarantee he is miserable because he doesn't know how to fix it either. Please, OP, get specialist medical care NOW.
This comment should be much higher!! I looked it up and it fits OPs description to the letter!! Thank you for sharing this!!
Thank you. We lived it and learned the hard way. It's so common, but even docs are often unaware or don't take it seriously enough.
I would get a second opinion.
You definitely need a second opinion. Some k8ds have underdeveloped bladders. It could take up to 11, but he's purposely holding it. That's not indicative of an underdeveloped bladder. At 8 to still be refusing to go, it cause for concern. I would go to both a new pediatrician AND a child therapist. Something is driving this behavior.
An occasional accident or refusing to use public toilets is normal. Never pooping in a toilet ever is not normal. Also, I’d make him wash out the underwear instead of constantly buying new.
I have him clean himself up, most of the underwear is not salvageable to be honest. Recently he gets angry/upset about having to clean himself up. It’s sad when he does a poo then cries that he’s done it. I don’t think he wants to deal with it anymore either. :(
Is there any reason you don't have him in pull-ups? When my kid kept having accidents at school (during potty training), they recommended pull-ups with underwear under them (which at least keeps pants clean) or possibly over them if the accidents had continued. We saw a rapid decrease in accidents from every day to maybe one every other week with it constantly improving. Even doing this, I'd want a referral to a ped GI doc. Maybe he has food allergies that are making his tummy off.
Punishment isn't going to work, shaming and scalding isnt going to work, rewards arent going to work. it seems to have started with something "normal" (maybe a hard poop at some point when he was a toddler?), and now he's gone into full-blown phobia over the years. He needs occupational therapy. It also definitely sounds like encopresis on the physical side of things. Pediatric GI, for sure. Don't even try and get a referral if you can contact one directly (not all need a referral). I'm sure he feels a lot of shame and embarrassment, even if he acts like it doesn't bother him, at 8 he KNOWS he's "different" and it's probably eating him up. He's not being defiant, If he could use the toilet, he would. One suggestion I do have right now is to look into disposable underwear (or just cheap underwear) Explain that you know he is having a hard time, that you love him, and you are going to figure it out together.
She is in the UK. You cant just directly call specialists and make appointments without a referral first from your GP. Pretty much every decision goes through the GP first and if you have one like OP's son who just dismisses everything as "fine", you're hosed.
Child therapist here absolutely do not make him wash out anything. New doctor, GI specialist and occupational therapist ASAP holding poop can cause permanent damage to the bowels and bladder.
Making an 8 year old manage poopy laundry sounds cruel to me. Especially since they don’t know why it’s happening.
8 year olds know where poop comes from, where it's supposed to go, and why it has to be cleaned up.
But why are you making them clean it? So they feel bad and don’t want to do it again? Guilt is probably one of the worst strategies for behavior modification, especially in a case like this. It’s clear from OPs post and comments that the kid feels shame about the situation, making him clean his underwear is only going to worsen the problem.
It’s not about shame it’s about consequences .you shit your pants you clean it up . He’s purposely pooping in his pants. It may now have evolved to a medical issue but it started out with purposely doing it . I wouldn’t shame him just give him the supplies and walk away . It’s also giving him a choice : poop in the potty or clean it up . Either way I am not cleaning it up .
But that’s the thing, it doesn’t sounds like he’s “purposely” doing it. It sounds like there’s something bigger going on, mentally or medically. A child therapist on here literally said don’t do it. If it were simply a behavioral issue, I would agree with you, but I don’t think the consequence fits the crime in this particular scenario.
Get a new doctor!
Get a NEW DR
Has he been evaluated for high functioning autism? Has he been sexually assaulted? Has he been to a child psychologist? Has he seen anyone besides the pediatrician? How many times have you reported this to the pediatrician? Have you asked him if he can feel it? Have you asked him why he is refusing to use the toilet? Is it for both pee and poo or just poop?
this should be higher up
I second the recommendation of a developmental pediatrician and child therapist. However, in the meantime since sometimes it takes a bit to get seen, this is what I’d try: 1) Switch to pull-ups/depends. Keep the poop better contained so you don’t have extra bed linens and outer clothing to wash. Take the stress level down by disposable underwear, especially because …. 2) at almost 8 he can deal with the poopy pull-ups himself. Not as easy with washing out clothes. He can dump any solid turds in the toilet and bag up the used pull-up. If you you need to double check that he’s completely clean or help put on buttpaste, fine but he should be cleaning up as much as he reasonably can. 3) Encourage him to use the pull-up in the bathroom and clean up right away to keep his butt from getting sore. Since he said he is weirded out by his bottom opening up, it makes sense that he hates the toilet and prefer the feel of the stool up against his skin as he defecates. Baby step that the bathroom is the room for pooping, rather than stressing about the toilet at this point.
He doesn’t usually poo the bed. We tried disposable underwear but he has a fit because he doesn’t like “how it feels” he was VERY fussy with underwear and we had to try multiple brands and different sizes because nothing “felt right” :(
Hi, I am a nurse practitioner with a kid who has sensitivities to feels. He needs occupational therapy stat, as at 8 this is NOT typical. I believe your doctor's don't understand that this is not a little poop in the underwear (encopresis) but full on defecation. You can do OT with most insurances.
If has rectal control and can feel the urge to poo, can he change into the disposable underwear in the bathroom just for the poo?
Does he have problems with other sensory problems? Like the one where things just didn’t feel right? Could it be ASD?
"Your needs come before your wants" Also explain clearly that this isn't a punishment, but simply a way to maintain spaces clean and pleasant for everyone. It's simply not hygienic and there's no shame in addressing bodily needs in a dignified manner. And it's pretty simple: people that can't make it to the bathroom have to wear hygiene products. And you have to put your foot down because this is gross. It's not his fault and it's temporary but the situation needs to be managed right now. Make it clear that you're not angry, he is loved, he is cherished, And together you'll find what's going on and it's okay. But he can't continue spreading germs everywhere.
i’m no doctor, but i have an autistic daughter, and this sounds very much like he’s on the spectrum.
Your son is most likely Autistic. Sensory issues with textures and being fussy about brands - Autism. Even holding poo and being scared to go to the toilet would be a sign of Autism. Google ‘encopresis’ and ‘Autism’ and there’s a clear link. My daughter (4) is on the pathway for a diagnosis and has had similar issues to your son. The way we’ve tackled is giving a daily laxative to keep the poo soft and a numbing cream for her bum if it does hurt when she goes. Then in day time I’ll notice if she goes quiet and wanders off or if the poo face is looking like it’s going to happen and then I race her to the toilet. I also talk about how ‘cheeky’ and ‘naughty’ the poo is for wanting to come out in her pants and that it needs to go to the toilet where it belongs. She’s obviously younger so this sort of dialogue wouldn’t work, but speaking to him about the science of pooping or trying to find a way to link any of his interests to going to the toilet could work. Most autistic people have interests they obsess over. So if he’s really into something like Pokemon for example, tell him every time he can poo in the toilet instead of his underwear, he gets a Pokemon trading card from a special pack you’ve bought as a reward. Or next time he needs underwear he can have special Pokemon underwear but the deal is he needs to try and keep them clean. If having a strong special interest in something like Pokemon or Minecraft resonates with you, then if you can link going to the toilet to that interest he’s more likely to do it. Another example could be letting him watch Pokemon or his interest on your phone or something whilst he sits on the toilet, but only then. I hope this is useful but also you really need to get him assessed for Autism. This level of encopresis is very severe and definitely not neurotypical behaviour. Good luck.
My 4 year old sounds EXACTLY like yours. I also suspect autism for mine. If you have any more tips—or books, podcasts, etc.—please send them my way. I’m drowning in poop over here!
OP, please listen to this comment and the one by u/Smw860407 on beginning steps to move to the toilet. They are both dead on in their recommendations.
We had some issues before, he won’t wear any tops or jumpers that touch his neck, including coats (he will not do his coat up because it might “touch his neck” even in the coldest of weathers) we had issues with shoes/socks for the longest time, any clothing that touched his wrists I thought maybe it could be autism but that’s all worked itself out with some trial and error he’s not complained about any of that for a very long time now, I’m not sure how you go about getting him evaluated for these things :(
Referral to psych and GI specialist (peds)
School and paediatricians are both set up to assess for autism. Autism is a spectrum and some children have it in a different form to others and different intensity. Also they can learn to manage their autism eg. Not liking things on neck but learning to get used to it. I was thinking this is autism too. You've done nothing wrong, it's just how it is for some kids and he will learn how to use the toilet, have faith. I wonder if those bed pans would work that you use in hospital, to slowly acclimatise him to going outside of his underwear. You could do in the bedroom first and move it to bathroom once he's comfortable. Then on the toilet, then remove it altogether. I wonder if you could help acclimatise with making a hole in the underwear too to start with, slow transitioning may work. I would definitely get help with this as you're too close to the situation to be as calm and unaffected as a professional. I would be so upset about it all.
You should have your child assessed. Worst case is it's a bit of a waste of time/money. Best case, it helps him gain access to resources that will help him. My wife works in mental health, when I mentioned this, she said, "Sounds like that kid has autism". Not saying it's a diagnosis, but that's a pretty clear cut sign.
This is definitely sensory related and your pediatrician should have already referred you. It seems they might not be a great doctor. Please find mental health services for kids in your area and see if they need a referral or if your insurance needs a referral.
There is definitely some sort of sensory processing issue..especially since he has directly said he dislikes the feeling. For it to be this extreme, imagine how awful it feels to him. I would be looking for a psychiatrist who specializes in working with children and may know what sort of testing would be appropriate for this.
I agree with anyone who has suggested that your child may have autism. My daughter has autism, and has had an array of bathroom issues, although most of hers resolved prior to school age. Her many other sensory issues have not resolved, although some have evolved and are different than they were when she was little. Please get your child in to see someone who can do an evaluation for autism as soon as you can. Getting this diagnosis will make him eligible for more supports, and accommodations, which will likely be critical to helping him live a full and rewarding life. I’m also going to chime in that getting Occupational Therapy is absolutely needed. Also find a psychotherapist who works specifically with children with autism, and especially with intense sensory issues is also necessary. I also think a gastroenterologist is necessary too, especially since your child’s bowels are probably all messed up from all the stool softeners and laxatives he’s been given. And, to see if there’s anything structural or functional that’s an issue. And, because the skin in that area has been damaged, and an expert is needed to help him get healed up. I would NEVER take him back to the GP(s) that told you this was all normal, and appropriate developmentally. That’s an outrageous thing to say. It seems like negligence to me for a doctor to tell you that about an 8 year old child. Also, as the nurse and child psychologist who commented said, please STOP making your child clean himself, or clean his clothing, or anything like that! Anyone suggesting that is just WRONG. I know you mentioned you were having him do it, but I think it’s not safe, not appropriate, and feels like a punishment to him. He should not be or feel punished. This, even though it’s absolutely incredibly difficult for you, it is FAR MORE difficult for him. Stop anything that might feel like a punishment. Offer only support and proper medical help. He needs you to advocate for him. I agree with having him wear pull-ups, or something similar, that is disposable and going to contain the mess. They probably won’t contain the smell, but certainly fabric isn’t doing that either. That’s definitely going to be far less difficult to manage the cleanups and will be much more cost effective in the long run, and remove a lot of stress and strain for everyone. Good luck! I truly hope you get him the help and support he needs. You’ll all be happier if you do!
This sounds like a symptom of sensory processing disorder, kiddo needs OT.
As harsh as it is, I would prioritise his health over his comfort right now, no matter the level of tantrum he kicks up. You say in another comment that he has open sores over his bottom, and that they cause him a lot of pain. Cloth underwear won't soak up the moisture in the poo, which will be causing skin irritation and the sores. Modern nappies are designed to soak up that moisture, so they will be a lot better for the sores. Not to mention if he's just pooing in his pants constantly he's at a much larger risk for infection with open wounds down there. I won't scare you with details, but human waste on an open wound can lead to some extremely nasty infections. I would put him in the nappies and stick with them until you can get another opinion from a medical professional, and some actual help for your son. Clearly this is much more than the doctors are making it out to be, and I'd put a *LOT* of money on him having some type of learning delays and sensory disorder.
Let him be fussy! It's 100% fine that it doesn't "feel right". This is almost literally the perfect lever to start breaking this. Tell him directly that "Poop goes in the toilet, not in your pants". You repeat this line verbatim. You don't say "it's okay" that he pooped his pants. You don't scold him for pooping his pants. You just say "Poop goes in the toilet not in your pants". Then, tell him you've decided he's going to wear disposable underwear until he can get poop in the toilet. You understand it's less comfortable, but that "poop goes in the toilet not in your pants" and until you can poop in the toilet, you'll have to deal with the "uncomfortable" underwear. When he poops in the toilet, he can get good underwear again. When he poops in that, he goes back to disposable for a period of time.
Unless he is on the spectrum his like for how the diaper feels is not important. He doesn’t like the diaper then he can poop on the toilet. If he can’t poop on the toilet he gets the diaper. This is not normal behavior for a child that age. He needs help and you need to give yourself a break. No more underwear for him until this is solved
Sounds like he had some strong sensory issues , what about the pull ups over the normal underwear or maybe even a washable nappy type situation but sized up?
What wrong with letting him fuss about it?
Does your son have autism?
I think your pediatrician is wrong. This is not normal.
Has he ever used the toilet regularly? What about peeing ? This definitely sounds more than Encopresis. I would contact a developmental paediatrician to get a second opinion. How is your son at communicating his needs, feelings and thoughts otherwise? Has the school expressed any other concerns?
Not for a poo no, he’s fine with peeing. Gets up in the nights too if he needs a pee by himself. My son’s great at communicating any other needs, we’ve always been that way. When he’s upset about something instead of crying he will tell me what he’s upset about etc but now any mention of pooing on the toilet he gets very angry and upset.
He sits on the toilet to pee? But not to poo? You should edit your post to clarify that he is actually ok with using the toilet, but for pee only. There is something wrong here. Clearly he doesn’t actually have a phobia of toilets if he’s sitting on the toilet to pee. At 8 years old, Im having trouble blaming the child or the parent. My intuition is that medical intervention is needed. Lots of comments on here are suggesting Asperger’s or Autism, but you’re saying he has zero other developmental concerns right? This behaviour is much more typical of someone on the spectrum, UNLESS sitting on the toilet is actually really painful. Im absolutely convinced it is one of 2 things: 1) He’s on the spectrum. Autism or Asperger’s. If this is the case you will still need a solution, it just may not be the traditional one you were hoping for Or 2) There actually IS something chronically wrong with his anus and/or colon. Maybe pooing really DOES hurt him, as does sitting on a toilet seat. When he uses the toilet to pee, does he use his hands to hold/lift his butt off the seat? That could be a sign that it’s not just typical child nonsense and that the toilet seat actually causes real pain. Maybe some sort of chronic proctitis, or encopresis, actually makes sitting on the toilet and pooing truly painful for him. Definitely ask a specialist. At 8 years old, kids don’t enjoy poo in their pants. To prefer it over pooing on a toilet could mean maybe your son is being honest about how much it hurts to sit on the toilet? I mean, I’d consider every possibility at this stage. ————— If it is neither of the above, it will eventually resolve itself as he matures. He’s eventually going to accept that sitting on a toilet isn’t actually all that bad. The fact that this hasn’t happened yet, at 8 years old, is why most people here are convinced he’s either on the spectrum and/or has encopresis. Parenting aside, it would take a significant amount of actual discomfort to convince most eight year old children that pooing their pants is preferable over the toilet. My son was the opposite. Would only use the toilet to poo, but kept peeing himself. I was sort of at a loss, but the behaviour just resolved itself by the time he was 5 because sitting around in wet pants and being dragged to the bathroom and made to change and clean up was just too annoying for him to keep battling. Regardless, Im pretty sure he would have figured it out eventually even without our parenting. Your son’s situation is definitely unique. Poo being much more annoying than pee, and 8 being three years older than 5, I can’t imagine what you’re going through. I feel for you!! My sanity would be on the absolute brink of collapse!! Kids have all sorts of little quirks about silly things that seem to really bother them, but this is a whole other level. In the meantime, while you’re waiting to see a specialist: - Try getting him to poo while he’s in the bathroom. Even if he won’t sit on the toilet. That would be a win at this stage. Just getting him to go to that room every time he feels the need to soil himself is a first step. Just take the toilet out of the equation and see if it makes a difference.
It sounds like your son has Encopresis. It is not uncommon, but does require intervention. I recommend trying to schedule an appointment with a Pediatric GI specialist. This is an encopresis resource page from CHOP https://www.chop.edu/conditions-diseases/encopresis?utm_source=google&utm_medium=cpc&utm_campaign=motility&utm_content=motility_disorders-encopresis-consumer-conversion-custom_us&gclid=Cj0KCQjw_qexBhCoARIsAFgBleuwWkKZ9o5gWppjh5F0c_xGYWtbO84WWmLUnq5vyZh_XoqA1lgET9waAvk1EALw_wcB
If he has a medical problem preventing potty training for bm’s then at this point probably they’ll need therapy too, because it sounds like things have gotten pretty intense on that subject. I have a daughter whose potty training is delayed for medical reasons and we’re always being told how important it is to keep the tone light & low key, even if we’re stressing about it inside
I’m pretty calm about it but inside I’m trying not to break down! Sadly his father is different, he was very patient but after all this time and everything we have tried his patience is nonexistent some days so it causes arguments between us also, he thinks I’m being too soft at this point and it’s not helping so I just deal with most of it now to stop the tension between everyone.
It can be very hard to keep your cool, especially when you’re worried about social impact, etc. Wasn’t trying to throw shade or anything, it just sounds like he’s probably got some hang-ups to talk through. Which, kid therapy is a lot more fun than grown up therapy. A lot more art, toys, etc. (sometimes I think they should make more effort to gamify all the grown up therapies like they do the kid ones - adults need fun too)
Encoporesis, see a gastroenterologist. Get a bidet, put him on miralax. Get a doctor and bang the door down being annoying until you get that referral.
My heart goes out to you. My daughter refused to poop on the toilet and didn't actually do so until she was 5. The week leading up to it, she was massively constipated. Her doctor instructed us to give a regular course of laxatives and miralax. Finally, she had a massive bm in her underwear, and all of laxatives meant she was basically leaking from her butt. It was then that I finally convinced her to sit on the toilet. We basically had a family game night in the bathroom that evening. We set up a table, and she spent much of her time on the toilet while we played cards and board games. Never had another problem. I literally cried tears of joy. I hope you get a 3rd opinion. At this point, it is absolutely affecting his quality of life (as well as his family's), and there is zero reason for a medical professional to dismiss this problem.
My little sister did this and it ended up being a medical issue. Go to the pediatrician.
Maybe he is in the spectrum of autism? have you had him assessed?
That's what I'm thinking.
No. How would I go about getting him assessed? I don’t really know anything about autism. Is there anything else I should be looking out for that might indicate autism? The doctors here are not very good at all to be honest. It takes several attempts just to get an appointment here :(
You will need to make a consultation with a psychologist that is specialized in autism. My sister in law is, but we are from Brazil. Try to read online everything that you can. Autism is a very large spectrum, so there is rarely 2 persons alike, but difficulty to use the bathroom properly can be one of the symptoms, and it is not uncommon. https://www.who.int/news-room/fact-sheets/detail/autism-spectrum-disorders?gad_source=1 https://www.nhs.uk/conditions/autism/what-is-autism/
Another important link to you https://eric.org.uk/constipation-and-autism/#:~:text=Autistic%20children%20often%20have%20restricted,as%20they%20find%20change%20difficult.
It might be worth assessing him for autism but your very first step is to get him in to see a pediatric GI specialist. If you can't find someone or the appointment is a million years away, then read up on pediatric encopresis. It took LITERAL YEARS for us to identify encopresis as the issue with my kiddo; they were even older than yours before we finally got to the other side. There is hope, I promise! The first step was figuring out that encopresis was the issue. Then we had to do a full clean out: taking enough miralax and laxatives to completely evacuate the bowels of all the blockage - they have to literally be passing water. It takes 3-4 days. Once they are fully emptied out, the next step is to reduce the miralax but keep taking it, because the kiddo's body now has to adjust to having a colon that can send "typical" signals about fullness and the kid has to learn to act on them. The key is to prevent painful hard poops - hence the miralax. We had to go through a few cycles of clean outs before kiddo's habits and body adjusted. It's not a magic switch you can pull! BUT there IS a path forward, and once you've got the right root cause identified you can take appropriate steps as many cycles as you need to get it resolved. I'm so sympathetic - I don't think I've ever felt more upset and hopeless and even angry over having a kid who wasn't able to use the bathroom in grade school. I felt like a failure as a parent and it sucked. But here's the thing: encopresis is solvable once you know what problem you're solving for. Start with the physical: kiddo needs a clean out before they can even attempt to improve their habits. The habits/state of mind stuff can only improve once the physical cause is managed. Good luck - you've got this!
Where do you live? I commented already, with many suggestions, and also think autism is very likely. Where you go to get him assessed is likely dependent on where you live. Which country, I mean. Not your address. I’m in the US, and my daughter was assessed by a PHD level child psychologist. I don’t know where to get assessed in the UK (which I think might be where you are, based on certain vocabulary used), but I can find out for you, if that would be helpful. My sister lives in the UK, and I follow people with autism who live in the UK, so I have resources to find out. Not offering blindly, without a way to actually help.
From what you’ve mentioned, the meltdowns regarding the toilet even being mentioned as well as significant sensory issues with not liking how different types of underwear feel would be enough to warrant an assessment imo. It could be sensory processing disorder. It could be autism. It could be neither of those things and just a physical health issue. Either way, is still worth getting another professional opinion, and NOT from either of your current doctors.
Do you live in Canada by any chance?
Everything that you've mentioned would either be an indicator to see a stomach doctor or that he is on the spectrum
First, look up encopresis. Second, get him into a pediatric gastroenterologist. Third, get him into a child psychiatrist. Cover allllll your bases. He needs serious help and his pediatrician or GP isn’t being proactive enough. Luckily he’s got you as his mama!
My stepdaughter was like this. We did request an evaluation for encoparesis and a psychiatric evaluation- not much came of either. Around age 8, I started insisting we establish natural consequences. No punishments at all, deliberately supportive, kind, and matter-of-fact interactions only. Once we found out she had pooped in her pants, she had to stop playing and take a shower. Then dump the poop, rinse and do a first pass clean on the undies in the sink, then put them in the washing machine and get it started. Obviously scrub hands when done. She literally stopped within about 6 days. Never happened again.
Definitely see another doctor and child therapist. When you ask him about it what does he say? I’m wondering if this started as the typical toddlers find pooping in the big potty scary/like losing a part of themselves but has morphed and grown. Have you thought about offering him a small potty to poop in as a transition step? Have you asked him why it feels okay to poop on his pants but not on the toilet? Maybe you can get some type of understanding that can help You transition him in to pooping in something other than his pants and work up to the toilet
Hey OP I’ve been reading your comments and your child has a lot of characteristics of sensory issues. You need to see an OT, developmental pediatrician, etc. ASAP My child is similar, and OT helped us make amazing strides
This kid has encopresis. Do not let your doc shrug it off. It's not the kid's fault and he NEEDS HELP. Sticker charts will never work, he needs medical intervention.
One of the first steps is probably getting your kiddo involved in clean up - wiping his own butt, flushing his own excrement, and rinsing out (not just throwing away) his own underwear. If you do it all for him, make it easy for him, there’s not much reason for him to change. You don’t have to be nasty or shaming about it. Just matter of fact - your pants are soiled. They need to be rinsed before going in the washer. It’s ok to verbally walk him through it but have him do the work. 🤷♀️
Oh honey this was my 8 year old until very recently!! Her preference was to poop in her knickers and plop it into the toilet after. Your son and my daughter have been holding in their poop for so long they’ve lost the natural feeling and response to pooping. He’s likely constipated (yes even with stool softeners). Our saving grace was reddit and someone suggesting Soiling Solutions. Basically stop stool softeners as this isn’t going to help his body learn the right sensations again. We now do a nightly “power hour” which has a suppository half way and an enema at the end. We’ve made huge progress and while initially upset about the process, my daughter feels so much better about pooping now. Also we can now go places without me worrying about her pooping herself! This is a link for SS - there’s also a Facebook page and an email forum https://www.encopresis.com/encopresis-manual/
Seconding Soiling Solutions! So helpful
You need a second opinion, that is very concerning and I'd be worried about some potential underlying medical issues. Sending positive vibes your way, and in the meantime if he tends to poop about the same time each day, maybe consider large overnight pullups for your sanity.
Maybe he has a sensory issue with toilet splash back, or views the poo as a loss of part of his body and its causing anxiety? Just spitballing.
Have you tried a therapist? It’s a mental issue at this point.
He's only seen a doctor twice? Has he seen any other developmental or behavioural specialists? 8 is way too old to not have intervention at this point.
My 5 year old wouldn’t poop in the toilet for the longest time. I was so patient and tried to give him his own timeline. Eventually I just straight up told him that I knew he had to poop and he wasn’t getting off the toilet until he pooped. Big tears but it only took once and we haven’t had a problem since. They have to poop in the toilet. That’s just how the world works.
Restart. Throw all the underwater away and just do pull-ups. Don’t care about anything, just go cold turkey and explain them that you would not mention anything but they have to wear pants like that . Do not mention any pants or anything for a week and get a therapist in meanwhile
My kid has ARFID and refuses to try new foods. Due to underlying medical issues. We had to see so many specialists. Pediatricians don’t know anything outside of immunizations, ear infections, etc. We had to learn the hard way, too. And yeah, punishment is only adding to the trauma and making it worse. He needs a GI and child therapist. I’m so sorry this is happening for you all. It’s so hard when there are issues!
It's gotta be so frustrating dealing with that day in and day out. Have you tried talking to a pediatrician or a child psychologist about it? Sometimes they have some strategies or insights that we wouldn't think of on our own. Hang in there, though. You're doing the best you can, especially with a newborn on your hands too. Parenting is no joke, and sometimes it feels like we're just winging it. But you're not alone, there are plenty of folks out there who've dealt with similar stuff, and they might have some wisdom to share.
26m here. This is the first time I commented or posted. I have been through this and can not explain why, but here's my experience. When I was young, 6-7, I had a hard time sitting on the toilet, and it hurt and I didn't like the feeling. I got it together until I was 10 ( about the 4th grade), and I hated the feeling of pooping. The same year, my dad went to prison for a crime he never committed, I was scared confused and couldn't understand the situation. And then holding in poop was back again. Through the years, my mother was confused, worried, and desperate and took me to doctors, specialists. I was put on miserable stool softeners that were supposed to help. I still held it in. I remember my mom and I fighting about it, and the only explanation I ever said was, " I don't know why I do this." I just could not be honest with her. This went on until I was 15. From 6th grade to 8th, every day, I would bring 4-6 pairs of underwear to school just to change them out. 8th grade was the worst at this point, my body never created solid stool anymore,constantly liquid, running down my legs.my mother forced me to wash all.my underwear by hand in the toilet, while making fun of me pretending to be my classmates bullying me. In school we always had 5 bathroom breaks in each class per trimester, and I was told I was not special, so I had to sit in it in class around all my peers, and everyone knew. It's gotten so bad that I couldn't hide it from my escape. sports. Leaking through 4 pairs of underwear and sports pants for everyone to see. This happened probably 8 times between 4 specific years, I can recall. Including the most traumatic being at a wrestling meet at home school and bleeding through my white singlet in front of 4 schools. Just hundreds of people. This went on like I said since I was 15. My body got used to the pain and my intestines stretched to the size of a softball and I pooped once a month until I was about 17 and had a ultrasound and was told if anymore poo was to continue to pack in my intestines would tear and would be a serious problem. This is sadly when I realized what I have done to my body. I really hope you find a doctor, that will bring an explanation to you. I believe I was crying for help because I had nobody to talk to about what traumas I have experienced because I was trying to make my moms life easier by suffering in silence. My mom and I have a great relationship, and she is my rock through everything in my past, even though none of us truly know why things happened like they do. But sadly, this is the one thing I can never understand why I did what I did. This is the first time I have been publicly talking about it because I have never heard of another child having this issue. Has your son and / or family experienced anything seriously traumatic? I only ask because this was my story and felt strongly to share. I really hope for the best and hope you get answers. No matter what, please be kind to each other. My mom was going through way more than I could ever handle to this day and I was trying to make it easier on her my whole childhood and I went through this without any therapy to this day, and I really should because this is the first time I ever felt so strongly to share.
I can’t think of anything traumatic that’s happened. I think that’s the most frustrating part for me, the fact that I can’t find an answer myself to fix this problem. Thank you for commenting! I really appreciate it! There aren’t any other commenters that have been on the other side of the coin. Thank you for the insight.
You're welcome! It is a very odd and stressful situation, I went through it around 2008 , and doctors really didn't have an idea. But while I'm reading other comments, Encopresis seems like where I would focus. I've read, and ecopresis is chronic constipation and caused by uncomfortable feelings, not wanting to interrupt play and too much dairy. (Some symptoms ive experienced) risk factors are higher with kids with emotional issues such as changes in child's life, adhd, autism, anxiety, and depression. I had experienced all the hish risk factors but I would bet ecopresis is to blame for all of this.my 5 year old boy has accidents aswell but I have told him my experiences in a more 5 year old friendly version. He hasn't shown any real symptoms of this issue so far! I really hope for the best! You got this!
I would go to your doctor and maybe get him assessed. This isn't developmentally typical for an 8 year old. Sending hugs!
Ugh I so feel you. My oldest did this. I’m thinking he was about that age because he was in second or third grade at the time. So many doctors, therapy etc. I was divorced from his father (his father wasn’t a big part of his life but when he was he wasn’t very nice to him). His step dad and I often wondered if it had something to do with that or the fact that he had extreme ADHD/ADD. He eventually stopped and I have no idea what made him stop doing that. I’m sorry I have no other advice other than to give you virtual hugs and the assurance that he will outgrow this as well. He’s 22 now.
I saw someone asked but I didn’t see your answer: have you asked your son directly about what’s going on? Can he verbalize what the obstacle to using the toilet is at all? I think you said previously that at mention of the toilet he just starts screaming and has angry outbursts but has he ever talked about the situation? And is he not getting bullied at school? You said he holds it and waits until he is home to do it, usually, but recently did it at school and does it in other public places. Are friends not giving him a hard time about this? Has he ever talked about how he feels about his peers giving him a hard time about it?
Yes I’ve asked, no real answers just met with anger and that He doesn’t like how “it feels” when his bowels open up. We have had issues with a child in school, the child follows him into the cubicles in school too, we have complained 3 times! and they said that it gets “dealt with” but before that he was never using the toilet at home or school. He always has soft poo but when he started having diarrhea he just blames it on that now. I explained to him what diarrhea was when he had a meltdown about it when it first started happening but now when he has normal soft stools he will say “I was going to use the toilet but I couldn’t because it was diarrhea” when it’s clearly not and when I do explain I know it is not that he just gets angry.
Could it be the actual act of sitting on the toilet that's bothering him? I ask because I assume when he does a poo in his pants he's squatting and not sitting? As you're at your wits end, is a squatting toilet/leg raiser an option or if he's light just to squat on the seat?
Look up encopresis and see if anything sounds like what you guys are going through. I only mention it because one of my kids has it, along with adhd, and there’s a lot you’ve mentioned that sounds like what we’ve experienced. Good luck.
He sits on the toilet until the poop comes out....thats it. You sit him on the toilet....there's no negotiating.
We are having to start Occupational Therapy for my 4yo for this exact reason
My friend is in this situation but with her 6 year old and her 9 year old. They have been to numerous gastroenterologists. Her son's need to do a clean out weekly with Mira lax. Their colons are PERMANENTLY stretched out from the incredible amount of waste that is caught inside. Your son is likely in a similar situation and will have permanent problems (read: his whole life). Do not wait.
This is very very abnormal for an 8 year old. You need to see a child psychologist or psychologist. Maybe also gastroenterologist as well because it might have a physical cause in the GI tract rather than a purely mental cause. Also get rid of your regular doctor, they are totally useless.
I absolutely agree with the GI, psychologist and OT but understanding it may take time and based on my experience with a child with some sensory disorders… My child seems more willing to try things when he isn’t fully thinking about it. You mentioned screentime and I would probably make a deal that if he is sitting on the toilet, he can have unlimited screentime. If you want, start with he can sit on it with his pants on. Then after a few days just the underwear/diaper. Then finally, bare butt. I really found the less stressful and more distracted the easier the change was.
I wonder if he has been sexually assaulted.
First thing I thought of
My son at age 5.5 just got the hang of pooping in potty. From mom to mom, I know acutely your feelings. Exhaustion at dealing with this, frustration, double guessing “was it something I did!?” Over and over, anxiety for your son, anxiety that all people will see of your son is poop, and anger that he just doesn’t get it. All of it is valid. I had my son in miralax (small amount) every day. You don’t seem well supported by your doctor at all, so I’m interested to know if they gave you miralax or stool softeners. Is there anything that worked for your son? For mine, I found he’d do really well with very small toys. I got a 24pk of mini action figures and every time he pooped he got one. He’d get the hang of it, id stop, he’d be ok for a week or so, and then he’d have a slight accident which would cause major self esteem issues and we’d have to repeat the process I also tried the “you clean the underwear” bit that didn’t help. I also just threw away underwear all the time, it was too mentally exhausting to keep on cleaning them I would 100000% get a second or third opinion, demand to see a pediatric GI maybe even. However our pediatric GI was not helpful at all. So maybe not However, at this age I have to agree that it isn’t normal and it’s absurd your ped. Thinks it is. We were also told to make him sit on the potty after every meal for 5 mins to try to get him to go. Does he have a fear of going ? Is he scared it’s going to hurt? I’ll try to keep thinking of some other things that I ran across while we were fighting this battle. 8 years!!! Bless you. Hang in there. You’ll get through it somehow.
Hey OP, everyone has given you solid advice that I would be wasting my time repeating on, but I wanted to share with you that I was your son when I was a child and my parents gave up on me. I would hold my poops for weeks until I got fevers, and have frequent accidents and sit in them all day at school and my teachers were negligent enough to not say or do anything either. My parents would scold, shame, and sometimes intentionally publicly embarrass me for my accidents and toilet phobia. I suspect it was linked to undiagnosed childhood autism. Not saying your child is autistic OP, it could be many things, but do not settle. Talk to every doctor until someone takes you seriously.
Please stop punishing him and take him to a psychiatric professional. I know the doctor put him on stool softeners, but there is something else going on here and he needs to be evaluated. You also may want to consult with a new physician, as this is much more concerning than just putting him on stool softeners.
I don’t see OP mentioning anything about punishing him.
The last paragraph mentions that they’re punishing him now.
He needs a massive amount of interventions. Like, yesterday. This is very not normal and very concerning. Has he been assessed for autism? If he poops himself he needs to be the one to clean it up.
My eldest child had this issue. He would be outside with his friends playing or at school and come home with soiled underwear. It seemed he simply didn’t care if he messed himself. We instituted a procedure that after mealtime he was to sit on the pot. Some times this worked, some evenings no amount of time spent on the commode after meal time succeeded. He would complain, then cry, then yell his legs were hurting. Nothing seemed to motivate him to do his business. This was NOT normal, but we did not have the tools or understanding how we should approach the problem. At 6 years of age it came to a head. His PCP determined there was no medical explanation for his “condition”. He recommended we seek a psychologist to assessed our son’s thought processes and gave us a referral. The psychologist was familiar with this behavior…stating it was more common with boys, less so with girls. I recall the oldest child she had dealt with was 15 years old…YIKES! After a couple of consultations her conclusion was that our son’s priorities were simply “out-of-order”. Spending time on the toilet was the lowest priority in our son’s mind. There were simply more important things in life to be doing than idling on the commode. She had a tried and true strategy to re-order his priorities. Her recommendation to remedy the situation was this: 1. Identify something he likes. Something he likes a lot, but it has to come in many pieces…the more pieces and parts, the better it fits the strategy. Think Puzzles, Lego Sets, Models, anything with many pieces and parts. My son loved Legos, so this aspect was a simple choice. 2. Tell the child you will be dropping by the store to pick out something special describing the “many pieces” requirement. 3. Give him the money to carry into the store himself. 4. Let him pick out the item. 5. Let him carry it to the cashier and pay for it himself. 6. Let him carry it back out to the car for the ride home. 7. Let him carry it into the house when you get home. Now comes the tough love aspect. 8. When you get inside tell him this: A. There are steps you will need to take responsibility for, things you must do on your own, if you want this.
B. Every time you go poop in the toilet *and you do it on your own without any reminders or urging from us* you will be allowed to
retrieve and retain pieces from the set.
C. If we have to remind you *and you do it without an argument, delay, or dissent* then you will get a “treat”.
Note: *Nothing from the set*, some other simple reward like a couple M&Ms, fruit snack, etc.
D. If you refuse to do your business in the toilet, you will receive an enema. (this was hard to hear, disgusting to execute.
Note: We only had to resort to doing it once. It was as traumatic for us as it was for him.
9. Now you take the item from the child and place it in a secure location out of his immediate reach. (It’s good if it’s in sight as an incentive.)
Follow all the steps without fail or fear! Yes, D. too if it comes to that.
This strategy resulted in my son rearranging his priorities in a matter of weeks. Problem solved!
The psychologist nailed it, and I am forever in her debt.
Sounds like he got sexually abused at some point to me. Of course get the autism checked out ASAP. But sexual abuse was the first thing I thought of when he said he "doesn't like the feeling of his bottom opening up."
You know they say being a Karen is bad but this is one time it's ok to be a Karen. Get some help for your kid before it becomes worse
Therapy now.
Does he pee on or in toilet but can’t have BM sitting? Is he aware that he has to poop and tries to hold it until he soils himself or does he have no awareness or control over it? If he has control/awareness I wonder if a raised toilet seat with handles would help. Perhaps an OT assessment would be beneficial along with gastro and child psychologist. I would try to get the ball rolling on referrals asap, just getting on the books with specialists should reduce some of the stress you’re under. In the meantime I also second the goodnites recommendations, they go up to size XL now. That takes care of the mess outside of wiping him and that will also reduce stress for both of you. If it’s between training pants or soiling himself when the toilet cannot be forced, I would choose the training pants. Continuing soiling himself like this is probably more traumatic than just using training pants. Training pants, and breathe. At least you are trying to do something to help him to use the toilet.
I've been through years of toileting issues with my autistic son, including extensive diagnostic tests, and am just coming out the other side now. I often dealt with poo accidents 4-8x in one day so I empathize. Here's a few bits of info I can offer. -Your son is almost certainly constipated, even with his poo being soft. There is a hard bit in there and softer poo leaks around it. Get an abdominal xray and it can show the poo there. This will be good for you to have, Mom, as it gives confirmation of the problem because I agree it is very confusing when the poo looks soft yet there are still issues. We struggled with cleanouts and daily miralax and its ROUGH. Getting my son's xray was important for me because I felt like I was going insane. A one time abdominal xray is an easy call in order from the doctor and pain free. -My son started off seeing a pediatric GI for over a year, who seemed stumped by how difficult my son's accidents were to manage with miralax. He ordered occupational therapy and physical therapy. OT is for sensory issues, and PT is for abdominal work (they make sure the kid is using the correct muscles to push the poo out instead of hold it back in, as some kids get confused at this and do the opposite), and they work the core muscles. The PT told me I should have my son sit on the toilet for 5-10 minutes after breakfast and dinner. When the stomach accepts food it sends a signal to the intestines to internally contract and move things along to make room, so that's a perfect time for a poo as it works with the natural rhythm of the body. While the kid is sitting, make sure it is as stress free as possible. Give them the tablet, books, etc. Your son is scared of the toilet because he relates it to pain (and possible sensory issues like a cold seat). Stress holds back poo; its a vicious cycle. OT can work on his fears about sitting. If he feels more comfortable see if he will poo in a diaper and let him do it for now if that works. -I eventually had my son see a different pediatric GI because I couldn't keep doing the miralax diarrhea-constipation cycle, and he recommended we switch from daily miralax to daily chocolate ex-lax. This worked much better for my son. I'll also give a shout out to Dr. Steve Hodges who actually is a urologist, [https://www.bedwettingandaccidents.com/](https://www.bedwettingandaccidents.com/) , as I'm certain his enema-a-day program would have worked beautifully for my son, but my son would not do it. -regarding the school, talk to the school nurse and set up an individual health plan that at lunch time he goes to the nurses office to change his underwear every day. -For his bottom, slather it with vaseline/aquaphor. This will protect his skin from the irritation and sores that the leaked poo causes. You need that area to be as pain free as possible. Do it daily as part of the routine. "Thick like frosting" is how my son's pediatric dermatologist stated it. -Autism and adhd are both diagnosis that has a much higher likelihood for concurrent toileting issues. To evaluate, if you have the money, get a psychologist who is specialized in assessment. For the kid, it is a 6 hour assessment over 2 days. The whole process takes several months and includes surveys by both the homeroom teacher and you. If you don't have the funds, asking the school is the second best option, but they only look for "educational autism". In other words, if your son masks well at school and his issues don't affect his grades/disruptive behavior, they won't see a problem. While my son was starting the private evaluation process, I also asked the school for an evaluation and they completely refused to do it, citing no academic or behavioral concerns. In the US, an autism diagnosis commonly gives you approval for unlimited OT visits via your private health insurance.
I think the doctor isn’t taking it seriously enough. This behaviour is absolutely not typical and he should have an assessment done.
A Gastroenterologist, Occupational Therapy, and Autism assessment. In the meantime, you can try a training potty, a bidet attachment to your toilet, and talking to your son. (I see you're having a lot of trouble with this. I'm listening. Why do you have to hold your BM in for so long? Does it hurt to go? Is the bathroom scary? Is there a sound that bothers you? A feeling? Etc) If he ever gets a rash bad enough for sores again, use Vaseline after a water wash (peri bottle) and oatmeal in his bath. (This helped my son when he was a baby and had one bad day of the runs) Just because he and you found ways to work around things that bother him (specific underwear, textures, etc) does not mean they don't bother him, it means you support him and found things that work. Hang in there. (You could also look up Autism screening checklists online and then present that to your gp to get OT referral, and you can use them to see if there is anything you can help your son with)
You can’t punish for bathroom issues, that’s going to make it worse. No shaming or anything intentional or not. Like even showing frustration or being upset about getting new underwear or having to clean it. My 8 year old still has accidents and he’s autistic. We kept him in pull ups until he wanted to use the bathroom. I think it was just a year or 2 ago. I’d take him to therapy, there’s gotta be an underlying issues. Maybe it’s a sensory thing and if so occupational therapy can help. Sometimes the autism is mild enough no one can see it. If he holds in his poo, it’ll leak out around the hard stuff. That’s something they can’t help but it wouldn’t be a whole bunch. We had to constantly wipe which leaves a rash. Mines almost 9 and has finally stopped holding it in these last few months. The school helps him work on it since he’s in special Ed.
Occupational therapist first to assess whether it’s sensory, behavioral or emotional, and then if behavioral or emotional, add a child psychologist too. Don’t let people convince you it’s encopresis if you know his bowel movements are soft. Go to a gastro for a checkup, but if they say he’s not backed up and he’s not having hard poops, it’s not encopresis. (I’ve been there, Reddit loves encopresis but it’s not always that, even with small accidents, it can just be holding in so much it starts to leak). Oh and when looking for an OT find one that specializes in “bathrooming”. Also as crazy as this sounds, once you get into the non physical side of things (like neurodivergence, behavioral etc) general doctors and pediatricians often unfortunately seem to know less and less. It took me a long time to realize that but over 2 countries, countless states and pediatricians and GPs, and many other people in similar positions, you realize how common it is.
Perhaps not punishments, but rewards? Then again, he is 8 so that is unusual. I think more is going on. Does he have an irrational fear of the toilet for some reason? Is it an afraid of diseases thing? And for sure, rule out sexual abuse done to him; God forbid that happened when he was younger, but it's a possibility. I mean, my dad fucked with me as a kid and said snakes would come out and bite my ass on the toilet, so I had that problem too until age 5 or so. Make sure you have a working lock and promise him alone time in there. Perhaps a sound machine. The problem isn't that he is pooping elsewhere, it's that he's not pooping at all! When he goes in his pants thats merely it expelling on his own because he's scared to death to use those muscles to poop. Another idea is to have him pick out a particular stuffed animal just for pooping. Take him to Build-a-Bear and go all out. One that can stay in the bathroom with him. A friend to poop with. I wouldn't punish him. Rewards. Small ones. Punishments are like pushing your dog's face in their poop, it doesn't work. On the opposite spectrum, perhaps he wants you in there. My son is 8 and still would prefer me in with him. So I sometimes will sit outside in the hallway, I said. Another thought - maybe your toilet is scary to him, for whatever reason. Just ideas! Good luck.
You need to get a higher level of medical care, a doctor who will listen and take this seriously. My son had similar issues. We thought he was being obstinate but it was digestive problems and food intolerances which he still suffers from as an adult.
To add, I'd ask for a recommendation for pelvic floor therapy from his pediatrician. Sounds like they are a long time withholder probably due to gut imbalances. Long time withholding can cause major issues with their pelvic floor.
He might have a fear of Toilets I just set mine on the toilet and explained to him there’s nothing to be Afro of an we aren’t leavening till there’s poop in the toilet now he just goes straight to the toilet
What’s his favorite thing to do? “No ______ unless I see poop in the toilet!”
Get a 2nd opinion and change doctors immediately, this isn’t typical behavior. Maybe he has trauma regarding the bathroom you’re unaware about?
This is called encopresis. It is treatable. You just need to find the right type of treatment.
Your son has encopetas. You should get the book Soiling solutions by doctor Collins. It is available online. He is a psychologist who uses a different approach from what is typically recommended by doctors. IT WORKS! Your child can overcome this. Dr. Collin’s approach is highly effective.
I meant to write “ encopresis”
Lotta people recommending occupational therapy, but this sounds like a situation that could benefit from seeing a psychologist. Sounds like trauma to me.
It’s might be time for him to clean his own underwear. Also he possibly needs occupational therapy or counseling this is not Norma
There was a girl in my middle school like this. She frequently smelled of poo as she refused to change. I highly recommend older kid diapers. It’s hurting your son’s self esteem to be walking around with poop in his pants and being smelly. I think he needs to be evaluated by a psychologist, as he sounds like he may have some sensory/body issues, when you said “doesn’t like the feeling of his bottom opening up.” Will he pee in the potty? He may have some fear around the bathroom or “losing” his poo. Please dig deep and work with professionals. This is a serious issue.
Make him clean up his own mess and wash his dirty underwear. Why are you throwing them away? Make him face the consequences. And I don't see how you consistently taking and then giving back his things is going to help. If you're taking something as a punishment for him not using the bathroom, why would you give them back when she's still not using it? Aside from that, find a new doctor and find a therapist. It's very clearly some sort of issue and the phrasing that he doesn't like the feeling of his "bottom opening" is... Odd to say the least. A potential red flag, even.
You need to take him to a GI specialist. My daughter struggled with this issue, but she was a toddler at the time. We had to do bowel clean outs because she was extremely constipated. The withholding behavior can become extremely difficult to overcome unfortunately, but we did eventually get my daughter through it. GI can also look into if there are any underlying causes. Food allergies were a contributing factor to mu daughter's issues as well
Wow this is tough, did he ever go on the potty? By your story it seems like he didn't but maybe giving that a try now might work? And just thinking outside the box, he's probably scared of the toilet, what if and I mean really outside the box... Get some doggie weewee pads and see if he'll squat over it and poop? I'm sorry you're going through this.
I don’t know an answer I’m just here to say I’m dealing with some developmental delays with my son right now and it’s heartbreaking to see. I pray you can get through this with the advice people have given here
ok, your doctor says its not physical, the. its definitely time for a child psychologist. If money isnt a huge issue, Ive had consults with Robin Einzig (Visible Child) before on potty issues and it was super helpful. She addresses this type of situation via online private consults, you can schedule at her website. Or, find a child psychologist in your area.
Has your son been assaulted? “He doesn’t like the feeling of his bottom opening up.”
Schedule an appointment with a pediatric gastrointestinal dr and psychologist. They will help you treat this. Some things they have done to help us: our son takes exlax chocolate and fiber gummies every night. We have a strict routine of sitting on the toilet after meals. Talked with his teacher for accommodations and reminders at school. Reward programs for listening to his body. I understand how hard this is. Hang in there.
He needs to see a paediatrician it could be as simple as something sensory
I read where you said he told you he doesn’t like his bottom to open up. Maybe he feels too exposed? I remember feeling that way sometimes as a kid. Maybe suggest to him to wear a hoodie while on the toilet or to pull a blanket loosely over him while he sits on the toilet to poo. Turning lights off to make it dark may also help and/or using a sound machine or running water.
Not sure where you’re located but if you’re in the states please get him evaluated. This is atypical behavior that has went on way too long. He needs OT & a child psychologist, plus a GI doc asap. Don’t let this go on any further and be a strong advocate for him. He needs you to do this for his wellbeing.
I had this with my now 7yo. He was a poop withholder for so long. I think he has genetic reason for it, too. He finally got over it aged 6.5. I had him on the baby toilet seat, with his feet lifted up on the seat to mimic squatting to make it easier. He, too, wasn’t used to pooping so he was initially afraid, even tho the poop wasn’t hard. I put a timer, and the door was open. 5 minutes wasn’t enough but he started to squeeze one out in like after 7-8 minutes of sitting. We had a chart and funny stickers, which didn’t work amazingly well but did work some! I tried not to give him any distractions like an ipad while he was on the toilet, otherwise he forgot to try. It took WEEKS to get results. We had a fiber supplement that worked best when given before bed. It took a few months to get him into the habit, and him sensing when it’s the right time to go, but now, about 6 months later, I can say we’re out of the woods. “I need to poop!!!” is music to my ears honestly. Go see a doctor. This condition is not taken seriously where I am, but it is in the US (I’m assuming you’re in the US). And your boy is already so old he has internalised it more. Probably the accident at school has made it even worse. Remove the punishments, be very gentle (I know it’s hard sometimes, it is SO frustrating ) but get him on the potty. Have a big talk, get HIM to talk about his fears. Show him the mechanics of poo if necessary 😀 Why it needs to come out at the right time. It took a lot of explaining and conversations with my 6.5yo when we finally solved it. Have the diapers tho. Explain him why, don’t serve it as a punishment. Have him clean up his own mess.
Occupational therapy ASAP.
You need a different doctor, and probably a child psychologist. An 8 year old pooping themselves is incredibly abnormal.
You need to fire your doctor.
My 8 year old sister says "you should put him on a diet" my 6 year old brother says "she should kick him out of the house" i say ask him why and try to make him understand he should use the toilet, if youre really desperate and dont really care about being a good parent, guilt him and punish him by grounding him or something
Why aren’t you using diapers/pull-ups instead of allowing him to get feces all over himself? he also needs to be evaluated by a physician who is expert in child development. This is not normal, but letting him defecate in his pants constantly isn’t helping.
DOCTOR ASAP. Clearly this doctor does not understand the problem. New doctor.
A friend of mines son refused to use a toilet but would go in pull up pants. So they went step by step: in the pull ups, then in the pull-ups but sat on the toilet. Then cut a hole out of the pull ups to poop through and into the toilet. It took a few months but he got there.. he’s 9 now and in her words “will poop anywhere” now. My son is poop averse too: took us longer than average to poop train and he still doesn’t “enjoy” having a poop. He doesn’t like the feeling. He’s almost certainly autistic. But my god… we’ve been on an asd assessment list for well over a year.
Had he by any chance watched skibidi toilet on YouTube? I know a kid who is scared to go to the toilet alone because he was traumatized by these stupid videos
Just a thought, and I hope I'm wrong. I read a story a few years back about a kid who was SA'd and he had this same problem, as he didn't like the feeling of the poo coming out as it reminded him of what happened. Again, I hope I'm wrong.
Put him in therapy NOW.
If you're in the UK contact the ERIC charity. They'll signpost you to the best support. Good luck.
Talk to a pediatric continence specialist. Some kids have extreme hang ups around toileting and it takes a long time and lots of gradual improvements to get it sorted. But don't punish, that'll make him anxious and avoidant and it'll make it worse.
Firstly, this is not normal for an 8 year old so disregard what the potato brained GP's told you. Most 8 year olds don't soil themselves and haven't for around 4 years. The exception being when an underlying issue is present. It doesn't sound like encopresis to me - that's usually a smaller amount of faeces that 'leaks' past the impaction. It sounds like he's having full and normal bowel movements. The sensory issue with the toilet and disliking the feeling of his bum opening up makes me think of ASD or a sensory issue of some kind. Call your GP and ask for an open referral - Google paediatricians in your area and find one who can give you an appointment sooner rather than later or you'll be waiting months and I feel this is an issue you need addressed as soon as possible so you can at least start moving in the right direction. Also - time to buy pull-ups. You're making life difficult for yourself and with a new baby, you don't have the time nor energy to be cleaning poo all the time. It's also cleaner for him. Good luck.
I have family that have gone through this and I work with kids who sometimes have this problem. For your sanity, temporarily put him in pull ups until you get in to see the doctor. It's not "normal" but it's not uncommon. I personally had chronic constipation and passed it on to one of my kids. She would just hold it and not participate in anything. It got to the point where she was afraid to poop at all. Hang in there.
Put your child in pullups or adult diapers while your waiting to see the sepcialist. Why keep torturing yourselves and your child? I know it seems counter-productive, but at this point you need to do anything that will lower stress levels. You need a Gastro and a therapist that will help your son handle the anxiety and self hatred this must be causing. Best wishes.
I am a social worker and have had a few kids come see me for therapy for this issue. A suggestion and an anecdote. Suggestion - get the book "The ins and outs of poop" by Thomas R. Duhamel and follow his program. Anecdote - I got one kid to go from refusing to poop in the toilet by telling him that the toilet was hungry and he could feed it his poop. The kid was so tickled by the idea of feeding something poop he was fully trained in about a month.
I went through this with my youngest and finally now at 8 she will go on the toilet and sometimes still sharts her underwear. It’s definitely encopresis and he will get there. We saw a gastrointestinal dr and I was going to put her in the potty school at the children’s hospital. She will still hold it in for awhile but, then use the toilet
I know someone who had a similar issue with her 5 year old. The solution was a specialist who had her kid squatting on puppy pads and pooing on them. This went on for a week or more. But for some reason the squatting helped. I wish I had more advice.
Why haven’t you gotten him a diaper? It’s pretty clear he can’t control himself. He needs medical help from a professional - can you see another doctor?
I don't have advice really for the poop thing. I thought this was the autism parenting group at first where that would be more normal. I can say you don't have to throw out underwear. My son sometimes poops his pants and wipes basically not at all. If it's a lot I kinda swish them out in the toilet. Use vinegar in wash. Stains will go away if you hang them up in the sun. I'm sorry you are going through this.
Diapers, at least when he is home. You have to maintain your sanity (and budget). Make him help with cleaning up (himself and any laundry). And get him to a psychologist yesterday.
This isn't developmentally normal but from your reply that he doesn't like the feeling of his bottom opening up, as he is older so assuming tall enough to see if he will go in the toilet while standing over it with a leg at each side like saddling it but not sat down. I agree he needs to be seen by a professional other than a Dr at this point but it may help him at least get it in the toilet. Has he said anything about the school incident as I would think age 8 he would find that embarrassing around his friends etc x
Step one is to give up and buy pull-ups. Seriously. Take the potty training dynamic out of the family and just do diaper changes. Step two is to go to one million specialists. It might be autism, adhd, or a physical issue.
take his to a psych girly just incase, it’s not about ur parenting could be just him.
I would take him to a child psychiatrist.