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May 2013

April 2013

Real Poop Story - A 6 Yr-Old Who Will Only Poop in Pull-Ups

This month's Real Poop Story comes from a parent who requested a phone consultation with Dr. Tom.  Dr. Tom requests that parents email him a brief summary of their child's poop problem prior to their initial phone consultation. He also answers post-phone consultation questions by email and encourages parents to update him periodically about their child's progress. Here is one mother's initial email reprinted with her permission and with names changed for privacy.

Hi Dr. Tom,

Here is a brief potty history for my six year old son Kyle. He was toilet trained for pee shortly after his third birthday. He successfully pooped on the potty early on in toilet training but seemed alarmed by the experience. After one success he wanted to go back to his pull-up. Around his 4th birthday I began to more actively try to get Kyle to poop in the toilet. We tried all sorts of things he could do while sitting. He got to where he would sit for a good while but no poop would ever come out. He would always “lose the feeling”. If I got angry about his use of the pull-ups he just wouldn’t poop for days.

Around Kyle’s 5th birthday I tried outright bribery. He could earn small Legos if he sat on his potty chair and a large one if he pooped. It was during this time that it began to dawn on me that it wasn’t just unwillingness on his part. He could barely squeeze out the tiniest bit of poop and asked me desperately if what he produced would be enough.

After some online research I decided to try a step-wise approach. During this period I once tried to encourage him by saying that he should “just hop on the toilet and push, it’s no big deal.” He looked at me with tears in his eyes and said, “It is a big deal for me, I just can’t do it”. I was heart-broken and decided to consult my pediatrician. I thought perhaps a stool softener would help.

Our pediatrician felt a stool softener wasn’t warranted because Kyle does poop at least every other day when allowed the pull-up. She assured me that he would likely outgrow his habit as social pressure mounted with increasing age. She also suggested making him clean himself up but I thought that was unreasonable and never pursued it. It is almost a year since that visit and my confidence that Kyle’s pull-up problem will resolve on its own has declined. So here is where we are right now.

I am looking forward to talking with you.