We started Charlie’s potty training in June and it went so, so well… at first. He was pretty much immediately pee trained, but after some initial successes with poop training… things fell apart. He began begging for a diaper every time he had to go. Then he would hide under the table to go, where he would proceed to grunt and poop in obvious pain.
We knew this behavior was probably due to his constipation, so we completely revamped his diet. Even after we addressed his constipation though, we weren’t able to fix his poop training. He continued to hold his poop all day at daycare, and when he came home he would beg for a diaper again (usually right after his bath, argh!).
That’s when we were lucky enough to discover Tom DuHamel, PhD, AKA Dr. Tom. He’s a clinical child psychologist who used to be the Chief Psychologist at Seattle Children’s Hospital; he’s been working with sufferers of childhood constipation for 30 years, and just wrote a book called, The Ins And Outs Of Poop.
Well, Dr. Tom’s book described Charlie’s symptoms to a tee, and suggested he might have something called, “functional constipation” (as opposed to the more common, “occasional constipation” that we all know about). The book recommended a six-step program that should help him recover (more on that later) – which hopefully means we can avoid the advanced symptom of “encopresis,” which is a fancy word for having pooping accidents in your pants.
I always thought of constipation as painful, but not that big of a deal. I didn’t realize that 20% of kids who suffer occasional constipation develop functional constipation like Charlie. Essentially, functional constipation is a phobia of pooping on the toilet. In Charlie’s case, like many kids, his phobia developed because of the pain of the occasional constipation he had developed earlier. I realize now that I was really ignorant about the potential long-term effects of constipation. I thought it was just about not pooping for a while, and know a lot of people who have wrestled with that their whole lives. I didn’t realize that it could blossom into a full-blown phobia and that that could result in our child withholding poop… which could then lead to years of suffering from the physical problems of an overfilled and stretched rectum.
Withholding causes stool to be retained in the rectum, stretching it.
(The Ins And Outs Of Poop)
Since reading Dr. Tom’s book, my eyes have been opened. I was so impressed that I asked him to join us for an interview so that we could spread awareness of this issue so that hopefully others could avoid Charlie’s suffering. He agreed, and we’ve now published our first ever Hellobee Interview! If you’re interested, I’ve put a PDF on the full interview which you can get here.
After talking to Dr. Tom, I pulled together this list of ways that you can spot a childhood sufferer of functional constipation. (Charlie exhibited almost all of these signs.)
* Only poops in diaper, even though they’re potty trained for pee. Often begs for a diaper.
* Hides to poop, and strains a lot too (grunts while pooping, while arms shake).
* Refuses to sit on a potty or toilet to poop, even if you offer a huge reward.
* Refuses to admit that they have to poop, until after they go. Then will tell you they pooped after the fact.
* May poop on potty, but has regular poop “accidents” in underwear
* Never poops at daycare, holds it until is at home.
* Poops hard pellets that are dark in color on a regular basis.
If your child exhibits any of these signs, I very much recommend you do two things:
1) Check out Dr. Tom’s website about his book, at The Ins And Outs Of Poop.com
2) Get a copy of the PDF of our interview with him! Just input your email below and we will send you a PDF of the interview.
We’re also pulling together a longer free course on childhood constipation, and will send that to you when it’s ready.
If your child is suffering from occasional bouts of “normal” constipation, please take it seriously! Charlie suffers every single day, and it kills me that I could have done more to prevent him from developing this phobia of pooping (and its related physical problems, aka Functional Constipation). More on what you as a parent can do to spot and treat occasional constipation in my next post.
Has anyone else had their LO struggle with these problems? How concerned do you get when your LO is constipated?
ed note: The information on this site is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment, and is for education purposes only. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
Constipation part 2 of 6
1. Toddler Constipation Remedies by Checklists2. The Ins And Outs of Poop, Part 1 by Mr. Bee
3. The Ins and Outs of Poop, Part 2: the 7 types of poop by Mr. Bee
4. Ask Dr. Tom: My child gets constipated when we travel (or even when we go to church) by Mr. Bee
5. Treating Constipation with Dietary Changes by Mrs. Bee
6. A Children's Book To Prep Your Kids For Potty Training, and Help With Childhood Constipation by Mr. Bee
honeydew / 7444 posts
Great post! Did i miss the link to the interview though?
While i know people say it’s normal for babies to go a few days without having a bowel movement, my i share my ped’s belief that it should be once a day to be healthy. I prefer to get things moving after a couple of days than to wait a week or two.
I hope things get better for Charlie!
admin / wonderful grape / 20724 posts
@caffeinated: Here’s the link to the interview!
http://www.hellobee.com/childhood-constipation/
squash / 13199 posts
Thanks for this post!
coffee bean / 41 posts
I am so interested in this! My 8 month old already doesn’t want to go poop. I don’t know that my doctor’s office wants to take it seriously because they say “she’s too young to exhibit that behavior” but she DOES! Ugh, I don’t know if the book speaks to kids that young or not, but I am desperate!
admin / wonderful grape / 20724 posts
@MintedLife: This will be the subject of the next post in our blog series!
pomegranate / 3503 posts
Look forward to future installments, especially for younger, pre potty trained toddlers.
coffee bean / 41 posts
@mrbee: Oh good! Thanks so much for letting me know!
nectarine / 2217 posts
Our LO is fairly regular at 5-6 times a week, but consistently will not poop if it has been a day with some stress in it — even something as simple as going out for a few hours. On a recent trip (2 hr flight to SF) he didn’t poop the whole 4 days we were gone! I don’t want it to become a habit of not pooping when the schedule is ‘off’. He is 5 months. Thank you so much for the awesome articles and information you guys provide on hellobee!!
admin / wonderful grape / 20724 posts
@MintedLife: Oh I forgot to answer your question about the book… it has a whole chapter on how to treat occasional constipation. Chapter 5: Speeding Up The Poop Assembly Line: Treating Occasional Constipation. It’s really great! A lot of the recommendations are all-natural, and would apply to an 8-month-old.
You can see the full table of contents here:
http://www.amazon.com/The-Ins-Outs-Poop-Constipation/dp/0985496916/
I can’t recommend the book enough… if you don’t like it, I’ll refund your money personally!
guest
This is so timely. My 26 month old does not poop at daycare. He has begun pooping only in the middle of the night. He is fully awake and grunting/crying through the whole thing. He is so traumatized he has a hard time going back to sleep. His poop is so hard
He does go 5 times a week.
I need to get this book!
blogger / pomegranate / 3300 posts
My pediatrician just reccomended this book to me yesterday. My oldest has been on miralax for a year. Every time I try to wean him off it’s a disaster. He has the phobia of pooping and it kills me. Even in miralax he can hold his poop for days then he screams, runs around and clenches his bottom until he can’t hold it any more. I feel so bad for him. He is about to be four and doesn’t poop in the toilet.
admin / wonderful grape / 20724 posts
@tysonja: It’s very common for children not to poop while traveling! Food schedules, lots of liquids and exercise all are important for pooping… so when food schedules are off + kids are dehydrated + they also sit all day long, this is not good for their pooping.
It can be tough for kids to drink lots of water when they’re in a car or plane. If you’re on a plane, maybe schedule regular walks up and down the aisle to the airplane bathroom to go potty? That will help your LO get some exercise and also allow them to drink a lot of water. That plus roughly sticking to your food schedule should help.
I will ask Dr. Tom to answer your question with his thoughts… he is going to start guest blogging on Hellobee.
He has 30 years of knowledge about childhood constipation! Which is 30 years more than I have…
nectarine / 2217 posts
@mrbee: thanks so much mr. bee! looking forward to it! seems like everyone can benefit from learning more about this — whether for treatment or prevention :).
persimmon / 1255 posts
LO has been regular since birth but I’d still be interested in how to prevent constipation. Great post!
pear / 1554 posts
Looking forward to your next post. My LO is 10 months old and for the past month, she’s been so constipated. We can totally tell when she’s trying to poop because she will stand and strain and cry. She used to be very regular, at least once a day but now she only goes once every 2 or 3 days and it is definitely painful for her.
nectarine / 2242 posts
Is it possible to get a copy of the PDF still? It says it’s not active and I know this post is very old, but I’m pretty sure my daughter has encopresis so I’d really love to read it!