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 51. Toddler Constipation Remedies by Checklists
2. 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