Sneaky Poo

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Pooing in their night nappies or night wear, is another sign of stool withholding. Once your child relaxes in bed, they can no longer hold and the poo escapes. We don’t normally poo the night because our bowel isn’t being stimulated by food and drink. Passing a bigger than normal poo (known as a mega poo) can make a small tear in a child’s bottom called an anal fissure. This can make pooing very painful and something they want to avoid doing again. Sudden onset of soiling after a long period of being reliably clean, with no evidence of illness, is likely to be due to psychological stress. White, M. (1989). Pseudo-encopresis: From avalanche to victory, from vicious to virtuous cycles. In Selected Papers. Adelaide Australia: Dulwich Centre Publications. (pp. 115-124). Original work published in 1984, Family Systems Medicine, 2(2).

It's really important to remember that children don’t soil or withhold on purpose or to be naughty. Treatment for this group is difficult, because any attempt to put pressure on them to use the toilet is likely to result in a stand-off. They may refuse to go, sometimes for days, which results in constipation with all the extra drama and unpleasantness which this brings, together with the risk of a painful motion which then makes the original problem worse.Babies' bowel movements change as they go from new-born to the weaning stage (eating solid food) and beyond. The type and amount of poo they pass can also be affected by the sort of milk they are given (breast or formula). The JSESSIONID cookie is used by New Relic to store a session identifier so that New Relic can monitor session counts for an application. Freeman, J. C., & Lobovits, D. H. (1993). The turtle with wings. In S. Friedman (Ed.), The new language of change: Constructive collaboration in psychotherapy. (pp. 188-225). New York: Guilford.

Faecal Incontinence is the medical term for soiling in children over the age of 4. In many cases, it develops as a result of long-standing constipation (Proctor and Loader, 2003). It is estimated that constipation occurs in up to 10 percent of children (Leung et al, 1996).

Causes of bowel problems

The bowels play an important role in maintaining your child’s general health from birth. Poo can tell us a lot about our body such as are we drinking enough and eating enough fibre. Maintaining a regular toileting routine is important. Encourage the child to sit on the toilet 15-20 minutes after breakfast, lunch and dinner when the gastro-colic reflex is active. Allow enough time for children who attend childcare or school to sit on the toilet before you leave home. Praise/reward the act of sitting on the toilet rather than just results. Seek professional help: If there appears to be no progress, seek advice from your health visitor or Community learning disability team if necessary

White, M. (1986). Negative explanation, restraint and double description: A template for family therapy. Family Process, 25(2), 169-184. As therapists, we have been especially trained in the use of words. But practicing the language of externalizing conversations is for us, as for many others, not so much about learning a technique as about developing a particular way of seeing things. As Roth and Epston (1996a, p. 149) write:A change in routine such as potty training, starting school and feeling anxious about doing a poo away from home can make it hard to relax and do a poo. Epston, D. & White, M. (1992). Experience, contradiction, narrative, and imagination: Selected papers of David Epston & Michael White, 1989-1991. Adelaide, Australia: Dulwich Centre Publications.