Hellobee

This is a guest post by Hellobee hostess Bao.

We potty trained my daughter Ava at 28 months. We did the 3-day potty training method and it went great. She was day and night trained fully within a week, and she had no accidents for months on end.

She is now 33 months, and starting about 3-4 weeks ago she started peeing her pants just a little bit — enough to have to change her, but not enough for anyone else to notice if out in public. She didn’t have any issues at night, and always woke up dry. Then she started having poop accidents. I thought it was stubbornness or flat out boredom from sitting on the toilet. Then for a whole week, she didn’t poop in the toilet once, and had a few pee accidents here and there.

I didn’t try too much at first, other than offering her treats like a piece of candy as an incentive. Her accidents became very stressful and I felt like it was getting worse; I had to do something ASAP. Ava starts preschool in a couple of months and the kids have to be fully potty trained.

I mentioned Ava’s problem to Mr. Bee and he introduced me to Dr. Tom. (Ed’s note: Dr. Tom is 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.) I learned Dr. Tom had two books, a really cute (and pretty funny) book for kids and also, a book for parents.

* Ava absolutely loved the Softy the Poop book! She wanted to read it every time we went into the bathroom, and after a couple of days she had half of it memorized. She really started to understand the book and would talk about her own poop a lot more because of it. It’s a very easy to read book with colorful illustrations, so it really kept her interest.

* I read through “The Ins and Outs of Poop” in one sitting. It was a very easy read and was full of great information. After reading through his book I was excited to talk to him some more, and that’s when I set up a phone consult with him. 

T A L K I N G  T O  D R .  T O M 

Dr. Tom and I had our phone consultation just a few days later. He took his time talking to me and getting to know Ava and her history. He advised me to start giving her Miralax daily to get things moving, and to really up her fluid intake with whatever Ava would drink. I had several questions for him, which he was kind enough to answer for me (these answers aren’t quotes, just what I remember of our conversation):

Q. Ava is also having small pee accidents, is that related to the constipation at all?
A. Yes, it can be related to her bowels being so full they push on her bladder giving her that urge.

Q. Any idea why constipation can occur so suddenly?
A. Some kids have experience with painful bowel movements and will then hold it in fear of it hurting again.

Q. Ava isn’t a big drinker. What can I do to make sure she gets Miralax?
A. Give her anything she likes: milk, juice, even root beer! What’s most important is that she is getting adequate fluids.

At the end of the conversation, I felt very optimistic that his plan to help Ava with her constipation issues could work. After I got off the phone, we immediately started her on Miralax.

I’ll admit it wasn’t easy getting Ava to drink 4 oz of water with Miralax. She’s never been one to drink much… just tiny sips throughout the day, which is likely part of the constipation issue. We continued this dosage for a few days with no luck. Ava had small accidents in her pants but nothing close to a normal bowel movement. Dr. Tom then advised me to increase the amount of Miralax and in addition give an Ex-Lax. We had a very small BM on the toilet after that, but then nothing again for a few days other than small accidents.

E I G H T  D A Y S  L A T E R 

When we were approaching day 8 of no real BMs, I was really starting to worry. I had never dealt with such a bad case of constipation before, and thought for sure I would need to take her to the ER. I was giving Dr. Tom updates every few days over email and he calmly helped me cope with the anxiety I had with Ava’s lack of BMs.

He even took time out of his weekend to call with our next step, since it had been so many days. We were close to day 8 without any real BMs so he suggested more drastic measures: two doses of Miralax a day, Ex-Lax once a day and a suppository. Finally two days of that, she pooped when she was with my husband! (I had caught a cold from Aava and was laid up in bed.) My husband said he had to sit in there for 30 minutes. I don’t think I’ve ever been so excited about poop before; what a relief, for us all!  I am so glad we were able to dodge a trip to the ER by tweaking doses when needed.

Later that day, Ava came in to see me for a second and I said, “I’m so proud of you for pooping, great job! Do you feel better?” She responded with, “Yeah, I does. And it was a softy!!” Hahaha I couldn’t stop laughing; it definitely perked me up a bit.

After this, she continued to improve rapidly. She even took herself twice without telling me. Plus her tantrums have cut back dramatically lately, perhaps because her tummy was feeling better.

After this point I knew I had to keep up her fluids, continue with the Miralax, and change her diet a bit to include more high fiber foods. She’s continued to be accident-free since then, and I couldn’t be more grateful! She just got accepted into the afternoon preschool class for the fall, and she wouldn’t be allowed to attend if she was still having problems.

R E W A R D S

Through this whole process, it was amazing to me how long my daughter could hold it in. I could clearly see on her face she really needed to go. At first we offered her candy and treats. But over time, I found that Shopkins worked a little better than a treat because it was something new she could play with and actually keep. They weren’t available at my local Target, so I had to order them online.

Even before the Shopkins arrived in the mail, she would say, “Now I get a Shopkins!!” after every bowel movement. I think the Shopkins rewards really encouraged her to go and not hold it in!

P E E  A C C I D E N T S

I mentioned before that when Ava started poop accidents, she also started peeing her pants. Not always a lot, but several times a day and I was confused as to why since she hadn’t had any accidents since being potty trained. The pee accidents lasted a good 3-4 weeks. I wasn’t sure if it was related to her constipation, a potty training regression or something else.

At first she didn’t mention any pain/urgency when she peed. But in the last week, she started crying/whining when she had to go and there definitely was urgency. I finally took her to the doctor and it turned out she had a UTI. Luckily just a few days on medication, she has ben completely accident free, happy and feeling great!

Later I read online that her constipation may have led to her UTI:

Constipation can increase the chances of bladder infections in two ways. First, if stool gets stuck in the rectum, it inhibits the emptying of the bladder, which can cause some people to retain urine. Urine retention leads to stagnant urine, which is a breeding ground for microbial growth, which will lead to a bladder infection.

The other way that constipation can lead to bladder infections is if someone takes too many laxatives to treat the constipation, they can get diarrhea. Diarrhea stool can easily contaminate the perineal area, since the rectum is only a few inches from the urethra, the opening of the bladder.

Source: Caring.com

If your child is having pee accidents during constipation, you may want to see a doctor and ask about a potential UTI!

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I am so grateful to Dr. Tom. Without his guidance, I think Ava would still be struggling with constipation and I have no idea what we would be doing for preschool this fall. I am so glad we made it through this battle and Ava is so much happier now that she is pooping regularly and has a happy tummy!