Almost 4.5 Yr Old Boy Digressing with Pooping His Pants and Doesn't Seem to Care

1. Put pullups on over his underwears so that there is no mess in his pants, but that he "feels it".
2. Stop punishing for it. He is not being naughty.
3. Find out if something is upsetting him lately.
4. Review his diet. Has it changed? Is he constipated, and then when he can finally go, it is backed up, so he just "lets it out" or is he having a bit of loose stool?
5. Don't make him feel embarassed.
6. Have a one on one meeting with the prek teacher. Ask for some help with this. She needs to help you out and start getting him to the bathroom more often.
7. Until this is remedied, I would not have him taking baths at friends' houses and what not. You do not want and should not make your friends deal with a 4 yo's toileting issues, in my opinion, sleepovers or almost sleepovers are for big kids. Not for little little ones.
8. I cannot stress enough - DO NOT PUNISH AT ALL FOR THIS. I think you will make the situation worse. He is already probably very upset. I have seen my daughters' friends have accidents in their pants and act like "they don't care". It is a defense mechanism. They DO care. they are mortified about it. Punishing will bring shame along with the embarrassment they already feel.

Good luck! Don't stress too hard, these things happen. Use the pull-ups so life is not made even harder!!!

Google "encopresis"--does that fit?
It might not be that he doesn't care--he might be unaware and if it IS encopresis, he can't help it. But it can be treated. Talk to your pediatrician. Good luck!

I had the SAME issue with my son. Honestly, what worked for me, despite my husband's griping, was to let my son decide. I told him I didn't mind cleaning him, but to let me put a pull up on him when he wanted to poop. I found that it was not an issue at school...he waited to poop until he got home. Only one accident at school. My theory was that he wanted to be my "baby" again, or felt like he needed mommy attention. So I didn't show any emotion...was just matter-of fact and let him choose. In truth, it lasted a couple of months, and I had to put up with some flack from family, but he ultimately worked it out himself. One day, he just up and went to the bathroom, came out and announced that he'd pooped on the potty. Big hugs, big celebration, and I constantly try to remind him that he'll always be my baby. Finally, I should add that I use a daily does of miralax to insure that pooping never hurts (there was one case of constipation before he regressed). My doc swears it is safe, and it keeps everything soft. Good luck!

Before this seeming regression, did your son have any difficult bowel movements or constipation? If so, he may have developed a condition called encopresis, in which stool collects in the bowel, stretching it out and causing local numbing. Fresh, soft stool squeezes past the blockage, but the child can't feel it happening. Be sure to ask his ped about this, just in case. Miralax is usually recommended to help the child get back on track if that's the problem, but it can take a long time.

I agree that your son could be completely appalled by this situation, but keeping a nonchalant demeanor as a coping mechanism. I've seen this happen with all sorts of events, including with a cousin who was house-sitting for us for 10 days and let my two parakeets starve to death. He didn't reveal until many years later how horrible he felt about it. At the time, he seemed not to care beyond a shrugged "sorry."

There's a website that lays out a very clear process for handling poop delays or regressions (assuming it's not a medical problem). I've never had to use it, but from all I have learned about kids and responsibility, it seems quite sound: http://www.rogerknapp.com/medical/pottytrainingrefusals.htm.

Wishing both of you luck!

You write, "We feel that he becomes so busy with circle time, playing, activiites that he does not want to miss out and then once he goes he is too embarrassed to tell any one."

The teacher needs to ask him at regular, timed intervals to go use the toilet. She should not wait for him to ask to go. It's clear he is getting too busy, as you note, and/or is not feeling the urge in time to make it, so she must step in and help you some here. Have a talk with her and tell her this is how you are handling it at home too -- don't wait for him to get to the toilet himself, have him go at regular intervals. Same when he visits the friend -- you need to tell the other parents what is going on and have them get him onto the toilet at intervals. (And no more baths or overnights until this stops. And instant removal to home if he messes his pants -- it is not their job to clean him up.)

He likely will resist some of this and insist "I don't have to go!" but all the adults in all the settings need to have the same response: "It's time to TRY. Playing stops until you try and sit long enough to really make it a good try." In other words, don't cave to "I don't need to go" and let him keep on playing.

Also, I would tell the teachers that if it happens at school, they should call you to pick him up immediately. Don't act like it's punishment but do go quickly, get him out and take him home for a clean-up (see below), explaining that it is not healthy or safe to have poop inside his pants, so whenever he has poop in his pants at school, he has to go home and not go back that day, so he can be safe and clean. The loss of the fun of being at school will impress on him that he needs to go when asked by the teacher. But again -- don't fuss at him, just ensure he knows that messed pants at school means instant removal for the whole day. And follow through and do that. The other kids should not be told why by the teacher. She can just say he isn't feeling well or has to be somewhere else.

I would not go back to pull-ups at this point. That sends him an unspoken message that it's OK to go in his pants, to be honest.

Also, is he responsible for helping to clean up his messes? Do NOT punish him -- he really seems not to be able to tell he's got to go -- but do give him responsibility once there is a mess. You should take him into the bathroom and have him strip off; rinse out the dirty underwear under the bath tap or place it in a plastic bag for you to launder later if you prefer, wipe himself up (you would of course finish up that job) and wash and wash and wash his hands. This isn't intended as punishment! So don't fuss while he does it; be matter-of-fact and calm and say "I know you didn't mean to do it, but now that it's done, we need to clean up." You are not trying to shame him, just trying to convey a sense of responsibility for his own clothes and self.

Taking away toys is not helping, so I'd stop doing that. Again, that's punishing for something he seems unable to control yet. At his age some kids still do not have great control over their bowels and some kids genuinely do not feel the urge to go in time.

J.,
I have a 9 year old son who still wets the bed fairly often and had multiple wetting accidents per day from age 3 to age 7. It was frustrating because, like you voiced, it did not seem to concern him at all. It was like he didn't care and it did not bother him. I think that is just a coping mechanism, because he really did care and was embarrassed. Definitely no punishments and try not to make a big deal of it. Go to pullups but do it in a matter of fact way.
My daughter (4) has also had her share of pooping issues, she was pooping her pants daily for probably 4-6 months but it has stopped finally. I finally figured out she was constipated. Because it hurt so bad to poop, she would hold it and hold it rather than face the pain of using the toilet, which obviously made it worse. Then she would poop her pants. It took a while to get her on course but the fiber gummies helped, lots of fruits and veggies, Miralax, apple juice, (I kept pushing water but she was very stubborn about it) and we even had to do the glycerine suppositories a few times. You might consider upping fiber and see if it helps while you wait for that doc appt.

When this happened with us, we were told we needed to 're-do' potty training - pay attention to his diet, at each change of activity to take him to the toilet, be there with him, exclaim and praise all effort and poop results. Make sure he is well hydrated and has plenty of fiber.
We don't realize how big a deal potty training is and how it can have such an impact on so much. I think all mums need better training in this area.
Good luck!