After my family moved, my 4-year-old suddenly started holding in his poop. Nothing I tried worked to get him to go to the bathroom. I turned to experts who explained why this might be happening and what I could do about it. Here's how my son started pooping again.

By Zlata Faerman
February 26, 2020
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My son has always been very routine-happy and that once included his bathroom habits. He would know "his time" to go poop and even had a whole poop routine to boot. But things changed soon after our family moved from Florida to New Jersey last year, and we spent a year in an apartment as we hunted for our forever home.

The day before we moved into our new home, my 4-year-old son pooped as he always did. This is not something I would normally take note of, but fast forward 10 days later with no poops, and all you can think about is the last time he pooped. As the days went on, I got increasingly worried. Every day, I'd introduce the idea of pooping and he'd answer, "I don't feel like I have to go."

We tried it all: prune juice, pears, milk of magnesia, a suppository, stool softeners, laxatives, and even a Fleet enema, but nothing worked. On the tenth day, I took my son to the hospital. There, a physician assistant prepared to give my son an enema, but after an initial exam that included the use of her finger, my son said he would try and go on his own. After laboring to poop, he finally did. I was elated but simultaneously riddled with fear. Would this become a pattern?

Why Do Some Kids Hold in Their Poop?

I know potty issues aren't uncommon. But when kids stop going to the bathroom, says Taunya Banta, an inclusion services manager at the early childhood education facility KinderCare, it usually boils down to three things: control, development, or fear. "The bathroom can be a scary place for some children," says Banta. "Kids may be fearful they'll fall into the toilet or be flushed away. Flushing can also be loud and startling for children."

The trouble is stool can collect and harden when a child doesn't poop for a while. This backup can lead to uncontrolled leakage—and that's what I feared.

Six days after the initial hospital visit, and again, no stool softeners or laxatives could get this little boy to say anything other than, "I don't feel like I have to go," as he stood there crossing his legs together in pain. So back to the hospital we went (I wasn't waiting 10 days again).

At the hospital, I had a great conversation with pediatric emergency physician Christopher Amato, M.D., who struggled for almost a decade with the same thing with his son. "It's more common in males," he says. "It may be related to behavioral components like a painful stool that stigmatized your son, or from his diet, related to high amounts of starch, dairy, or not enough water."

What it came down to for my son, in my opinion, was being in a new place and out of the flow of his routine. Dr. Amato agrees. "Any stressor, such as an altered routine, can have an affect on our bodies, which ultimately may manifest as constipation," he says.

What Doctors Suggested to Get My Son to Poop

Dr. Amato told me that continuing to give my son enemas could traumatize him and that we should focus on a course of treatment that starts from the mouth rather than the rear. Since this was more of a mental issue versus a physical one, he recommended we try Miralax so that my son "physically couldn't hold it in anymore."

Every doctor I talked to during my quest for a solution suggested Miralax, but I was nervous to try it. While many parents swear by it (and really no judgment), Miralax has hit the media circuit for the negative side effects it was causing in their children's behavior. These include anxiety, paranoia, and rage.

But Syeda Husain, M.D., a pediatrician based in New Jersey, refutes the claims against Miralax. "It's mainly polyethylene glycol (PEG), which is nontoxic and water-soluble, and an inactive ingredient that is not absorbed in the gut. It works to pull water into the bowel to soften the stool," says Dr. Husain.

As for affecting a child's behavior, she says, "children who have behavioral issues do occasionally have some kind of sensory issue where the act of stooling is an unpleasant one for them, in which case parents may think Miralax is causing the behavior concerns."

What Treatment Worked to Get My Son to Poop

I still wanted an alternative solution and Dr. Amato suggested that we start with mineral oil, which is what "old school doctors" used to use. Just like Miralax, it's not absorbed by the gut, and it's expected to work the same way.

Jennifer Shu, M.D., FAAP, a pediatrician and editor of the American Academy of Pediatrics' website, HealthyChildren.org, says “mineral oil is probably fine for children over age 1, but Miralax may be a better alternative.” The reason: Osmotic laxatives like Miralax have largely replaced mineral oil because they are “more palatable and easier to administer,” according to UpToDate.com, an evidence-based clinical resource. Anal leakage of mineral oil is also possible and often means the dose is “excessive.” And mineral oil may lead “to dangerous lipoid pneumonia if aspirated.” That’s why it’s best to avoid it for babies 12 months and younger, those at risk for aspiration, and children with neurodevelopmental abnormalities or gastroesophageal reflux. Always check with your pediatrician first, advises Dr. Shu.

That evening, I devised a plan of giving my son mineral oil at night and talking a lot about how we never want to go to the hospital again. We discussed the importance of pooping every single day, we learned from books about how poop is made, how it is garbage that needs to get out of our system (shout out It Hurts When I Poop! and From Chewing To Pooing), and we implemented a rewards chart.

A cousin of mine also suggested a tactic that was surprisingly a lifesaver. She insisted my son walk her 13- and 17-year-olds through the process of pooping as they pretended they couldn't go either and needed help. The idea was by putting my son in the position of being the successful helper, he'd become proud and want to go himself. It worked like a charm.

Caroline Fisher, M.D., Ph.D., a board-certified child psychiatrist based in Corvallis, Oregon, says this isn't surprising to her. "Little kids idolize older kids, so the idea that he could help an older kid took the focus off of him 'doing something wrong' and put him in the role of expert," she says. "Our internal hypocrisy-detector goes off if we don't do as we say, and so when we are acting as experts, we are more likely to also follow our own advice."

We did this every night for about five days and continued with the mineral oil until I noticed it caused a reaction of raised bumps on his back and arms. Although the bumps weren't itchy, we tapered off after about a week and introduced aloe water and probiotics in the mornings instead.

During this journey, I talked to more than 25 moms who have struggled or are struggling with this same issue. Most of them had unique stories and ways of dealing. I learned every child is different and so is every parent when it comes to what treatment they're comfortable with and that's OK.

Every day I still hold my breath (pun intended) and hope that my son will tell me he has to go. I make it a competition and suggest we "race" to see who will "be the winner" and poop first at night. (Spoiler alert: it's been him.) I don't know how much longer it will be until I feel we're in the clear, so I'm learning to take everything day by day.

Zlata Faerman is a Jersey Girl with @ZlataThoughts. Full-time publicist, part-time writer, and round-the-clock ambassador to wit and humor, Faerman is making her way through life with her husband and son. When she's not working, this self-taught home cook is crafting kitchen concoctions for simple, healthy, and delicious (mostly low FODMAP) recipes for her food blog @lifeandthymez, crossing the line between funny and inappropriate, and fantasizing about being a Real Housewife of New Jersey.

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