Wednesday

What Should Nanny Do About Boy's No. 2?

Received Wednesday, June 3, 2009
Perspective and Opinion on ISYN I have worked with this family for a year (just after the boy turned three) and he just turned four. When I started, he was in underwear but pooped and peed his pants daily. It was very frustrating. He has since mastered peeing, but he poops his pants ALL THE TIME. It upsets us both when he and I have to leave the park/museum/etc, to go change and sometimes end our outing. We've tried everything to encourage him, all sorts of rewards, encouragement, etc. but nothing is working now. He made some progress up until a month ago when he stopped pooping in the potty all together (for me, at least, mom reports some success). I'm frustrated, what do I do?

31 comments:

Tales from the (Nanny)Hood said...

First, you have him checked out by his pediatrician to rule out any physical or physiological issues. They will likely want to know if he is actually having a BM in his pants or if he is "leaking" stool, meaning he might be very constipated.

If this has been a (power) struggle for more than a year, I would bet he is chronically constipated because he is holding his BM due to the control issues he is experiencing.

Once physical issues are eliminated as a cause of the problem (i.e., laxative given by Doctor's prescrtiption or suggestion), you can start working on solving this issue.

You need to basically start over with potty learning, IMO. Luckily, he is likely old enough to understand that putting his poop in the potty is HIS responsibility, and that you will help him learn, but that HE is going to need to do the work.

Focus on how his body feels when he needs to poop - helping him recognize those physical signals will help. He may also (especially if he has been holding his BMs) need to relearn how to relax and let them out in the potty.

When a toddler is learning his body signals in preparation for potty learning, we focus on three steps:

1) Child realizes they have just pooped or peed

2) Child realizes they ARE pooping or peeing

3) Child realizes the NEED TO poop or pee

Your charge needs to go back thru those steps, IMO.

Obviously, punishment is not going to work, and if rewards/stickers/etc. have been tried but haven't helped, don't offer those either now. I assume you are very matter-of-fact when he has an accident? If so, keep that neutral face on, and keep leaving for home when there is an accident. That neutrality ensures he isn't feeling shamed, but that he does have to deal with the consequence of not using the toilet.

I had success once with having a 4.5 yo deal with the soiled underwear with minimal help from me - full on "actions have consequences". The issue was resolved in 2 days, but there were NO medical issues involved with that situation. Of course, you'd need to have mom on board with this method, and I would definitely try "re-learning" first.

Good luck to you and to your charge!

Nanny Sarah said...

Tales from the (Nanny)Hood- and OP

I agree with all that was said- but please remember that don't push the child- it is up to the child- just like learning to ride or walk, crawl, etc- you have to encourage all the way and rewards when he goes. BEST OF LUCK!!

WTF? said...

It doesn't sound like the poor little guy has ever been poop trained. I'll bet the constant going in his pants when he was forced in to underwear prematurely has been very stressful for him emotionally. He may now be exerting the only control his has left in his life by pooping inappropriately. It sounds like pretty much everyone around him is very overemotional, punitive, and kind of crazy about it now. Kids just don't thrive under that kind of pressure. You and mom need to leave this up to the child and put him back in to a pull-up. All this stress just isn't worth it. It's damaging, IMO.

Also, if you know for a fact that this child is more than likely going to have accidents, why aren't you prepared with extra clothing, plastic bags, and clean up supplies? My 4 y.o. literally never has accidents, but I carry all that stuff just as a matter of course. I'd imagine most people with young children do.

TC said...

Three pieces of advice

1. let it go, put him back in diapers or pull ups and just leave it at that until he's ready to go

2. if he is on any sort of a poop schedule as in he always poops at noon then around that time you need to find a potty and sit there for a little while

3. find underwear that has a character on it...let's say Buzz light year. Then explain to him he's a big boy and he gets to wear big boy underwear but he has to be careful not to poop on buzz. Just go on and on about how buzz doesn't like to be pooped on and so forth.

NEVER shame him, it doesn't work and usually ends up backfiring.

The other thing that might work is let him help clean up after himself. If the underwear is salvageable put it in the washer and have him add the laundry soap and push the buttons, when it's washed have him put it in the dryer and when its dry he puts his clothes away. If you throw the underwear away then have him help wash his pants or shorts.

Laura said...

the lady i work for had a family member whos son could not for anything master pooping in the potty. They tried everything...She told me he once even wrote a letter saying sorry he was a bad boy.

It turns out he doesn't have feeling when it comes to pooping. He was totally retrained.

world's best nanny said...

I know I will be accused of playing "I can 1 up ya." I worked for a family for 4 years and their oldest would not use the bathroom. He would run and hide to poop and pee in his pants. The boy was going on 6 years old and still was pulling this stuff. I would make him rinse out his own underpants and he'd be in the bathroom dry heaving. He could not stand the sight and smell of his own poop, which made no sense to me. If it bothers you, go to the toilet and flush it away before it begins to bother you! He began kindergarten wearing Good Nights. We had to keep it a secret from the teachers. He was so afraid of the kids finding out he became constipated. Eventually he had an emergency appendectomy. I know it was because he was holding it so much that his poop backed up into his appendix!

chgonanny said...

WBN, that's awful!

Currently, I'm potty training my youngest charge, and it's my first time doing it. She's also having trouble pooping in the toilet, but I think her problem is that she only poops maybe once or twice a week. Her parents let her and her brothers live on a diet of sugar and salt. Yeah, I've tried everything I could to get them to eat fruit and veggies, but it's kind of hard to do that when Mom and Dad will just give you cake anyway.

I digress. Basically, I'm glad to know I'm not the only one who struggles with the whole potty training thing.

chrissyma said...

When I was a little kid, I had the same problem up until I was 6 years old. Part of it was I had a fear of pooping in a toilet because I was teased once or twice by cousins and because I used to have really hard time actually doing it. (TMI, but it's good to hear a story) It was very painful so I would hold it in til the last possible moments and when it was done, I'd either hide or just pretend it didn't happen.
I'm a nanny for a baby right now so we haven't hit potty training yet, and my only other potty training experience is with kids who have autism and my case liked to play in the toilet and had the mentality of a 6 month old so I don't have any helpful advice other than asking him if maybe he's afraid, forgets or if it hurts.

MinuteMuggle said...

World's best nanny,

If I had been in your situation I would have encouraged the parents to speak to the pediatrician: that sounds like a sensory issue to me. Poor little guy. Perhaps he didn't understand it either. If he couldn't stand the sight or smell it sounds like a fear of sorts. If he was fearful of it I doubt he was trying to "pull" anything. Children with sensory issues have very real fears regarding different things, and poop is high on the list.

Anonymous said...
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I forgot my moniker said...

consistency is key! doesn't he display signals when he is having a bm? facial movements? grunts? hiding behing something? when you are familiar with these signals, he needs to sit on the potty asap! I have a similiar potty training story, however my charge always goes for me...even tells me. but for his parents it is a completely different story. he refuses to go for them and hides behind the couch. I find this very frustrating, as he knows what to do when he has a bm and knows the feeling. the parents are not consistent or firm with him!

Jun 4, 2009 11:59:00 AM

mom said...

The child needs evaluated by his pediatircian and all of you need to follow his advice.

Chantel said...

My son did the same thing. It turned out he was constipated. The doctor gave us a prescription laxative and no problems ever since. I would make that suggestion to his parents. If that isn't the problem, my uncle (who is a pediatrician) told me about "Poop Parties". I laughed when he first told me, but it worked WONDERS on my son. Basically, you tell him, "Your poop is so sad." This gets a curious look and maybe some questions. Then you say, "Your poop is sad because it can't go play with it's friends in the potty and go to the poop party. Now your poop has to go in the trash/laundry/etc..It's so sad" When pooping actually does happen in the potty, sing a song, have a dance and say, "Bye poop. Have fun at your party!" And flush. I also rewarded my son with a star sticker on the calendar and 2 M&M's.

mom said...

Chantel,
This sounds to me like a great plan! I used
Pee Pee Candy" (M&Ms) to entice my kids to use the potty. Once they got the concept that they could have a couple of M&Ms for going in the potty instead of their pants they were all to pleased to squeeze anything they could manage out of themselves to earn a treat.

Also compelling to them was the concept that they didn't want to go potty on their favorite super hero or princess (which was conveniently pictured on their underpants.)

But this boy sounds like he may have further issues, as this is a very late stage to be potty training. I would still consult the doctor just to be sure there's not another issue preventing him from being able to control his bowels.

ericsmom said...

I don't think kids like when the water splashes on them. I think that could be a reason.

So what you can do is take the diaper and stretch it across the toilet. Tape the ends to the toilet. Let them poop and it won't fall in the water. It will hit the diaper. And it won't scare them to feel the cold water hitting their tush.

Hopefully, after sometime you can remove the diaper.

sf said...

I feel for you! I watch two older kids who are 10 and 11 and they both pee their beds almost nightly. Of course it's me who gets to do the daily laundry and the smell of pee day after day after day really grosses me out. If they were my kids, there would be some kind of recourse, maybe doing their OWN LAUNDRY?!! Or something of that nature. But that's the problem, wetting their bed's is like second nature to both of them, there is no discussion in the morning about it from the parents, there is no consequences for their actions.

I realize there could be a medical issue, but I also know for a fact they are not undergoing any treatment for it. The 11 year old has told me herself "I'm just too tired to get up in the middle of the night, I don't feel like it"

I suppose if that was my mindset I'd wake up in a pissed bed every morning too! Especially if I had someone to come along and clean it up daily. The daily fresh clean sheets must be nice!

Sorry to hijack, had to vent!

cali mom said...

The big toilet can be quite intimidating to young kids, ESPECIALLY when it comes to pooping and having to climb up and sit on it. I remember falling in when I was really little, potty training age. It almost goes without saying, but the child needs to be comfortable on whatever device they are pooping into, and accomodations should be made in the very beginning, or if they are having major troubles mastering the potty pooping. So if he doesn't already have a training potty that he can poop in, get him one. Let him pick it out, maybe even try a couple of different ones. At this point, the primary goal is to get him to poop NOT in his pants, and if a potty helps him there, he'll get more comfortable soon enough with doing it in the big toilet.

We used "poop stickers" on a chart for my son. At first he'd get a candy and a colored dot sticker just for trying to make it come out in the potty, then a fancy sticker for a successful potty event, and after a while th epeeing was old hat but he'd get a super special sticker on his chart for a poop. We also gave him a goal and a reward-that when he'd had clean underwear for 1 week he got some money and when he'd had it for x number of weeks, he got to take his earned potty money to Target and pick out a toy to buy with it. He's an old hand at it now, but sometimes he still decides to put a "poop sticket" on a pice of bright paper when he does a poop, just for fun.

oh well said...

sf, if your charges are 10 and 11, they can and should take care of their bedding. It is really about empowering them (and probably doesn't hurt if it gives you some relief). But even if they say that they are just "lazy", there might be more to it. Stress levels and heredity often play a part, among other things. You should remain as neutral as possible about the incidents, make sure that they are comfortable emotionally, and definitely put them in charge as much as you can!

no name said...

I will remain anonymous for this one. When I was still wetting the bed at 10 years old, it was not because of some medical issue. It was because I was being molested by my dad. When I look back on it now, it was definitely from being emotionally distressed, but I also think subconsciously I was hoping he wouldn't bother me if I wet the bed and smelled like urine.
I'm not saying that all kids with toilet issues are being molested, but it could be some kind of physical or sexual abuse.

Chiming in on bedwetting said...

Just a quick example for the nanny of the bed wetters - I doubt they are doing it because they are lazy (it feels horrible sleeping in wet pee sheets). I peed the bed at night until I was 11, and even with having drinks eliminated way before bedtime and peeing before sleep, I still peed at night.

Please keep in mind that it can be hereditary and if so, hopefully the child will outgrow it. (My son is a bed wetter - payback time for me!)

DenverNanny said...

LOVE the Poop Party suggestion! I've never heard that one before...

sf said...

I agree with most of the comments, I'm not sure how their Mom would feel about them doing their own urine soaked sheets.

There is no molestation in the house, she is a single mother.

Also, the children are not related to each other at all, one is biological, one is adopted... so that really makes me question the hereditary part.

You can say the same thing for alcoholism as well, an addictive personality is sometimes thought as hereditary, but there are things that can be done to prevent it from happening or at least taking some action when it does happen.

I don't know, I suppose I'm just the nanny, I don't live there nor am I there 24/7 but I do know I have been cleaning their urine soaked sheets for years and it gets old!

Any suggestions? said...

Minute Muggle. Have you potty trained a child with sensory issues? How did you go about it? We attempted training my 2.5yo ASD son a few months ago. He knows when he needs to go, points to himself to let you know (he's still non-verbal) and he can't stand to be in a wet or dirty diaper, so we thought he was ready. But, he screamed and cried bloody murder every time we sat him on the potty. At his school (he's in a strict ABA program), they gave me a schedule and chart and discussed the reinforcers they were using, and told me we should be strong and insist he sit on the potty every 45 minutes despite the tantruming, but I couldn't take it and brought back the pull-ups. He's a bit older now and has been progressing nicely in other areas and I'm thinking of trying it again. Do you have any tips on how to make it a little smoother?

MinuteMuggle said...

any suggestions,

I am struggling with the same issue with my child. I wish I had some advice for you. I am relying on Early Intervention to help me and they have been wonderful so far, as well as my pediatrician. I think the number one thing is patience and love, not to sound corny. He may not be ready yet.

Good luck, you sound like a great parent.

oh well said...

sf, I still think that at 10 or 11, if they are physically able to do it, children should take their wet sheets off their bed, put them in the laundry and get some clean ones. I have done it with younger children, and I could sense that they actually feel relieved to be able to turn a negative situation (oh no, your bed is wet again) into a positive one (thanks for helping me change your bedding). You should of course talk to the mom first.
How does she feel about the whole situation?

fox in socks said...

Can someone post more info about sensory kids being afraid of poop, or not wanting to poop on the toilet or whatever it is? I've never heard of that and would like to know more. Thanks.

As for the 10-11 year olds who pee their beds nightly, I don't understand why they're not put in goodnights before going to bed. Obviously there's something going on there and they are not going to the toilet during the night, and it hardly seems acceptable to change the beds every night. Goodnights are made specifically for older children who cannot control their urine at night. I wonder why on earth these children are not using them at night.

sf said...

Fox -

The sad thing is, there are Goodnights Diapers involved. The older child wears them, but she soaks through them on a regular basis, her Mom once told me (I don't know how often this happens) that she woke up and changed her 10 year old's diaper in the middle of the night! Yikes!

The older child who is now 10, he won't wear a Goodnights, they are too "babyish" and embarrassing for him.

They have also been known to wet their own bed, so they crawl in bed with Mommy and then end up wetting her bed as well. Yay, double the bedding for me to wash the next day!

The Mom says they will do their own laundry when they turn 12 (doubtful) but I don't see anything wrong with them doing just their own sheets at this age.

Any Suggestions? said...

I don't really know what causes my son to be afraid of sitting on the toilet. He was afraid of the bathtub for a long time too (we overcame that by moving his "bath" to a blow up pool in the yard with his older sister and then trying several times to transition him to the bath with her until he eventually tried it. He still sometimes has trouble when trying a bath alone, but eventually got to the point we can bathe him in the bathtub). His OT therapist said it's not uncommon for kids with sensory processing issues. Other than try again, didn't get much advice on how to overcome it.

mom said...

My daughter was exceptionally small for her age and was afraid of the big potty because she thought she would fall in. And she was, in fact, small enough to fall all the way inside. Not only that, but it would have been a major feat for her to crawl up onto it by herself.
At first, I lifted her up and held her in place each time so that she felt perfectly secure. Kids need help every single time at first anyway, even if they are using a potty chair. That ended that fear. When she was more competent in going by herself, we got a step stool and a contraption designed specifically for potty training that made the hole in the toilet very small, so she was free to squirm around all she wanted without fear of falling in. And the step stool was light, so she was able to put it by the sink when she was finished and climb up to wash her own hands all by herself like a big girl.

fox in socks said...

sf, thanks for adding more info. Why don't they just put on double goodnights? meaning in two layers?

I'm missing your point on the mom changing the kid's goodnight during the night. That seems like a positive step. Some children sleep so heavily that they don't wake up no matter what you do (and that is why they pee their bed) and it sounds like that is what happened. So maybe it will help if the mom changes the kids, say, right before she goes to sleep for the night herself.

As for the younger one seeing goodnights as too babyish, first of all I would stop calling them "goodnights diapers" because that just makes it more difficult. Just call them goodnights. Second, the mom might try checking out the goodnights they are now selling in the stores. They are greatly improved and some of the styles are designed to look just like underwear, to the point of fooling people who see a kid walking around in them during a sleepover.

I don't think the problem will be solved if they are made to wash their own sheets. Although this will ameliorate your workload, this will not solve the peeing in the bed problem.

Good luck.

sf said...

Fox - My point in the Mom changing her 11 year old's diapers is that the 11 year old can and will wake up if you wake her up. She is just grumpy. But waking up to pee is a part of life and if your Mom continued to change your diaper through the night, what is the motivation to wake up?

I'm not sure why she doesn't double up on the diapers, we don't get into it that much. The mom probably doesn't care that much because she is not the one doing all the stinky laundry.

Also, we don't refer to them as "goodnights diapers" or anything like that. The Mother, kids, and I refer to them as "pull-ups" and always have.

The younger one that will not wear them, would just simply not wear one regardless of any design. He is picky, requires a separate dinner of his choosing each night, refuses to throw things away "the garbage is too gross" and refuses to wear a cup to his baseball games because he "doesn't feel like it" he is very whiny and cries a lot and his Mom babies him completely.

I love the kids but their Mom lets them get away with murder. I don't really know where I am going with this besides explaining myself and venting!! :)