9 year old dirtying his pants

amother

Sun, Feb 14 2010, 5:40 am

9 year old ds started again dirtying his pants.
He won't go to the toilet outside the house and even in the house I think he often starts in his pants.
He doesn't notice it and gets very insulted when I tell him that he smells and he must go shower.
He says that just I and my husband notice it and nobody else. (impossible he ends up smelling like a 2 year old with a dirty diaper)
what can I do? it's ruining our relationship as he thinks I'm out to get him but I cannot leave it alone.

Health is a Virture

Sun, Feb 14 2010, 5:53 am

two possible reasons for this (can be combo of both too)
1. very often this occurs when a child has a problem with constipation. The child is constipated and then some liquidy stool just sort of leaks out...observe if he is general constipated and/or ask doctor to help you.
2. sensory issues, that he just doesn't feel that he has to go, then certain exercises can be done to help him.

You should NOT make a big deal about this and argue about it with him, as this can be giving him subconsciously attention, and it may cause the problem to be exacerbated. I would definitely seek medical help and find out that there is not some medical problem causing this. He may really not be feeling that he has to go and by you embarrassing him, it can only make matters worse.

You may want to see if he wants to do a contest that if he doesn't have any accidents for a day then he gets a point, prize, etc. This would help if it was not a medical related issue, and more a psychological issue.

good luck!

amother

Sun, Feb 14 2010, 5:56 am

Health is a Virture wrote:

You may want to see if he wants to do a contest that if he doesn't have any accidents for a day then he gets a point, prize, etc. This would help if it was not a medical related issue, and more a psychological issue.

good luck!

Might not be a good idea. If your son can't help it this will only make him feel worse. I agree to see a doctor.

amother

Sun, Feb 14 2010, 6:20 am

so what do I tell the dr?
I feel ridiculous going to the dr. and my son would be so embarassed.
I'm stuck either way because I have to tell him to change - otherwise he goes out smelling which is terrible for a 9 year old and other children will just make fun or stay away.

I think it might be constipation and I tried adding fiber but he's a very picky eater.

Health is a Virture

Sun, Feb 14 2010, 6:25 am

if you think it's constipation then try to figure out ways to incorporate more fiber into the diet. And even more importantly, is more liquids!! when adding fiber, you need to increase the liquids even more. maybe he'd like diluted prune juice or prunes? they are very sweet. you might want to sit down and explain to him that this is not his fault and is very likely caused by constipation, give him stuff to read and then he on his own, if it is important to him enough, will incorporate more fruits and vegetables into the diet. or, you can buy him lots of raiins, fruits, and lots of wholegrains and see which things he likes, and let him eat a lot of them. good luck!

if you think it's constipation, first try treating it by yourself, so you don't have to make a big deal and go to the doctor, if it doesn't seem to work, speak to the doctor without your son and explain to him the situation. good luck!

amother

Sun, Feb 14 2010, 7:05 am

First of all, don't feel ridiculous going to your pediatrician. Ours told us that it is one of the most common problems he sees.

We went through this with one of our children, and I'll give you our pediatrician's advice, which really did work.

First of all we had to "clear him out" with a fairly high dose of Miralax (hence, again, you need to talk to your doctor to find out how much is the right amount assuming he gives you the same advice). Then he had to take a maintenance dose of miralax everyday for several months. In addition, we increased the fiber in his diet, in particular the doctor recommended grapes and pears. The pediatrician also recommended greatly reducing or even eliminating dairy, which we also did, even switching to rice milk.

The other part of this was taking advantage of the body's natural rhythms. We'd remind him to go to the bathroom when he woke up and shortly after each meal and again before bed. We had a sticker chart with a prize for x number of days clean.

We did not fuss at him when an accident happened. We did, however, require him to clean himself up. Like your child, ours claimed that there was no odor, but generally we didn't have a lot of problem getting him to go get clean.

We explained to his teacher the issue and gave her a sack with extra underwear and two extra pairs of pants (one black and one blue) so that he could discreetly change clothes at school if needed and hopefully the other kids wouldn't notice.

I'd say it was difficult for the first couple of weeks, but after the first month the problem was almost nonexistent. When another child in our family developed the same problem, we caught it much earlier and it was far easier to stop.

amother

Sun, Feb 14 2010, 7:23 am

to the amother above - how old was your child?
mine is 9 and getting him to shower is very difficult in general so it ends up a big fight. I just can't leave him smelling.
He is also too big for me to clean him.

He will be very embarrassed to go to the dr. can I go without him and explain the problem?

amother

Sun, Feb 14 2010, 8:40 am

He was 8. Ours also argued, but we just sent him to the bathroom and told him he couldn't come out until he had showered and that if he came out before that, then there'd be no videos or Nintendo DS for the rest of the day. We had to follow through once or twice, but then he realized we were serious and started taking showers when we asked.

As far as the pediatrician, I think he'll want to see the child. Ours palpated his tummy and could feel the distended colon from the constipation. What I did was ask if I could speak to the doctor privately for a minute - we stepped into the hall, I told him the issue, we went back into the exam room, and then he examined DS. Actually, I think the doctor was a big help in getting DS's cooperations - just his explaining to my DS that this is a common problem and how we can overcome it got DS "bought in" to the solution.

life'sgreat

Sun, Feb 14 2010, 11:28 am

amother wrote:

Don't go to your pediatrician with this issue because IME they usually brush it off and say it's normal, it happens more often than you think blah blah blah. Go to a specialist. If you are in the NY area, I highly highly recommend Dr Daum in Long Island. He's had success in the most impossible cases and has helped autistic children as well. He has a 'program' that is fairly successful. There is nothing to be embarrassed about, as this is a medical issue just like any other, even if the reasons behind it are emotional.

You need to very firm about him changing/showering and he needs to know that there's no monkey business about this. Try not to show him how much it bothers you (it's hard), and just say matter of factly that you need to go up, get your stuff and shower now. Period.

amother

Mon, Feb 15 2010, 1:17 am

My son is the same age and he has had this problem recently when stress cropped up. First, when my dh had to travel and was away. He would have a small accident at school (a little leakage) and would smell all day. I tried to explain to him that he needs to get rid of the smell and clean up at school with the extra underwear in his bag but he was more embarrassed that someone should see him with a bag going to the bathroom than smell him as he didn't think there was an odor either.

He also had a bit of diarrhea then so I think when he needed to pass gas, more came out by accident, sorry if TMI. I felt so bad for him and in the beginning I told him to go to the school office and call me if there was a problem and I would help him out, either over the phone reminding him what to do or by coming over there if necessary. Once, his tzitzit strings got into the mess and it was really bad. I just went there and pulled him into an empty office and helped him get cleaned up with wipes. My son would not have been able to do that himself. He evens needs help showering still.

I found the problem went away in a day or two. Then it happened again a while later when he was stressed over something else and also had diarrhea. Poor kid. I don't there's much I can do to prevent it, I can only try to minimalize the other kids noticing. If it was a chronic problem or from constipation, I would definitely go to the doctor.

He also wets at night once in a while and I don't worry about it either. Kids do grow out of this stuff.