You know you're an encopresis parent if...

You know you're an encopresis parent if...

1) You have an extra pair of underwear and pants for your child in the glove compartment of your car and in your purse at all times.

2) You spend more time chatting online with other enco parents (that you've never met in real life) than you do with your actual friends.

3) An old friend from high school emails you out of the blue because their child is having pooping problems and they heard you might be able to help.

4) You know where to buy pull-ups to fit a 7 year old.

5) When you strike up a conversation with another parent at the park, you inevitably start talking about pooping.  Every time!

6) You've ever caused hundreds of kids to leave a waterpark because your child leaked some poop into the pool.  

7) You're on a first name basis with the receptionist at the pediatric gastroenterologist's office.

8) You know the laxative aisle at Target like the back of your hand.

My favorite aisle at Target! :)

9) You are willing to do anything and everything to help your child heal from encopresis!

Are you an encopresis parent? Do any of these ring true for you?

What should poop look like?

I hope that you did not just eat lunch.  This is kinda gross.  But helpful, I promise!

I downloaded this fabulous poop chart from here.

The goal is to have Type 3 or 4 poop (4 is the best).  Types 1 and 2 are too hard (constipation).  Types 5, 6 and 7 are too soft).  Your goal is to have ONE HOTDOG-LIKE POOP EVERY 24 HOURS.

These numbers are useful to use if you are keeping a poop journal.

Have you used this kind of poop classification before?

What I've Learned

I never imagined that I would have a child with pooping problems.  It just seems so random.  And gross.  But I think I've learned a few things from the experience.

1) Compassion for others. I have so much more compassion for other people's struggles now.  I see people with parenting problems and health problems and my heart just goes out to them.  I know how hard this can be.

2) Love for my child. I have always loved my child, of course.  But working through her encopresis problems has deepened and expanded my love for her.

3) Don't give up when the doctors are out of ideas.  Medical doctors are wonderful and they provide great service in many areas.  For some reason, however, the doctors we saw were not very helpful in treating my daughter's encopresis problems.  I had to do a lot of outside reading and reach out to family and friends with similar challenges in order to find solutions that worked for my daughter.  I learned that I needed to be an advocate for my daughter in the doctor's office.  

4) I am not alone. When my daughter first started having pooping problems, I was confused.  What was wrong with my child?  No one I knew had a child with this kind of problem.  I have since learned that lots of people have pooping problems, they just don't talk about it much!  I have now connected with dozens of families who have encopresis problems.  There is strength in numbers!

5) This too shall pass. For about a year, I wasn't sure that we would ever get over my daughter's pooping problems.  I wondered if she would ever go to school or ever be able to lead a normal life.  But now that we are mostly over her pooping problems, I can look back with gratitude and realize that we made it through to the other side!

6) Poop can be really gross.  I never dreamed that I would have to clean up so much poop!  I have cleaned poop out of carpets, rugs, bedding, mattresses and hair.  I have cleaned poop out of the bathtub more times that I care to remember.  I have cleaned up poop at church, at parks, at the pool, at pre-school, in the car, on the side of the road, at museums, at the grocery store, and at friends' houses.  Pretty much anywhere we've ever been :)

What have you learned from dealing with encopresis?

Pooping Books

There are lots of books out there about pooping problems.  

Here are three children's books:

1) It Hurts When I Poop

2) I Can't I Won't No Way

3) Clouds and Clocks

And three parent guide books:

1) Childhood Encopresis and Enuresis

2) The Ins and Outs of Poop

3) Constipation, Withholding and Your Child

Have you read any of these books?  Which did you find most helpful?

Get Support

Having a child with encopresis can be overwhelming.  Sometimes it feels like the problem is taking over your life.  

There are lots of support groups out there.

Here are some examples:

1) Encopresis.com - This site offers a book and an online forum for treating encopresis.

2) UCanPoopToo.com - This is a comprehensive online program with videos, chats and reading materials.

3) Facebook support group - A great place to ask questions and get advice.

4) Doctor Daum - A pediatric GI doctor who provides personalized treatment plans via telephone.  I didn't know about this doctor when we were struggling with encopresis, but I wish I had!!  

Have you used any of these support tools?  Were they helpful?

Keep a poop journal

The best way to monitor your child's progress is by keeping a poop journal.

With everything you've got going on in your life, I'm pretty sure that keeping a poop journal is not high on list of priorities.  But it really is the best way to see what works and what doesn't.

Here's what you need to do:

1) Grab a word document or excel spreadsheet or just a plain ol' notebook. Use whatever method is going to be most convenient for you.  It's not going to be super fun to keep a poop notebook, so make it as easy on yourself as possible.

2)  As best you can, record the date and time for each of the following:

*Any medications taken (including Miralax, Ex-lax, etc)

*Every time the child poops (also include a brief description of what the poop looked like and amount)

*Any poop accidents or crumbs/ smears in the underwear

*Peeing events (if you've also got peeing issues going on)

*Any medical visits or tests

3) If possible, also record what the child eats and drinks.  This is especially important if you are making dietary changes, like trying a dairy-free diet.

Why a poop journal is helpful:

1) A poop journal will help you make connections.  The intestinal tract is long and it can take a while for medication and dietary changes to show up in the poop.  A journal will help you make connections that you might miss otherwise.

2) A poop journal will help you to talk to you doctor.  If you show up at your pediatrician or gastrointestinal doc with a poop journal, they will be able to give you much better advice. 

2) Healing from encopresis can be a long journey.  A poop journal will help you see how far you've come!

Have you kept a poop journal for your child?  Did you find it helpful?

Enemas and Suppositories

Enemas and suppositories can help with constipation and encopresis symptoms.

I know, I know.  You're freaking out a bit even just reading the word "enema."  But enemas and suppositories can be really helpful.

Here's what they are:

Enema: An enema is just water with a little salt in it.  (Feel better already?) It is just salt water that you insert into the bum.  You insert some salt water up into the intestine, then sit the child on the toilet and the salt water comes back out, along with a bunch of poop.  Not too bad, right?  You can buy disposable enemas at any drugstore or online.  They are cheap and easy to find. You can also get high volume reusable enemas.  These are even more effective than the disposable ones.  I would highly recommend the high-volume enemas.

Suppository: A little capsule made of glycerin. You insert it in the bum and it irritates the intestine just a bit to encourage the poop to come out.  Suppositories are not as effective as enemas, but they work great for some kids.

Here's why you may want to use enemas or suppositories to help your child overcome constipation and/or encopresis:


1) Enemas and suppositories are great to use as a last resort.  

Now when I say "as a last resort," I mean this: 

It is better to give your child an enema than to take them to the emergency room because of an intestinal blockage.

It is better to try using a suppository than to have your child poop in a public pool.

It is better to use an enema occasionally than having your child constantly embarrassed at school for pooping in her pants.

You get the point, right?

Some people believe that enemas are extremely invasive and can be psychologically damaging to the child.  However, an enema is nothing more than salt water.  It can be administered in the privacy of your home by a loving parent.  It is not painful.  In fact, the enema or suppository may give the child relief from intense abdominal pain. People have used enemas for centuries for natural colon cleansing.

2) Enemas an suppositories can help you child be successful.  Using an enema or suppository allows your child to poop on the potty and feel successful.  They can get used to the feeling of having a regular bowel movement on the potty.  This is very important!  If your child has had very few experiences with successful potty use, this is a great way to reprogram their body and their mind to associating the potty with pooping.

3) Enemas and suppositories and natural and inexpensive.  You cannot say the same thing about many other treatments (I'm looking at you, Miralax!).


Here's when to administer an enema or suppository:

1) Use when you child is extremely backed-up.  If your child's intestine is full of poop or if they are leaking poop out around a blockage (meaning poop crumbs or peanut butter-like smears in the underwear), it is probably a good idea to try an enema.  Enemas are great to use at the same time as some Ex-lax in order to get a good "clean out."

2) Try a suppository first.  Suppositories are less effective than enemas.  Some people have great results with the suppositories alone.  If you don't get a good poop with the suppository, then try an enema.


Have you given your child enemas or suppositories?  How did it go?

Try using Ex-lax

Try using Ex-lax.

Ex-lax makes a fabulous little product called “Chocolated Stimulant Laxative” (Did I just used the word “fabulous” and Ex-lax in the same sentence?). You can buy it at any drugstore or online.

Unlike Miralax, Ex-lax is an intestinal stimulant.  That means that the medicine helps the intestine to push the poop out.  Yes! This is what we need!  I have found this product to work much better than other intestinal stimulants (such as Senokot or Milk of Magnesia).  

Here’s why I love the Ex-lax chocolate squares:

1) They taste just like chocolate. I have no problem getting my daughter to eat these.  I cannot say the same about gritty Miralax drinks, yucky miny Milk of Magnesia or Senokot capsules.  In fact, they taste so good that my other daughter (who has no pooping problems) has been known to get into the box and eat them.  Not good.

2) They provide a laxative effect without going overboard.  If you give the Ex-lax in small doses, it seems to provide just the right amount of stimulation without causing diarrhea.  Important note: Go with SMALL doses and then work up. The first time I gave my daughter Ex-lax, she hadn’t pooped in about 5 days so I thought, “She really needs this stuff, I’ll give her lots!”  She had some pretty serious diarrhea.  But actually I was kind of happy to see so much poop come out of her.  You know you’re an Encopresis Mom when you’re happy about diarrhea!

3) Ex-lax is cheap, easy to find, and easy to administer.

Here’s how to use the Ex-lax chocolate squares:

1) First off, they’re not really squares.  They’re rectangles.  Even my four year old corrects me on this. But a lot of places I read calls them “squares.”

Ex-lax rectangles in all their glory.

2) Start with one half of one rectangle.  If you know your child is really backed-up or if she hasn't pooped in 24-48 hours, give one half of one rectangle. Wait 6-8 hours.  If no poop is produced, then give the other half.  If still no poop, then give another half rectangle 6-8 hours later.  The dosage will depend somewhat on the child’s weight.  My daughter is 40 lbs and I will not give her more than 2 full rectangles within 24 hours.  If I have given her 2 rectangles and no poop is produced in 24 hours, then it is time for an enema.

Ex-lax is an intestinal stimulant, which gets the poop moving along.

3) Use as a maintenance dose if necessary. You can give small doses of Ex-lax to maintain good pooping.  Ex-lax is not habit-forming.  Try giving one-half of a rectangle every morning to maintain the regularity.

[Note: Using Ex-lax is helpful, but you're probably going to have to make some other changes too.]  

Have you used the chocolate Ex-lax squares? Did it help your child?

Try a dairy-free diet

Try eliminating all dairy foods from you child's diet.

I admit, I was skeptical of a dairy-free diet at first.  Kids need milk to grow strong bones, right?  And besides, my daughter loved milk and cheese - - that was mostly what she ate!  I half-heartedly tried going off of dairy a couple of times and it didn't seem to make a difference in her encopresis symptoms.  Finally, her condition got so bad that I was willing to give it another try.  

Here’s why a dairy-free diet might help your child’s constipation and encopresis symptoms:

1) Dairy is constipating in many people.  Many adults and children suffer from constipation caused by dairy but are unaware of the cause. 

2) Your child may be lactose intolerant. Dairy foods are made up of two main parts, the milk sugar (also called lactose) and the milk protein (sometimes called casein on food labels). If your child's digestive tract does not handle the milk sugar well, it can cause constipation and encopresis.

3) Your child may have a dairy allergy. Your child may be able to handle lactose ok, but not the milk protein. Some people are also allergic to both the milk sugar and the milk protein. An allergy to any kind of dairy may cause constipation and encopresis symptoms.

Here’s how to get started on a dairy-free diet:

Sorry, milk.  You're outta here!

1) Set a date. For our family, starting a dairy-free diet was extremely daunting to me. I could hardly think of a single meal that my family liked that didn't include a dairy ingredient.  I set a date for two weeks in advance to go dairy-free.  Then I used those two weeks to do some research on dairy-free products and collect dairy-free recipes.

Replace dairy milk with almond milk.

2) Get rid of all the dairy products in your house. At first you may be tempted to prepare special dairy-free meals for your child and let the rest of your family members continue to eat dairy. This didn't work for us, though. It was too hard to tell my daughter what she could eat and what she couldn't eat.  She would sit and stare at the cheesy enchiladas and beg for them.  Or the sippy cups would get mixed up and I wasn't sure if she had just drunk a glass of cow's milk or a glass of almond milk.  I think it's better to just have the whole house go dairy-free for a while.  Then after you've gotten a handle on things, you could start introducing a few dairy products back in for the other family members. (And of course I always give you free license to eat ice-cream after the kids are in bed.  If you haven't tried Talenti sea salt caramel gelato yet, you must!).  So eat up the obvious dairy foods first: milk, butter, cheese, and cream cheese.  Then start checking the labels of prepared foods.  Most labels have the warning CONTAINS MILK if there are diary ingredients.  Also look for the words "casein" and "whey" (both are dairy products).

Eat ice cream when the kids are in bed!

3) Plan to not eat out for a week or two. It is hard to find dairy-free food at restaurants. It is also hard to be certain that the food you are given is really, truly dairy free (even if you've requested it!).  Plan to eat at home for a few weeks so that you are certain of what your child is eating.

Use non-dairy butter substitutes.  It's not as good as real butter, but it tastes ok.

[Note: Cutting out dairy is a great first step, but you're probably going to have to make some other changes too.]  

Have you tried a dairy-free diet with your child? What were the results?

Fruit Juice

Fluids are key.  Try giving your child lots and lots of clear juice.

Now I know that fruit juice is considered poison juice in some parenting circles: it causes obesity, diabetes and makes your child grow horns. 

But my experience has been that adding a fairly large amount of juice to my child’s diet greatly improved her constipation and encopresis symptoms.

Here’s why I give my daughter 16 oz (2 cups) of fruit juice a day:

1) Our pediatric GI recommended adding 100% fruit juice to her diet.  He suggested starting at 16 oz (2 cups) of 100% clear fruit juice (like apple juice or grape juice, NOT citrus juice like orange juice).  And really, 2 cups of juice isn’t that much. 

2) A diet low in fluids causes constipation. The body needs fluids to keep things moving in the intestines.

Fruit juice will not kill your child.  And it might help their encopresis symptoms.

3) Fiber without fluids causes constipation.  Many people recommend high fiber to fight constipation.  Fiber is good, but fiber without fluids will increase constipation problems.  It will create bulkier, drier stools.  Not good.

Citrus juice (orange juice, grapefruit juice) isn't the best choice, but it probably won't hurt.

4) It is hard to get young kids to drink water. When my daughter was young, we had a “no juice and no soda” rule.  I think in some ways, that may have contributed to our encopresis problems.  Since she wasn’t drinking juice or soda and she refused to drink plain water.  She drank a little milk, but not much (unbeknownst to us, the diary was giving her stomach cramps).  So she was having very little to drink. Low fluids = pooping problems.

[Note: Adding fruit juice is a great first step, but you're probably going to have to make some other changes too.]  

Have you tried giving your child  16 oz/ 2 cups of fruit juice per day?  What was the result?

Quit using Miralax

My number one recommendation for helping to solve pooping problems is to quit using Miralax.  This may seem counter-intuitive.  Miralax is a laxative afterall!  That should help, right?  Miralax also comes highly recommended by many pediatricians (Side note: Don’t get confused by names, Miralax is sometimes referred to as PEG (polyethylene glycol 3350) or Movicol).

Miralax is not the answer!

However, Miralax can actually make constipation problems worse.

Here’s why:

1) Miralax is a band-aid fix. Miralax does nothing to solve the underlying intestinal, dietary and/or psychological problems that are causing your child’s constipation or encopresis.  At its best, Miralax is short-term fix for softening up hard poop.  At its worst, Miralax can make encopresis symptoms much worse. If Miralax helps relieve occasional constipation in your child, I say, “Great! Go ahead and use it!”  However, if you’ve been using Miralax for more than a month and your child is still soiling (meaning leaving poop streaks or crumbs in his/her panties) or still exhibiting holding patterns, then it is time to get off of the Miralax.   See more about this in a blog entry by pediatrician Dr. Claudia M. Gold. 

2) Miralax does not help get the poop out. Miralax draws water from the intestine into the poop.  This changes the consistency of the poop to be more watery.  So as you take Miralax, the poop becomes softer and softer. This may help if you have occasional constipation. However, it does not provide any intestinal stimulation that your child needs to push poop through the intestinal tract.  The poop can still sit in the intestine and the child can still hold it in. Ex-lax, on the other hand, is helpful because it is an intestinal stimulant and actually helps move the poop along. 

Generic brand Miralax.  This ain't gonna help either.

3) Miralax can INCREASE your child’s desire to hold the poop in. The main cause of encopresis is holding the poop in. For most children, it’s the holding patterns that we’re trying to help them overcome.  When the child takes Miralax, it makes the poop more watery.  The nervous system in the intestine works best when a solid hunk of poop presses against the intestinal wall and sends a signal to the brain. If the poop is watery, the nerves in the intestine may do not function properly.  This can cause the child to hold even more.  Also, if the child is seriously constipated, the watery poop created by the Miralax may leak out around larger poop blockages in the intestine.  Not good!

Not gonna lie, Miralax is expensive.

4) Miralax has not been approved by the FDA for pediatric use.  Miralax has also not been approved for long-term use, yet many child take it for months or years.  (See New York Times article about this here).  This alone should give you pause about giving to your child on a long-term basis.

The label says to use no more than 7 days!  I know parents who have given Miralax to their children for YEARS! Don't do it.

5) The bottom line is this: Ask yourself, “Is Miralax helping my child heal?” Have you been dealing with pooping problems for more than a few weeks?  Has your child been soiling in her panties for months?  (My guess is that the answer to this question is “Yes!” since you are reading a pooping blog!). Miralax is not working.  Any positive effect that you will see from Miralax will occur within the first 14 days.  My pediatrician kept recommending Miralax for my daughter for 18 MONTHS before I woke up and realized that it was not working. 

[Note: Quitting Miralax is the first step, but you're probably going to have to make some other changes too.]  

I’d love to hear from you.  Have you given Miralax to your child? What was the result?

Pooping Solutions - 6 Easy Steps to Ending Your Child's Pooping Problems

Having a child with constipation and encopresis problems is no fun!

* Constipation (hard poops)

* Encopresis (a fancy term for "soiling," or frequent poop crumbs or smears in the underwear)

You are not alone and there are solutions!  Your child does not have to suffer with pooping problems.  

Here are 6 EASY POOPING SOLUTIONS that you can implement immediately.

1) Quit using Miralax. (Read more about Miralax here)

2) Give your child 2 cups of 100% fruit juice per day. (Read more about fruit juice here)

3) Start eating a dairy-free diet. (Read more about a dairy-free diet here)

4) Try using Ex-lax. (Read more about Ex-lax here)

5) Use enemas and suppositories as a last resort (Read more about suppositories and enemas here)

6) Keep a poop journal (Read more about keeping a poop journal here)

I have struggled to help my daughter overcome constipation and encopresis problems for several years.  It has been our experience (and the experience of dozens of other parents with similar problems) that these 6 easy steps are the keys to getting your child on the road to healing.  You probably didn't even imagine yourself reading a blog about POOPING, but here you are!

Also on this blog, you can read about:

How to get support from other families

Reviews of books about constipation and encopresis

Bed-wetting (enuresis)

How to talk to you doctor

How to talk to your child's school

and much more.

Constipation and encopresis are very common childhood problems.  They are not fun to deal with and your family and friends are sick of hearing about it!  But these are problems are treatable.  You can solve this!

Disclaimer: I am not a medical doctor.  Obviously you need to follow the medical advice given to you by your doctor. This is what has worked for us.