Tuesday, February 15, 2011

Adoption and Potty Issues

A reader sent an email asking for help:

My daughter is adopted from China at age 10 months from foster care in 2006. She is wonderful, smart, and delightful and on target in every way except one…she is not potty trained. And when I say that I mean potty and poop trained. She is seeing a therapist (for the last year) who has just said that she thinks A. might have Post Traumatic Stress Syndrome with potty training issues. We are working with her just sitting on the toilet in a pull up and cutting a very small hole in the pull up. She hasn’t gotten to the point where she will let a drop come out.

She has gastrointestinal issues and was seriously constipated as a baby and still is and takes Miralax. When we got A. she had anal tearing and scarring so we know that she had major pain when pooping. She will be 5 next month and it breaks my heart to see her so scared to potty. I mean it is real fear and her therapist does not think it has to do with an attachment problem or control problem. Could you ask on your blog if anyone else has these issues and what they did to resolve them? A. is a very shy child and so scared of the toilet, potty, and poop. It just breaks my heart. I’d appreciate anything you could do to help.
Any advice, especially from been-there-done-that parents?

13 comments:

Anonymous said...

Our case is not as severe as yours. Our little one began withholding once we began toilet training. She wouldn't even go in her diaper. We eventually had to give her two doses daily of "poop juice" (a bright orange stool softener) before we broke through her barrier. She hated the "poop juice" more than pooping so we had success. Now we just need to get her to flush the toilet and not gag at the smell (sensory issues with PTSD)

travelmom and more said...

Have you visited with a GI specialist? They might be able to help.

Anonymous said...

Mix liquid pro-biotics that you can get refrigerated in health food stores to restore the balance of cultures in her intestines.

Also, mix small amounts of prune juice in with other juices during the day.

Get a potty training doll. I used one for both of my kids. My son was a late potty trainer. I got him "Potty Scotty" and he helped his friend Scotty go to the bathroom. It was a great modeling tool. I used a girl one for my daughter, too.

Kids don't like to be watched. Make sure you give her a sense of privacy.

My adoptive mom always used to cringe and make comments when I soiled my toddler diapers. It was discouraging and embarrassing. Make sure only positive comments are made.

bytheriver said...

Our daughter was potty trained for poop when we adopted her at 16 mos. However, she just would not go. For a long time I found that I needed to bring a chair into the bathroom and "hold shoulders" to comfort her and talk with her. She did cry as it hurt. For no. 1, her preschool teacher told me to get training pants from Gerber and disallowed pullups - she was right - our daughter was potty trained within 2 weeks at age 3.

Regina said...

Since she's still constipated, I would say that that's the big issue for now. She's not going to get over the PTSD until pooping isn't painful anymore.

Have you tried an elimination diet? I wonder if a food sensitivity is causing her to have on-going issues. I have a friend whose little boys were chronically constipated for years. Finally, when the boys were 4 and 2, they eliminated dairy and after about 2 weeks (that's how long it takes dairy to get out of your system), the constipation began to lessen and eventually went away.

Definitely talk to a GI specialist. I think there's more going on than just trauma. :(

Anonymous said...

I'm not a BTDT, but I'm considering the adoption of SN child who has imperforate anus. It's a complicated issue, but what several BTDT parents in that case have said that their kids didn't have a large enough anus to comfortably pass stool, and the kids would get constipated and impacted. I'd get a GI consult to rule out any physical contributions to the issue. Good luck and keep us posted - Laura

lisawall said...

She has been to the Gi dr. He says she is functionally constipated and Mirlax is the best. Since she won't potty on the toilet either, he beieves it is trauma from perhaps past harsh potty training experiences.

Kris said...

My daughter, adopted from Russia had similar issues. She was on Miralax for a long time. I don't have any real words of wisdom. One day my father (her grandfather, who she adores) asked her if she would go to the potty. She did (!!!) and that was pretty much it. She still has some issues with "holding it in" and consitpation but she toilets independently now. I know it is not what you want to hear, but maybe she is just not ready?

Kris said...

Sorry...I forgot to mention my daugher was almost 5 when she finally was potty trained

a Tonggu Momma said...

We dealt with catheters for awhile because of our daughter's sensory-related fear of urination once she developed awareness (pre-potty training - this was just in the diaper).

One of the most empowering, effective things for me to say to her was, "it is your job to make your pee/ poop come out of your body. If you cannot or will not do your job, the doctor will have to help you." Telling her that she had a job to do... it surprised me how much it helped to phrase it just a little differently. I'm not sure if that would help in your case, but I thought I would mention it.

Once we'd gotten past the issue listed above, and took a couple of months break, THEN we tackled the potty training. Nothing seemed to work until she went naked from the waist down for about a week. Her choices were to either go on the floor or the potty. There was no shaming if she chose to go on the floor (I was very matter-of-fact about it), but she did have to "help" me clean it up. After two floor incidents, she started trying the potty. Again, don't know if this would work in your case, but it did for our daughter.

I actually have a three-sheet photocopy of the potty training method that we used. It was designed for special needs children, and really worked for us. If you are interested in it, shoot me an email. It's listed on my blog.

lisawall said...

Tonggu Mom I would love a copy and any all help. She is so afraid just to potty on the toilet. Anyone else ever heard of this problem?

a Tonggu Momma said...

Email me at tonggumomma(at)gmail(dot)com with your snail mail address (I don't have a soft copy) and I will be sure to send it to you. I remember how difficult it was going through this with my daughter. I'm not sure if this will help, but it worked wonders for us and I'm happy to pass it along.

Anonymous said...

We also adopted our daughter from China at 10 months of age. She caught up in every way and soon surpassed other kids her age in verbal skills height, etc. BUT. she will not use the potty. I am talking about urination too. She will hold her urine for 10 hours or so until the screaming from her and tears on the potty and begging for a diaper makes us cave. She is more than 3 and a half right now. She actually tried it with a tiny bit of success twice amid much hysteria and many many many hours of encouragement and book reading etc. It seems clear to me that at least part of the issue is wanting to stay a baby; she has almost said as much. Regardless, it represents something monumental to her. Every 2 steps forward and 1.999999 steps back we tell ourselves she will do it in her own time. As long as you rule out physiological problems it will eventually work out. It is incredibly frustrating and a real issue with trying to find an appropriate school, etc. but you have to remain non judgmental. Believe me she knows its a problem with no comments from us. These little ones are so smart.My friends daughter from China (adopted at 13 months from a foster situation) is 10 and still has serious issues with going "#2". Whatever we all can do to add water and the a few prunes to the diet will go a long way toward at least taking away the discomfort of a bowel movement. But I would like to respond to one of the comments : what is the difference between training pants and pull-ups? Thanks.