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Question
I have triplets who are 4 1/2 years old.  All three have been potty trained with peeing for over a year now.  However, one of them has not been potty trained with pooping.

He poops at night in his diaper.  He refuses to sit on the potty during the day.  A quick back ground on him: he was diagnosed with mild to moderate ASD since he was 3.  He has anxiety and is also very rigid with his routine so we have to balance the anxiety and inflexibility with introducing new things.  

I think he's asleep when he poops, and his pediatrician seems to think so too.  The pediatrician does not seem concerned about the fact that he has not potty trained while his special ed teacher thinks we need to "force" him.  So, I have two experts giving me different advice.  

Can you tell me what to do? If I am to "force" potty training, how do I change his body's clock from going in the middle of the night to during the day?  

Thank you.

Answer
Hi, Abbey,

Interesting question.  I am pretty adverse to the idea of "forcing" anyone to do anything, especially a stubborn kid who has anxiety and is inflexible.  He will just buck up and refuse.  I would think that giving a dose of Miralax, a powder that is tasteless and can be given in any favored beverage, in the morning, would reset his poop clock and cause, painlessly and easily, a daytime BM.  Discuss this with your doctor or just try 1 cap of Miralax in 4-6 oz of a favorite liquid each morning at breakfast.  I'll bet it will work.

Good luck, dr. Olson

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David Olson, MD

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I would be happy to attempt to answer any questions about general pediatric topics, either medical issues or behavioral issues. This would include all the various questions one receives in a busy pediatric practice. I`m a board certified pediatrician in northern Michigan and have been in practice for over 15 years. I enjoy the teaching role I have in our practice and would enjoy the opportunity to help others with their pediatric problems.

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