Delayed reaction to baby, or something more?

Posted by Barbara F. Meltz  August 9, 2010 06:00 AM

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Barbara,
My 3 -year-old grandson was doing very well with the potty. Recently he has started urinating and defecating on the floor and in beds and covering it up with blankets, etc. He has a 6-month-old sister, but this started recently so it doesn't seem to be something he's doing to get attention. My grandson lives in another state with his parents, my son and daughter-in-law. They've called me and discussed the behavior. What could be the problem?

From: RG, Columbia, SC

Hello RG,

The most common explanation is constipation, according to developmental behavioral pediatrician Alison Schonwald of Children's Hospital Boston. She is author of "The Pocket Idiot's Guide to Potty Training Problems."

"When a youngster gets constipated, the poop that is higher up in the colon leaks around the harder poop that has formed at the rectum," she explained in a phone conversation. When the rectum gets stretched, a child loses the signal to go. Confused and overwhelmed, the toddler might cover the poop or pee because of magical thinking that typifies this age: "If I put a blanket over it, it will go away."

Since it sounds like your grandson was fully potty-trained, this also could be a red flag that he's experienced some kind of trauma. Trauma can run a gamut, Schonwald said, "from the minor trauma of a baby being born six months ago, to something more substantial and out of the range of normal experience."

It's true, six months is a longish time for a regressive reaction to surface, but sometimes a toddler can have a delayed reaction to the baby. Maybe he's only just realizing that this baby is here to stay, or maybe the baby is mobile and suddenly getting into the toddler's space.
One way to test this theory is for mom and dad to each (if possible) make "special" time with him every day, even if it's just five minutes, where nothing interrupts their time together, not the cellphone and not the baby crying. If this theory holds, when he sees that he has unimpeded access to them, he will have less need to act out in negative ways to get their attention.

To be on the safe side, however, Schonwald said, "I would want to screen for trauma. It is possible that there has been a traumatic event to which he is reacting, that he saw or experienced, something a child his age is ill equipped to face."

Her recommendation is for the child and family to get a medical as well as psycho-social evaluation.


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2 comments so far...
  1. This might be a question of semantics, but I'm wondering how the situation changes with the following interpretations of the letter. The "covering up" behavior seems age appropriate irregardless, but the accidents themselves could have different circumstances. It could mean as you interpreted it, Barbara: the child is bedwetting or accidentally defecating outside of the bathroom after being potty trained. Or it could be that the child is intentionally choosing not to use the bathroom. I.e, removing pants and pullups/undies and choosing to use the floor, the bed as a bathroom area. Does that change the recommendation?

    Posted by SDP August 9, 10 03:23 PM
  1. SDP,
    He needs the evaluation either way.

    BFM

    Posted by Barbara F. Meltz Author Profile Page August 9, 10 05:42 PM
 
2 comments so far...
  1. This might be a question of semantics, but I'm wondering how the situation changes with the following interpretations of the letter. The "covering up" behavior seems age appropriate irregardless, but the accidents themselves could have different circumstances. It could mean as you interpreted it, Barbara: the child is bedwetting or accidentally defecating outside of the bathroom after being potty trained. Or it could be that the child is intentionally choosing not to use the bathroom. I.e, removing pants and pullups/undies and choosing to use the floor, the bed as a bathroom area. Does that change the recommendation?

    Posted by SDP August 9, 10 03:23 PM
  1. SDP,
    He needs the evaluation either way.

    BFM

    Posted by Barbara F. Meltz Author Profile Page August 9, 10 05:42 PM
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About the author

Barbara F. Meltz is a freelance writer, parenting consultant, and author of "Put Yourself in Their Shoes: Understanding How Your Children See the World." She won several awards for her weekly "Child Caring" column in the Globe, including the 2008 American Psychological Association Print Excellence award. Barbara is available as a speaker for parent groups.

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