With the start of school resulting in a major transition for many children, families are likely to see significant changes in their child’s behavior with regard to toilet training. Stressful separation issues from the mother often results in stool and or urine accidents during the day. These problems can be easily resolved if parents and school personnel and school nurses are sensitive to these issues. Most parents are very tuned into a child’s changes in behavior and signs of ‘withholding’ or need to use the bathroom. However, observation of your child’s behavior may not be as obvious to the school staff.
Parents should not feel that occasional encopresis represents a failure or “back to the way it was”. It is imperative that school personnel, who should understand behavior, be very supportive of families at these times.
It is best NOT to lower the laxative dosage during the first few weeks of school. Have a wait and see attitude and seek constant input for guidance.
In addition to the inherent stresses of school itself, many of your children are also starting a host of fall activities including after school programs, extended day care, sports practices, tutoring/enrichment, religious education, play dates, etc. Some children have evening programs for additional activities. Children also may be on a school bus for extended periods of time, arriving home as late as 5:30- 6:00 in the evening.
I spend many hours with parents to determine the appropriate dosage and timing of laxatives to avoid school and or bus accidents. All effort is made for your child to go to the bathroom at home in a more comfortable environment. Michelle and I recognize the stress felt by parents to have a perfect resolution of your child’s encopresis. Spend time reflecting on what you think will work best and help us individualize the right strategy for your child. Do not panic…we are here to support you and your child.
Dr Daum
