Faecal incontinence, faecal soiling or pooey pants - whatever you want to call it, it can be very distressing for children and parents. But it’s also more common than you think. We just don’t talk about it much!

Generally, faecal incontinence in children is defined as involuntary defecation (pooping) at inappropriate times, occurring after the typical age of completed toilet training which is generally four years of age or older.

The most common cause of faecal incontinence is constipation. This is because the hard, compacted poo has stretched the bowel, so that it no longer registers the need to poo.

Softer, more liquid poo then makes its way around the hard poo, and leaks out, known by the experts as sneaky poo.

Autistic children quite frequently suffer from constipation, and so are also more likely to experience faecal incontinence. It is also possible that your child has reduced or overactive body awareness.

A child with low body awareness may happily sit in a full nappy, or only go to the toilet when told to. A child with high body awareness, may hold onto their poo as they find the experience of going to the toilet too challenging.

What to do:

Reassure your child that the problem is not their fault, and you will help them deal with it. 

Talk to your doctor to decide on a management plan. They may refer you to an incontinence nurse for extra help.

Let your child’s school know about the issue and what you intend to do about it. Ask about support through the school such as a teacher aide who can help carry out the plan. If your child needs to be changed at school, this comes under High health needs funding not ORS funding. 

Set realistic expectations – there is unlikely to be a quick fix for your child. The general rule of thumb is that it may take months or even years to fully resolve the problem.

Your doctor may recommend a programme of laxatives to initially empty the large intestine and rectum. They will want to establish regular bowel movements. Your child may need to have some time off school for this part of the programme. It is possible your child will benefit from ongoing doses of carefully monitored laxatives.

Look out for signs that your child is becoming constipated again. This might be stomach aches, bad breath, flatulence, or soiled underwear.