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Peer Pressure May Help: Sylvia Rimm on Raising Kids

By Sylvia Rimm

Q. My 9-year-old had colon surgery at one week old and reconstructive surgery at 10 months. He's doing well now and is very healthy.

However, he still has bowel movements in his pants almost every day. The doctor said to give him Imodium AD every day (he's had physicals and everything is fine), but he still continues to have accidents. He refuses to use the bathroom at school and comes home smelling almost every day. I put clean underwear and pants in his backpack, but he doesn't change them. At home, he gets so involved in what he's doing that he forgets to go to the bathroom. I have to constantly remind him or ask him, and I know it must be terribly humiliating and annoying.

I've tried rewards, punishments, almost everything -- nothing works. Any suggestions?

A.When it feels as if you've tried everything, it may mean you haven't tried the one thing that could work long enough. For starters, it would be important not to ever remind your son to go to the bathroom in front of siblings or peers, because that would be terribly humiliating. You may want to replace those nagging and embarrassing reminders with a secret signal. Also, be sure he doesn't hear a lot of discussion between you and other adults about his problem, or he'll feel he won't ever be able to control it.

Your best choice for persevering is using a reward. Select something special that he'd really like to have, and then calculate a reasonable number of points for him to earn toward its purchase. For every day he manages to stay clean, award a point so he can save up for this special gift. Keep encouraging him until he finally earns his reward.

In addition, consider that peer pressure is on your side. You might like to quietly remind him that if he smells bad, friends will probably stay away because of the unpleasant odor. Furthermore, it could cause some very unpleasant teasing by kids.

If these suggestions don't work, I suggest you see a psychologist directly for more help.


A. I responded to a letter from a parent whose daughter was about to have open-heart surgery. The mother was concerned about the potential negative effect on her self-esteem in our body-conscious society, because of the scar that would remain on her chest. Although I reassured her that as long as her daughter had good health, which was anticipated, there wouldn't likely be other negative effects. I've included a letter I received in response and wanted to share, since there's nothing more reassuring than a message from someone who's already experienced the problem.

"Our 20-year-old daughter had open-heart surgery when she was 9 months old. It left her in great health, but with a scar over her breastbone from her cleavage to her diaphragm. It has never caused her any problems with friends or others.

By all means, take a camera to the hospital. Your child will be asking where that scar came from, and it will help to have pictures of what she went through. Most of the other parents who saw us taking pictures of our daughter in the Children's Intensive Care Unit (CICU) thought we were crazy, but I think it helped a lot later on.

Also, be very open but unemotional in discussing the subject later with your child. If the parents assume that surgery was necessary, but don't get emotional about discussing it, it will go a long way in helping your daughter be matter-of-fact about it later."

Dr. Sylvia B. Rimm is the director of the Family Achievement Clinic in Cleveland, Ohio, a clinical professor of psychiatry and pediatrics at the Case Western Reserve University School of Medicine, and the author of many books on parenting.


Categories: Children's Health, Health & Wellness,

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