M.D. promises 4-day fix for potty-training problems

Swapna Venugopal Ramaswamy | The (Westchester County, N.Y.) News Journal

Show Caption Hide Caption Potty training holdouts get help Dr. Frederic Daum of Lachmont, talks about how he consuts with parents and how he helps them and their children solve their potty related problems. (Video by Joe Larese/The Journal News)

Daum is a pediatric gastroenterologist

Traditional treatments for encopresis can be very traumatic to the child%2C fellow doctor says

Daum%27s treatment called %22quick%2C but it%27s not easy%22

LARCHMONT, N.Y. -- Stacy Arinsberg was skeptical of a new treatment that promised to help her 5-year-old become potty-trained in four days. Over the phone.

Her increasingly frequent visits to hospitals for her daughter Julia's chronic, painful constipation and her refusal to use the potty had proved fruitless.

In April, browsing the Internet for information on stool withholding or encopresis, Arinsberg came across DoctorDaum.com, a telephone coaching service offered by Dr. Frederic Daum, a Harvard-trained pediatric gastroenterologist who lives in Larchmont.

At first, the claims by the doctor, the chief of the division of pediatric gastroenterology at Winthrop University Hospital on Long Island, seemed too good to be true.

"I didn't really believe it, but I wanted to give it a try," said Arinsberg, of Sellersville, Pa. The method would cost $450, and didn't include a single face-to-face interaction with the doctor.

The very first call reassured her.

"He asked so many questions. It was very intense. He wanted to know everything about Julia and our family from the time of her birth," Arinsberg said. "He was trying to figure out the behavioral issues."

Most other doctors she had been to would prescribe a laxative for a few days, "But that never really worked," she said.

What Daum required from Arinsberg was a total commitment for four days, and an unusually tough stance as a parent. Apart from a regimented system of oral laxatives administered under his guidance, the child would spend the first three days entirely in the bathroom. Arinsberg, who works as an office manager, picked the Memorial Day weekend to begin the treatment.

A television set was brought into the bathroom. The space was filled with toys. And all Julia was allowed to wear was a long T-shirt — no underwear, no diapers. Arinsberg would remind her to sit on the toilet every hour. The next day, it was Julia's responsibility to set an alarm to use the toilet every hour.

All through the four days, and for several days thereafter, there was much hand-holding over the phone by the doctor.

"He would call every few hours, just to check on the progress," Arinsberg said.

By the end of two days, Julia was asking to go the bathroom. But the accidents didn't completely stop.

"We had to tell her this was not acceptable. We took toys away from her," said Arinsberg. "It was tough love. One day she sat in the bathroom with no toys and nothing to do."

By the fourth day, Julia was allowed to move back into her bedroom. She also started using the bathroom.

"It ended up taking a little longer than four days, but it worked," said Arinsberg.

Apart from his 45 years in the field, and specializing in encopresis, his own experience with one of his five children is what led to his approach, said the 71-year-old Daum. He started with a seminar called "All About the Toilet " at Winthrop more than a decade ago.

The prevalence of encopresis, however, is difficult to quantify.

"This population is underserved, under-diagnosed and under-treated," Daum said. "The embarrassment and the anxieties for families dealing with the problem prevent them from seeking attention until there is a major social crisis. These patients are seen initially by primary-care doctors and nurse practitioners who infrequently keep data."

Among his patients now are children in Europe, Saudi Arabia and Mumbai.

"I toilet train parents," he said. "In a way, it is teaching parenting skills."

Dr. Daniel Miner, a pediatrician on Long Island, has recommended many of his patients to Daum over the years.

"Kids who are not toilet trained by age 3 are what we call potty-refusers. They know what to do, however they will fight you every step of the way," said Miner. "It's where potty training has turned into a power struggle. It's a battle a parent can never win."

Traditional treatments such as enemas may be very traumatic to the child, said Miner. Sometimes, older, previously toilet-trained kids struggle with encopresis, which is usually brought on by stress.

"The treatment has to tackle the behavioral issues that underlie a lot of the difficulties that lead to the refusal," said Miner. "What Dr. Daum does is quick, but it's not easy."

What surprised Phyllis Prater, a grandmother from Tempe, Ariz., was the barrage of negative comments she said her daughter was subjected to when she posted her successful experience on a Facebook page dedicated to encopresis.

Prater's had been struggling with toilet-training her daughter for a couple of years when she found Daum on the Internet.

"They think she's a plant," said Prater, 71. "It seems so foolish to me, but I think it's because they feel so helpless, like when you have a child who is an alcoholic, and you are just not able to get through to them."

Arinsberg said Julia remains on a low dose of laxatives, and she checks in with Daum often. The thought of starting kindergarten in September is no longer filled with dread.

"She's a lot happier now. You can see it in her face, her body language and her appetite," said Arinsberg. "It was hard, and if Dr. Daum hadn't been checking in with us, we would have given up after the first day."