The move from diapers to the toilet is often a challenging time, for both you and your child. There are some hurdles that parents may face in the potty-training phase — and sometimes you find yourself up against a toddler who simply refuses to poop.
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“Stool withholding, in which a child avoids having bowel movements, is a fairly common issue that we encounter,” says pediatric gastroenterologist Deborah Goldman, MD. “Kids eventually get toilet trained, but it’s important for parents to address this problem right away because it can lead to other issues down the line.”
Why stool withholding happens
Depending on how ready your child is, potty training can start as early as 18 months or as late as age 3. Stool withholding behavior is more common in boys and and can potentially develop at some point during this process, Dr. Goldman says.
“The most common reason is if they passed a very hard or large stool — either from a change in diet, constipation or something else — which is painful for the child,” she says. “This causes them to associate pain with passing stool, and they start withholding it instead. So it can take just one painful experience to turn into a vicious cycle.”
Some children might start withholding stool because they aren’t emotionally or physically ready to start using the toilet yet. Others find the experience intimidating — the size, sounds and location of a toilet are sometimes overwhelming for a toddler.
It’s also possible that your child is using stool withholding as a “power play” for more attention. There are certain medical conditions that cause this behavior as well, but these cases are very rare, Dr. Goldman says.
Nip the problem early
If stool withholding continues without proper treatment, other problems will develop that make matters even worse, Dr. Goldman says.
When a child doesn’t poop for a while, their stool collects and hardens. With this backup in the rectum, other softer or liquid stool can leak around it and stain their underwear. Unfortunately, many kids cannot prevent this soiling because they eventually lose control of the muscles that control their bowel movements.
According to Dr. Goldman, kids who are withholding their stool also can have bedwetting issues, urine leakage or even urinary tract infections if the problem continues for long enough.
Practical tips for potty training
“Parents can usually get most stool-withholding issues under control as long as there’s no underlying cause or medical condition,” Dr. Goldman says.
First and foremost: “You can’t force a toddler to use the toilet when you start potty training,” she says. “Make sure they’re ready before you begin training them. Otherwise, they may develop a fear.”
Making your child feel comfortable while he or she is learning is important for success. It’s important to make sure:
- Your child’s feet are at the appropriate height for the toilet.
- There’s a stool in every bathroom.
- Toilet seats are secure so your kids don’t think they’ll fall in.
Also, if your child is anxious about using the toilet, ask what he or she worries about and address the concerns, both in and out of the house. Some children fear public bathrooms, so prepare for that, too.
It can also help to make changes to your child’s diet or use fiber supplements or stool softeners. However, you should check with your doctor first for specific advice.
See your doctor if your child is still having issues after two or three months, or if you notice any other problems like vomiting, eating or weight issues.
When your child’s ready for potty training, a good dose of patience and a little understanding from you will help your child soon say goodbye to diapers for good.