7 Ways to Overcome Poop Withholding
For some parents, potty training proves to be one of the toughest battles of child rearing. And if you managed to convince your child to pee on the potty with any sort of consistency, you may find it troubling when your child won’t poop on the potty. Even worse, your child starts resisting the act of pooping all together.
There are a number of reasons that a child might resist eliminating their waste – some physical, some psychological. If you’ve ruled out any physical reasons (constipation, intestinal blockage, etc.) why your kid is bowel withholding (of course, check with your pediatrician first), then today’s post is for you. Not only will we discuss why children may be withholding their stools, but we’ll also share 7 ways to survive this developmental phase.
RECOMMENDED BOOKS FOR POTTY TRAINING:
What is “poop withholding”?
- Also known as paradoxical diarrhea, stool withholding or bowl withholding: voluntary or involuntary fecal soiling in children who have usually already been toilet trained.
This condition is most common among children between the ages of 2-4 years old, but it has the potential to affect babies and school-age kids, often triggered by an episode of painful constipation. As you might imagine, this episode is mentally categorized as a traumatic experience for the child; so much so that when future bowel movements need to be made, the child will refrain from going #2 for as long as possible in an attempt to avoid being in pain again. In fact, the child may be able to go weeks at a time without eliminating their waste. In this situation, the child may or may not be constipated. A lot of children who poop withhold aren’t in any significant pain. They will urinate without any problem and play like any other kid. However, the longer they withhold, the smellier the child will become. Your best case scenario is that the child’s gas will reach unspeakable limits (if you’ve been here, you know that it can be hard to even sit near your child when they are resisting to poop). On the other hand, this resistance can cause a child to soil their underwear, which can lead to a child who hides dirty undies around the house. Whatever the case, no one is having fun.
Why some kids won’t poop
In many cases, a child is experiencing some sort of physical limitation that makes it hard to use the bathroom. Whether they are constipated, have some sort of intestinal blockage, bowel obstruction, irritable bowel syndrome or even undiagnosed food sensitivities; pooping hurts. In particular, children with cerebral palsy have a particularly hard time passing stools. You may or may not be able to get to the root of the problem by talking with your child as most preschoolers don’t know how to communicate why it hurts or how it hurts – only that it hurts. If this describes your situation, call your pediatrician to discuss options.
If your child has been diagnosed with a Sensory Processing Disorder (SPD), then he may not like to poop because he doesn’t like how it feels. Even if your child hasn’t been formally diagnosed with SPD, he may have a sensory aversion to pooping. Kids who have an aversion to pooping would rather clench their sphincter muscles for days or even weeks than to feel the sensation of waste being eliminated from their bowels. It sounds ridiculous, but it occurs in roughly 1 in 5 kids.
In the book, Ina May’s Guide to Childbirth, Ina May Gaskin describes something she calls the “sphincter law.” Yeah, it seems a little odd to reference a child birthing book while talking about kid poop, but stay with us. Just as we think of the cervix and the vagina as a type of sphincter (relative to childbirth), the same laws of taking a poop successfully, apply to delivering a baby. So, in much the same way that many of us have difficulty having a bowel movement in a public restroom, or when we travel out of town, but can easily go as soon as we are back in the comforts of our own home; children experience the same sort of thing – except that a 2 year old finds comfort in a quiet corner (or by the train table) so that they can relax their body enough to poop. Essentially, we all crave some sort of privacy and solitude in order to do our “business.” However, the sphincter doesn’t react well to time limits or pressures to poop on demand.
Fears or Bad Experiences
Many children will accept pooping in a diaper (or their underpants), but will avoid pooping in the toilet at all costs. All kids are different, but common fears include being afraid of balancing on the potty or falling in, the sound of the toilet as it flushes, or fear of the bathroom itself (maybe the “Boogie Man” sleeps there during the day?). Alternatively, a child may just have a bad memory associated with pooping. This can easily happen if your child has a bout of constipation, followed by blood in their stool. It could also happen if an older sibling or another child makes fun of them over a poopy situation. Of course, while we’re on the subject of bad experiences, be sure that you rule out any possibility of sexual or physical abuse, which can also be a root cause for elimination issues in young children.
7 Approaches Worth Trying
1. Be Very…Very Patient
First recognize that everyone poops in their own time. For some people, that means after every meal, for others it means once a day, and for others it means every few days. Whatever the case, everybody’s body is different. Even knowing that, you’re going to get frustrated with your child when they withhold, but forcing the issue will not make anyone poop on demand. It may take some time, but your child will eventually figure it out. In fact, the best way to deal with the situation is to act as if it doesn’t bother you at all. For some reason, the more attention you bring to the situation, the more it becomes a problem.
If your children are anything like our children, they love to read and be read to. Just as you read books about colors and shapes, parts of the body, their first trip to the dentist and their favorite fairy tale characters, be sure to read and talk to your child about poop. Here are a few of our favorites:
“I Can’t, I Won’t, No Way!: A Book for Children Who Refuse to Poop” by Tracey J. Vessillo For parents and children coping with the intensity of bowel withholding, this book presents the issue in kid-friendly terms. By the end, the little boy character has used the potty and is mighty proud of himself and tells the reader that he/she can do it, too.
“It Hurts to Poop: A Story for Children Who Are Scared to Use the Potty” by Howard J. Bennett In this book, the main character (Ryan) is scared to use the potty. He’s afraid to have a poop because he’s afraid it’s going to hurt. When Ryan’s parents take him to visit Dr. Gold, she engages his imagination with the story of Bill the Coyote’s messy house. She also shows him what happens inside the body, and explains how different foods make using the potty easy or hard. This story, along with Ryan’s “poop program,” will help young children gain the confidence they need to overcome this common problem and establish healthy habits.
Alternatively, if your child responds well to videos, we really like these “Potty Time” videos by Two Little Hands. The main message is “listen to your body when you need to go potty.” It’s kinda catchy! Either way, when you notice that your child is demonstrating signs of needing to poop, get down on their level and talk about it. You can reference the books and characters. Keep your conversation simple, nonjudgmental and to the point. What does it feel like? Does it hurt? Does it feel weird? Is it scary? Kids don’t always know how to describe what they are feeling, so these questions will help your child better use their words.
RECOMMENDED POTTY CHAIRS
3. Establish a Routine
A consistent routine is often the key to creating a pattern of elimination. It’s as simple as keeping regular meal times, followed by a trip to the bathroom. If you can encourage your child to use the bathroom at these regular intervals (after waking up, following a meal, before bedtime); the stomach, bowels and bladder will have a chance to empty. It’s much like when your mom asked you to use the potty before getting in the car for a long road trip. The same thing can be done here, but you don’t necessarily have to be going on a road trip. And, this isn’t to say that your child will eliminate waste every time they sit down on the potty, but food tends to stimulate the bowel.
Avoid using the potty as punishment (ex. “you better poop on that potty or I’ll take away your iPad!”). Simply focus on establishing the routine. If they go – great; but don’t express disappointment or frustration if they don’t. Just keep trying. Over time, you’ll find that your child follows a pattern. Rather than forcing poop on your schedule, just follow your kid’s natural routine.
4. Adjust Your Child’s Diet
Many times, your healthcare provider will suggest that you increase natural fibers in your child’s diet. While this can encourage the bowels, it may not cure the situation. However, it’s never a bad idea to emphasize non-constipating foods, increase natural fibers found in most fruits and vegetables, make sure your child is getting plenty of fluids (water and juice – avoiding sodas that dehydrate) and limit foods that have a tendency to constipate.
If your child is also a picky eater, you can always sneak fiber into their diet. We really like the blueberry breakfast biscuits by Nature’s Valley, Fiber One’s Fruit Flavored Snacks (our kids actually like these better than the character flavored gummy snacks), and Fiber One’s Brownie Bars. Other more obvious choices are broccoli (with cheese) or brown rice with dinner, and pear juice (often found in the baby section of your grocery store). In addition, you can offer daily probiotics to support gut health.
The goal here is to keep those stools soft and regular in the event that there is any hint of constipation or pain. However, if your child is not constipated and is withholding for other reasons (mostly psychological), even a healthy diet won’t do the trick.
5. Add a Daily Supplement
Another common tool recommended to kids who bowel withhold is the use of a fiber supplement, laxative, stool softener or enema. Talk to your pediatrician before trying any of these options, but a daily half-cap dose of Miralax mixed with your child’s morning cup of juice helps a lot. Your child may still go through bouts of withholding, but when you start applying all of the approaches listed, your child may relax long enough to let their body do what it needs to do.
That said, having mineral oil (found in the laxative section), along with Pedia-Lax Saline Laxative Chewable Tablets and Pedia-Lax Liquid Glycerin Suppositories on hand just in case your kid goes more than 3-4 days without a bowel movement is recommended. We try really hard to avoid using enemas, but they are sometimes necessary.
6. Ensure their Comfort
Figure out where your child prefers to use the bathroom and roll with it. If that means your child will only pee and poop on their little potty, suck it up and buy that exact potty for every level of the house (even bring it on the road with you when visiting relatives). Yes – that means more cleaning for you, but your job is to remove any obstacles that may be preventing them from making poo.
What if your child is only comfortable pooping in a diaper? Again, roll with it. If your child is withholding, at some point you will realize that it’s more important that they eliminate waste in a diaper than it is that they poop in the potty. In fact, there are many preschoolers (and older kids) who are “pee trained,” but will request a diaper just for pooping. Pay attention to their pooping behaviors though. Typically, children will seek some form of privacy to empty their bowels (be it in a corner, behind furniture, squatting in front of the train table, etc.). Gradually encourage them to take that private moment to the restroom, even while staying in a diaper.
Over time, you might suggest that they sit on a potty (big or little) and poop – again, still in their diaper. Then, cut a small hole in their diaper and increase the size of that hole over a period of weeks until your child is pooping through the diaper straight into the toilet. Alternatively, if the sound of poop splashing into the water scares them, you can have them sit on the potty directly while having a diaper taped under them (on the potty) to catch the poop. If it sounds like a lot of work – it is, but poop is poop.
Some parents find that reward systems work really well for their kids. So, if your kid will poop for stickers that will eventually earn a toy, more power to you. Our experience has been that the relief of pooping is enough of a reward.
If you’ve put all of the other tips into action, you’ll find that your child has all the tools they need to overcome whatever it is that is preventing them from pooping. When they do finally get over that hump, it feels good and they’ll want to celebrate it with you in some way or another (high fives, hugs, etc.). Not only is their body thanking them, but there is a sense of accomplishment.
We know how frustrating this situation is, but we promise that your child will eventually learn how to poop. Until then, hang on tight and breathe.
Tags: bowel obstructions, bowel withholding, childhood fears, constipation, constipation solutions, encopresis, fear of pooping, fear of the potty, food sensititives, ibs, intestinnal blockage, irritable bowel syndrome, paradoxical diarrhea, poop withholding, pooping behaviors, potty challenges, potty training, potty training obstacles, real kid challenges, sensory aversions, sensory issues, sensory processing disorder, sphincter law, stool wittholding, toilet fears, toilet training
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