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Tips for When a Toddler Withholds His Poop
Potty-training complications are pretty common topics of discussion around here. Stephanie’s question about one of the more common complications — poop withholding — comes up at a time when many of us are frantically trying to get our toddlers ready for preschool in the Fall. The frantic pressure parents feel to get their toddler trained — at any cost — so that they can start school — can be a major impediment to the natural process of potty training. 
Here’s Stephanie’s question:
Dear Dr. Heather,
I am sure I have fallen victim to what many moms before me have, and it’s the sense that we have to have our toddlers potty trained for preschool. My eldest, just turned 3, advanced to his new classroom where all the kiddos were “poop-potty-trained”, and mine was not. They said they would work with him. We had been talking about it and reading funny books about it at home. But with this new classroom I upped the ante at home, and disaster has resulted!
He pooped in the potty 2 times and I rewarded him HUGE with toys and praise. He then pooped at school and everyone got super excited for him. And that is where my story ends. Prior to his successes he has pooped hit and miss, not consistently in the potty. And I am embarrassed to say if I caught him pushing in his underwear I would walk/run him into the potty and tell him to poop here and say things like “I know you can poop in the potty, I have seen you do it before. If you poop in your pants Mommy will not be happy. You are a big boy and need to poop in the potty.” I thought I was motivating him and he knew he would get toys/rewards for pooping.
So now we have a withholder. He dances around on tip toes and is trying to hold it in. I see him trying. I try to encourage him and still nothing. After 4 days we used a glycerin suppository and he got relief. Then another 4 days goes by with this same behavior. Another glycerin suppository with positive results. Now we have these frequent (20+) smears a day in his pull up. I am encouraging him to poop-even if it is in his pull up. He won’t sit on the potty anymore, but will still pee in the potty standing up-no problem! I realize now we and school have stressed him out. But now what??? How do I get him back to normal bm’s?
I took him to the pedi and they said he wasn’t impacted and his “tone” was normal. So now this is a control deal, right?
Advice please!!!
Stephanie
Hi Stephanie,
Yes, unfortunately now this IS a “control deal”. And your little guy is proving to you that HE is in control — and he IS — of his pooping.
The common preschool policy of “toilet independence” by age 3 is completely ridiculous, in my opinion. It puts too much pressure on at a time that can easily lead to the complications you’re experiencing. What’s wrong with a few more months of diapers or Pull-Ups? Many schools do understand this, and although they may not advertise it, WILL work with each child on an individual basis. Each child’s timeline is a little different. Giving your child control over the issue is the secret to simplified potty training. The more parental interference, the more complications.
The only thing to do now, Stephanie, is to back off, completely. And by that I mean NO mention of the potty or toileting behaviors, at least for a couple of weeks.
But first, explain to him that “I can see we pushed you too hard to poop in the potty, but YOU are in charge of your pooping. You decide where and when you want to poop.” At this age, he can’t understand the rationale that “poop is inside of you and needs to come out, for your health”. So quit any attempts to reason with him about this. In his preschooler’s mind, he believes that he can WISH away the poop with the FORCE OF HIS MIND. Don’t argue with his fantasy wishes. Rather, back off completely from all pressure to go in the potty. You can still rescue him from long-term withholding by taking the pressure off, and eventually letting nature take it’s course.
Go back to the old way, before Pull-Ups. Try diapers and act like the old way is normal. “It’s OK, let’s go back to diapers.” Or use whatever he prefers; let him choose. Don’t pay attention if he dances around and tries to hold it in. Force yourself to ignore it, but not in a frustrated way. If he poops in his diaper, don’t reward or praise him, just act very matter-of-fact. You want to unload all the emotion out of this issue. You want him to feel comfortable pooping, first of all, since withholding can really cause problems, in the long-run. Then, make sure EVERYONE is on the same page; parents, sitters, teachers, grandparents. You are all on a 2-week-hiatus from potty training.
In the meantime, I suggest doing a major fiber-loading of his diet (of course, with his pediatrician’s approval and direction). The doctor might also suggest something like Miralax to add to his juice in order to “speed things along”, and to minimize the chance of withholding and constipation. (Sneak it in to his drink, so he doesn’t feel manipulated by you.) And make sure to pretend not to notice any accidents or staining, or clean them up without commenting negatively. “Oops, here, let me clean this up,” is enough.
Huge rewards can also complicate matters. Over-doing it with the toys and praise takes away from the child’s own internal sense of satisfaction with mastering this important skill. A huge response, positive or negative, tells the child that he’s doing it for YOU, not for himself. So when you do use rewards, keep them low-key. Stickers, token rewards, and simply stated praise shows your approval for his progress. But it’s HIS progress. You’re just a supportive observer to the process.
And about the suppositories: While effective, they can be rather harsh, from a psychological perspective. It tells the child, “I am forcing you to poop. I am in charge of your body, by forcing this inside of you….YOU are not in charge.” Ideally, we want to reinforce the notion that the child is in charge of his OWN body. Suppositories and enemas can be experienced by the child as a violation of his own fragile sense of bodily control. And while they MAY be necessary if, later on, he has a more severe problem with this, right now I do think it’s premature to resort to that degree of intervention.
After a couple of weeks, it will become clear whether this has already settled into a negative, long-term pattern, or whether he is willing to turn this around. Try this approach and let us know what happens. Good luck!
Aloha,
Dr. Heather
The BabyShrink
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- Sep 25, 2009: babyshrink.com » Blog Archive » Poop-Withholding After a Trauma
This was exactly our situation, and we did things almost exactly as Dr. Heather has described to great results. My daughter had been withholding since she was about 2 – we’d go a week or so without any poop, and then giant, blood-streaked poop would eventually happen. When my son was born (daughter was 2.5), she apparently put all of her emotional stress over the situation into withholding, with the result that (at the risk of being too graphic) we were ‘rewarded’ with the biggest turd I have ever seen in my life, once she had calmed down some.
Our doctor advised that she might have lost the sensation of needing to poop, since she’d been waiting until the poop got unreasonably large to pass it, so he also recommended Miralax and/or Benefiber. We also backed off talk of pooping on the potty, and I went back to changing Pull-Ups for awhile. Once she was pooping on a fairly consistent basis, we cut back on the Miralax (actually, she never had much of it to begin with; with us, this turned out to be a relatively short process) and kept an eye on how often she was pooping. One day after she’d become pretty regular, my mom was watching her and told her there weren’t any Pull Ups that day, so she just pooped in the potty and that was that. She’s been doing it ever since, sans Miralax.
I also agree that the suppositories (we used the liquid kind twice) are awfully traumatic; we also had a situation in which the first worked like a charm, but she managed to withhold the second time for much longer.
Our preschool also told us that, all stated “completely potty-trained” rules aside, they’d work with her if needed. Our experience was that she was so good at withholding that there was no way in the world she was going to poop at school.
Just my $0.02.
(edited to add that we started Miralax when she had just turned 3; she completely potty trained at about 3 and a half).
THANK you soooo much Dr Heather! And Thank you Lori for your respose.
I have been beating myself down these last 2 weeks thinking I was the only one going through this and wishing I could go back in time and undue the pressure we put on our boy! (Lesson learned at least we know better for little brother!)
We’ve kinda been flying by this last week alleviating all pressure and just going with the flow. I will integrate this new advice today….as soon as he gets up from naptime and let you know how it goes.
Thank you so much for your personal advice to our exact situation. I appreciate it!
Wish me luck!
Stephanie
Although our 2 week hiatus went okay and the smears have stopped, we still are having issues. I don’t know what to do. I’m hesitant to run him to the pedi again and risk more “probing” into his personal issues. His smears are more like soft bms now and he has about 5-6/day, but they are far from his normal pattern. He acts like he has the urges to go and runs off to hid. I have followed him and what I see is him standing there with his legs crossed making stressed out faces. I asked him is he is pushing or holding, he tells me pushing, but let me just say it doesn’t look like it. And although some stool comes out, I think it is an accident. We watched a potty training video and after ward he sang the songs but told me he wants to be a baby and give his underwear to his little brother and take his diapers. GEEZ….what do I do? Is this a long term problem now? Should I take him to see someone?
HELP please. I am so worried and upset to watch my little boy go through this. It is consuming so much of his day.
Thank you.
Stephanie,
I think he’s telling you what he needs…more time. 2 weeks clearly was a good start for him, and it helped. More pressure at this point isn’t helping. Can you try to go back to that mode where you let him “cruise”? I’d really try to follow his lead. What’s so bad about diapers? Lots of kids — especially boys — use a diaper until after age 3, nowadays. One of my kids pooped in a diaper until he was more than 3 1/2. He’s fabulous and awesome now at 6.
Brazelton addresses this issue beautifully. Have you seen his “Touchpoints” book? I strongly recommend you take a look at that. He reinforces the fact that we can’t force an unwilling toddler to toilet train, and really risk some negative outcomes if we do…and that we have to learn to trust our kids’ unique developmental progress in the meantime.
When you say it’s consuming so much of his day, is he able to enjoy other activities, when they are available? I would emphasize age-appropriate social activities — preschool is great, except for if they give him a hard time about the diapers — give him fun stuff to do and be engaged with. If he’s already consumed with toilet training, to the exclusion of other activities, even after YOU let it go, then it might be time to call in some expert help. But I would try going back to the “no pressure” approach, for at least several more weeks. FOLLOW HIS LEAD…and good luck! Let us know!
Hi everyone! I am new here and was just browsing the web for pooping problems in toddlers. Here I am! My daughter will be 5 at the end of November. She has had pooping issues from day 1 of life. She has had molasses in her bottles with us “helping” the poop out with q tips….gross and graphic, I am sorry! Here I am now, going on day 5 of no poop again. She has had prunes today and warm apple juice which sometimes works. She gets Metamucil every other day to help with her fiber. She has poop stains every day in her undies. She has been poop and pee potty trained for well over a year and a half now. The longest that she has held it was 13 days. Too long in my opinion! Every night, she wakes us, crying that her belly hurts. I tell her it’s because she has to poop, to no avail……I wonder what I can do as diapers are no longer even in our house. I have a call into the doctors to see if maybe there is a problem internally with her. Any suggestions would be GREATLY appreciated!
Hi Carolyn,
At your daughter’s age (almost 5), it does seem to be time to have a professional medical evaluation. This doesn’t sound like the typical email I get of a 3-year-old being oppositional and striving for independence by withholding poop — it sounds like there are underlying medical causes (since you said she’s had problems since day 1). She’s withholding now maybe BECAUSE of the underlying problems — which would need to be addressed first. GOOD LUCK and don’t give up until you get a medical workup and treatment plan that WORKS for your daughter!!
Hi Dr. Heather.
We’re having the same issues here. My son is getting close to 4 and withholding and we’re becoming very frustrated with it! I’m also glad to know we’re not alone in this venture. He will say how much is hurts and that he’s afraid – but he is not constipated. I feel like this has been going on for too long. At some points he will be just fine with it, but then he will go through phases of holding it and it hurts to see him in such pain. My gut tells me that we should ignore this because it is a behavior and doesn’t seem to be physical. But I have a hard time getting my husband on board with this! Any advice would be greatly appreciated!! Also, he does pee in his pants as well – he will just go a little bit and then keep playing. We started to give him a jelly bean when he pees and has dry pants and that has helped tremendously!
Hi Lynda,
At his age, he can certainly appreciate the jelly bean approach. I think it can be very useful. They don’t need more than one; but it sure seems to do the trick for many kiddos. Or maybe 2-3 jelly beans for pooping in the potty, 1 for peeing. Rewarding his choice of the right behavior is bound to get you further than scolding or pressure for regressive behavior. Good luck!
My little girl is two in a couple of days she has started to say I have to go potty but nothing yet on the potty. She has had some problems with pooping she is just going a very little bit alot during the day and it hurts her but it is very soft. what do I do?
Hi Leslie,
I would first have her checked by her pediatrician to see if anything is going on physically. She’s still pretty young to be worrying about potty training, anyway….follow her lead. Check out some of my other posts on potty training and good luck! Let me know if you need more help.
Dr. Heather!
I am SOOO glad that I happened upon your blog. I have a 3 1/2 year old son who is the KING of withholding. WOW. We just gave him a saline enemia this evening and he hopped around for an hour and still managed to hold the “big one” in. (little splashes or puddles of liquid come out-but he tells you that the big one is still in there)
We have been to a GI specialist, so we know it is not physical. It’s all emotional and you are the first one i have seen who actually addresses the psychological factors of this pretty common issue.
I am going to try the two week program of NO POOPY TALK (very very hard for mommie) and just pull-ups. he is already on miralax two times a day and has had supposetorys and the enema. i am worried about the “big one” he mentioned. will the miralax soften it to the point that it will pass? i am so afraid of him becoming compacted that it makes it very stressful for me..sigh.
Anyhoo, thanks for being here at 9 o’clock on a saturday night after superpoopholding boy managed to hold in another poop and mommie is exhausted..i feel better
Dr. Heather
I don’t know if you’re still following this thread, but my daughter who is 2 1/2 is also withholding throughout the day and now, even in her sleep! She is taking Miralax, so I’m not worried about the physical problem– it’s psychological aspect I find so upsetting. She spends her day hiding in corners, visibly fighting the urge, crossing her legs, grunting. Poor thing. If I even mention the word “poop” she yells, “No, I don’t want to poop!” It is definitely a battle of wills, because this same sort of negativism is manifesting in other ways in our relationship. My pedi says not to worry– to continue not discussing the issue with her, but the issue has come to rule our lives. She struggles to hold it in all day long, wherever we are– the park, the store, playdates. I feel like she’s struggling emotionally and it’s breaking my heart.
I’ve bought some potty dvds– like Elmo’s Potty Time and Potty Power. Can I let her watch those or is it too invasive? Can I try taking her out of pull-ups and putting her in Dora underwear as an incentive to use the potty? Or is this also doing too much at a time when I should be doing nothing in order to lessen the power struggle? Thank you!!!
Thank goodness I’m not alone! One of my twin boys at 3 and 2 mos is holding in poop and I’ve been feeling like a failure that he and brother are not potty trained. I wish everyone else around me could let it go that it’s okay for them to be in diapers. I just need to keep reading that I need to relax as well and to not talk poop – it is so hard because it does seem to take up a lot of our time. We give him Metamucil and were giving him Miralax on dr’s rec but then over the last few days he’s going each and every time I change him so the sore tush that we got cleared up was getting sore once more (this seemed to be his original reason for holding). He doesn’t push anything out because he’s crossing legs, tip toeing and holding on not bearing down so I know that it’s just escaping him. I just fear that he will retrain himself and not know how to push again. I miss him telling me that he’s pooped and smiling about it because he “feels better”. He doesn’t say go away when he poops and he doesn’t seem to care that it’s there. But from reading here it seems I need to stop saying a word about it and just change without saying much…I hope it helps him. I want him to be confident about his body and that we all do this and that it is okay. I want to be reassured that they will us the potty even if they are not trained yet. I want to be told that not pressuring them if they are not showing interest in the potty is ok.
I posted on Nov 7th and thought I would follow up. Like Meredith’s son, my daughter developed a terrible, terrible rash from the Miralax. We were only giving her a quarter cup a day but she was leaking all day long. She feared diaper changes and I dreaded doing them because of the pain they caused. I tried every cream on the market, nothing helped. I put her in the tub to rinse her instead of using wipes, but even the water hurt her. After 2 months of this I had to take action. It was so heartbreaking watching her cross her legs, walk funny, cry out in pain etc. I knew I had to help her– not talking about poop wasn’t working. So I chose a time when i knew we could stay home a few days and took the diaper off her once and for all. I hid the ones I had in the house. I dressed her in a shirt and nothing on the bottom. At first she panicked, begging for a diaper. I told her I didn’t have one and told her that she knew where her potty was. She cried and had an accident. I cleaned it up, told her it was okay and in general didn’t draw too much attention to it. When it happened again, she did the same thing but this time she ran toward the potty. The third time I actually got her to sit on the potty. When she was finished I gave her a tiny handful of mini m&ms and told her she could have some everytime she used the potty. She was so pleased with herself and I was so very proud. My goal was to tackle the rash first, and then the poop issue. I felt the rash and the constant, painful diaper changes were contributing to her withholding. By the morning of the 3rd day, her rash was gone! And…she pooped on the potty! It was painful. She cried, poor thing. I had bought some presents at Target that I’d wrapped and put in a basket. I let her choose one. She was thrilled. I told her when she pooped again she could have another. I never went back to diapers. I bough a little $10 portable travel potty for the car on Amazon. It fits in your purse. I only use the pull-ups at nap and bedtime. I now call them her “sleep pants”. She’s not pooping every day. She’s afraid of the pain– her stool can be quite large and hurts to pass. But I feel like we’ve made progress. I started the Miralax again (I had stopped initially). Now I only give her a teaspoon a day. My goal is to soften her stool so it’s not so painful. The important thing is once you take the diapers off you can’t go back– even if they beg for them. Remain consistent for their sake. It was hard but I stayed strong. I believed that she could get through it and she did!
Hi there, i am writing because my child started having pooping problems since she was born she is now 3 and i have had her to the doctor and pediatrician several times.. the problem is that she complains about her belly all and i mean all the time. When she does poop which could be 1-3 times daily it looks like rabbit poop small small hard balls about 5 0r 6 each time and she never and i stress never has normal movements can you please help me and tell me what u think…this has started at 4 months of age with a suppository given WHAT CAN I DO i am so fustrated!!!!
Tara ~
It sounds like a medical problem, and I’m a doctor, but not that kind of a doctor. If you give me some more information about your situation, I can try to make some recommendations. Either post another comment or email me by hitting the “Ask Dr. Heather” button. Aloha!
Hi there thanks Heather, well it all started when she was an infant she was always constipated the Dr. changed her formula several times she was on good start / Similiac lactose free // then on isomil and then last but not least they gave her the perscription milk from public health… this did not do anything at 4 months old i had to give her a suppository and nothing ever got better.. And i am gonna say something this child eats everthing and i literally mean everything . So then i had her on a stool softner // laxative drops which of course laxative drops help but does anyone really want to give their child this everyday or even a couple times a week. No so i refused to keep her on this stuff because all it was doing was making her bowls lazy …. so then i started her on baby fruits at 5 months of age and she loved them but it still did not work … then i started giveing her a bottle of baby prunes every day that seemd to help a little ……so then when i started her on regular milk i started with 2% still the same i went to another doctor and he thought i should try something else… so itried soya milk // and rice milk nothing seems to work …..when she uses the bathroom they are small small round balls and are hard she says it is hard to poop and also complains all the time about a sore belly ….i just fell lost i keep telling them that this is not normal they say alot of toddlers are constipated …but are they constipated every every every day of their life like my little girl i doubt it … so they did an ultra sound but said they did not see anything…Can they do a scope. I know as a mother that this is Not normal and that there is something wrong and if in fact they find out when she is a teenager oh man will i be mad! this to me is not right i have another apptointment for her next week with the pedatrician again… Can you recomend anything!!! and i also give her lots of fiber // i took her off dairy products for 3 weeks nothing changed i will list the food my child loves to eat…
strawberries
blueberries
salmon
cod
carrots
apples
bananas
ceral of everykind
yogourt
rasians
mushrooms
brocolli
pees
oatmeal
can pork and molasses beeans
as you can probably tell my daughter loves everything i never have to cook a separate meal for her she eats everything served at the table PLEASE PLEASE give me some solutions or tell me what i can ask my pediatrician to do next week THANKS in advance…
ok well thanks for everything anyway i hope you can recommend something !! it all started when she was an infant she was constipated since about 3 months old they changed her milk several time from good start to similac lactose free / isomil // perscription milk from public health … then it went on to giving supositories to stool softners to laxative ……then i tried fruit at 4 months still did not work then when she turned 1year when i was to put her on whole milk i did not i put her on 2% then the doctor suggested i try soya milk // then rice milk///nothing worked !! and since she was 6mnth i gave her a bottle of prunes everyday helped a bit // i then got her on a high fiber diet still nothing i am lost her symptoms are pain in belly all all all the time and hard hard small balls all the time and when i say all the time i meean all the time this child never never has a regular bowl movement…. she eats everything EXCELLENT eater and i know not many parents can say that ….she even tells me it hurts and it is to hard to poop she farts alot and her poor eyes water when she tries to poop can you HELP me i am going to see her pediatrician again next week they also did an ultrasound but said it did not show anything can a child have a scopre done would that determine if there is a problem ….. i think her food is not digesting right because with what she eats she should not have this problem… PLEASE PLEASE HELP
Tara ~
Sounds like a medical problem. Has your doctor suggested Miralax yet?
no what is that?
she was on lax-a-day which worked but gave her alot of cramps so i was in a no win situation!!
Ask your doc whether Miralax might help — sometimes some fine-tuning of the dose is needed — maybe a little less would work??
Hello Dr. Heather! What a relief to find this site. I am kind of in the same boat as the original question however my son Ryan is 3 and half years old. He mastered going pee pee in the potty at 2 but has always gone poop once a day in his diaper before bed time. We let it go on for a long time because it wasn’t a problem for us. It was always expected he would go poop before bed each night after we put him down. Lately we have decided to push him to go poop in the potty now. He wants to but I feel like he doesn’t know how push. After watching him go poopy in his diaper I noticed that he runs around in his room in circles and wants to keep it in but in the end lets it come out without really pushing it out. What can I do to help him learn how to “push”? I ask him to make a little toot but he doesn’t really get it. Every time he poops its because it literally busting out and he gives in and lets it come out. I am going to definitely try the ‘let it be’ technique you described above because I know he really wants to go on the toilet but he just doesn’t know the pushing part. Any suggestions? I’m thinking Miralax will help him have that sensation more times a day and that it would him with the opportunity to poop? I don’t know but its getting awfully old having him sit on the toilet when I know he needs to go and telling him to push over and over again. I think I am stressing him out and I am definitely stressed too. Thanks for your time in answering all these questions!
Hi Laurel ~
It’s hard not to “push” a 3-year-old to go in the potty, I know. But he seems to be withholding for a reason, and if you get mixed up in his motivations, you’re bound to lose. All you can do is explain what you expect (which you have), and then “back off”. Of course, big praise and rewards when he makes progress, but try to be as neutral as possible about it otherwise. Because you can never “make” him push, just like you can never” make” him eat or sleep. You can only support his development in the right direction.
And remember — the kids who develop major potty problems often either have true medical issues (which I don’t hear you say he has), or have parents who have stumbled into a “pushy” or controlling role. So try giving the control back to him for a few weeks and see what happens. Comment or email me again if you need more help!