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.
You can't PUSH them to poop!
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
Mom of Four, Parenting Expert
Hey, parents! Make sure you scroll through the comments below. There are lots of interesting questions, with my answers, below — this is one of my most “googled” posts! (Oh, I’m so proud.)
173 Responses to Tips for When a Toddler Withholds His Poop
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Dear Dr. Heather, My daughte will be 4 in a couple of months. We potty trained her about 9 months ago and she was able to poop and pee in the potty with no problems. She wasn’t pee trained over night and we still used pull up’s for overnight. Recently 4-5 months ago she was constiptated and was having difficulties passing poop. We didn’t take action right away and things took a turn for the worse. She started holding it and my doc recommended Miralax. We tried the miralax which seemed to make the poop “gummy, sticky” it just would hang from her butt and she wouldn’t push it out. My husband and I tried everything from trying to scare her by saying if she held poop her tummy would explode to threatening suppositories. Looking back I know we screwed up really bad and both of us feel totally awful. I’m trying to be real here in that we are first time parents and have no background in child psychology and thought she would just go, but instead we made the poblem 1,000x worse. Now she is so scared to poop and constantly worried I’m going to give her a suppository. She cries and says “don’t put the medicine in my butt”. I have only given her 5 suppositories in her whole life, and none of them was easy and I felt awful afterwards. PLEASE help us. I feel so terrible and don’t know what to do. I read your article last night and my husband and I told our daughter we were so sorry, we pushed too hard and that we were going to let her choose when and where to go. Clearly she didnt understand. We were at the store that night and in the checkout she started screaming don’t put medicine in my butt and crying, shrieking and stiffening uncontrollably. We were just purchasing items no one was even looking at her or touching her. It was heartbreaking. I feel like a monster, although I know we didn’t do anything to hurt her. Please help. We are so saddened by this and just want to see our little girl happy and healthy, and feel awful and overwhelmed
Our daughter is almost three and we began potty training with her four months ago. All seemed to be going fairly well, and when she would pee in the potty we would give her small rewards, (1 tiny teddy graham cookie). She even had one successful poop in the potty for which she got an even bigger treat.
After a few days of successful potty training, she came down with a very bad cold and had a high fever, and because she was too tired to get up and use the potty, we put her back in diapers. She didn’t want to go back to the potty after this, and also suddenly started holding in her poops for reasons unknown to me. This presented itself as her squirming around all day and leaking small amounts of poop in diapers all day long. One day, I counted 21 changes, and as a result she got a terrible rash.
The doctor had us give her miralax, but the leaking did not stop. I changed her to benefiber, and the leaking / smearing got better, but she is still holding in her poop. After waiting many weeks, and out of frustration, I just put her in underwear, and she was almost instantly and easily pee-potty trained, to my surprise!
She now wears diapers at nap and night, and poops in her sleep most nights, and the poop seems soft / regular. During the day, if she has an urge to poop, she screams, whines, cries and wiggles all day long, and it is unbearable for us all. What do I do to get her to poop on the potty during the day?
I have a 3 1/2 year old daughter and I have dealing with her holding in her poop for some time now. We moved three weeks ago and she held it in for 7-8 days and finally we had to give her a enema. Now we are on day 7 again and we have been giving her flaxseed meal everyday and prune juice. Now I read you article and it makes sense and I really want to try what you said but I want to know should I go ahead and give her another enema or just start the process with no talking about pooping at all and see if the poop comes naturally?
Dear Jennifer,
I can hear how upset you are. Please ditch the guilt, and instead try to use this as a learning experience. It certainly won’t be the last time you encounter a tricky situation in parenting — we often don’t know the “right” answer, and need to modify as we go along. That means this is an opportunity to demonstrate to your daughter — over and over, in a calm, reassuring way, that you are trying new things now to help her poop. Repeat your reassurances to her that you’re changing direction. Don’t feel you have to beg for forgiveness, but rather be matter-of-fact about it. You tried something that didn’t work. Now you will try something else that might work better. You’re modeling problem-solving for her.
Let some time pass. Keep up the Miralax and whatever else her doctor recommends, and go over these issues with her again and again. Children often need to process complex issues a million times before they get past them. Try to be patient and reassuring. If your doctor says you are clear to wait and let the Miralax work, without the suppositories, go ahead and tell your daughter you will NOT use the suppositories. If you can avoid it, it really helps, because children often do feel very violated and upset by them. The Miralax often takes several weeks to work properly and for you to find the right dose, so do keep at it.
Try this approach and then come back and let us know what happens in 3 weeks or so! Please ALSO read ALL the comments in this and other related posts here — you will find lots of other good tips. Good luck and go easy on yourselves
)
Mary,
Luckily, she is still quite young, so you have time to be relaxed about this. For now, start talking regularly about her body and how it works — how the food goes in her tummy, and she uses the good stuff to grow big and strong, and then has to “take out the garbage” — just like you put the garbage out for the trucks to take away. Otherwise it gets all stinky and yucky, just like garbage. Maybe even let her smell old garbage, just for impact. So pooping out the garbage is important. But she clearly got frightened by something — open up a path of dialogue about it. Ask her if her bum hurt from pooping before. Take her into the bathroom while you do your business, and explain what is going on. Talk about how good your tummy feels after you’ve gone. Follow her interests — if she likes puppies, let her watch them doing their business. Potty books and videos are good, too.
Then, talk to her about how she seems scared of going on the potty, but reassure her that one day, she will feel like being a big girl, and want to try the potty. She will be allowed to try if she likes. But she will not be forced to go. Talk about it in a nonchalant way, letting her know it will happen when she’s ready. Be confident and reassuring about it, but no pressure.
Don’t offer rewards again until she seems interested and asks about it. Clearly, she feels pressured, and rewards can sometimes backfire that way. Follow her lead, and I bet she will show you the way. Let me know!
Hi Katlin,
Of course this should be decided by her doctor, but if the doc says it’s OK to forego the enema, that would be my vote. Some children feel very upset by enemas and suppositories. But yes, go ahead and remove the pressure, but DO talk with her about the process. Talk about how the body works, and why pooping helps us be strong and healthy. Let her watch you in the bathroom. Follow her interests, which often emerge after a potty training break. And please do read all of the comments in this and related posts for many other tips. But for now, back off, keep up the super high fiber diet, and tell her that SHE is the boss of her body. Come back and check in here if you need to!
Any advice for a mother of a non-verbal autistic child? He autism really only affects his speech, so at 5 he has the same vocabulary as an 14 month old. He has been holding his poop since Thanksgiving, that’s right, about 5 months. He wiggles and screams randomly just as other parents have mentioned and we get so many poop smears everyday. He gets enemas every 7 days (per doctor recommendation) to keep him from getting too impacted. He fights like crazy and we’re all exhausted afterword. I don’t know what to try. He’s non-verbal so he won’t nderstand anything I try to tell him. Maybe we should try getting him on the toilet more? By the way, he is still in diapers, haven’t figured out how to potty train him yet since I can’t explain anything to him verbally. Any suggestions there would also be early appreciated
I’m not going to do the same story all over again. Same issue 3 year old girl holding. How many days without poop until we should be worried? All the talk is about potty training but what if she won’t even go in diapers? How much fiber until its impossible for her to hold it? We also supplement with flax oil and prune juice. Please help!!!
My 3 year old son is peeing in the potty and he sleeps without a pamper for 2 months straight. He hasn’t sat to poop since never . Even as an infant he couldnt lay down or sit to have a bowel movement. He asks for a pamper to poop and when he does he looks like he is in pain. He stool isn’t hard and he isnt constipated can anyone help him?
Aimee,
This is a complex case, and I really recommend you reach out to your son’s treatment team for a referral to a behavioral specialist with expertise in this area. Not easy to find, I understand. But hopefully there is someone available who can get to know your son and family well enough to find the best ways he learns. Perhaps he responds best to PECS cards, or maybe to rewards and incentives, or maybe simple modeling. This will be an individualized process, and should be treated as part of his overall IEP/treatment plan. Good luck and let us know!
Dear Frustrated,
First, check with her pediatrician about what is recommended, to see if there is a medical issue, and also to ask your questions about “how many days: etc. Then, check out the comments section in this post — at last check, there were 156 — so there are lots of ideas here that might help. Then, adopt a “fresh start” approach with your daughter. Tell her you’re there to help her, and you promise to work with her to find a solution that will help. Try some of these ideas and let us know what happens.
Dear Unique,
This sounds like it could be a medical issue, because you’re saying that is always in pain. Eliminating the source of the pain is the #1 priority. Work on that with his doctor, and if his doctor can’t help, ask around to find one who specializes in a kind, expert approach to toilet training. Then come back and see if we can help more!
Hi dr.heather this is pinky2 I have the similar problem like others.actually I have 3 kids twin toddler girls & a infant boy I really want my girls to potty train soon but they don’t want to sit on potty iam trying & trying my elder one holds the poop and afterwards when I make her wear diaper she poops in diaper but not at all in potty but my younger one gives me signs & she even doesn’t want to wear diaper but when I force her to sit on potty she refuses & sometimes cry I want them to go to pre-school.shall I try potty training in 3 days or u think I have to wait further plz let me know your suggestions I’ll really appreciate your help thank you.
Hi Pinky2,
I know it’s hard, but don’t let outside pressures like preschool lead you to push your girls before they are ready. This can really backfire and make it more difficult in the long run. You don’t mention how old your girls are, but many children often aren’t day-trained until 3 or even 3 1/2. Follow THEIR interest and willingness to potty train — and please come back soon, because my NEW potty training book — “Let’s Get This Potty Started! The BabyShrink’s Guide to Potty Training Your Toddler” is coming out THIS MONTH. In the meantime, check out all the other comments in this post for lots of tips and ideas! Good luck, busy mama! It WILL happen, hang in there — and look for a preschool that will help you with the potty learning process.
So I made an earlier post about my 3 1/2 who is scared to go poop. I have started your advice and she hasn’t gone poop in 8 days, she has been showing signs of having to go, she paces around the house and wants me to hold her and then when that feeling passes she is fine. This has been going on for a couple of days and it still is holding it in. My husband and I have done good about not sayi g anything to her but 8 days it a long time to not poop and we don’t think it’s good for her to not go that long but we want to make her want to go on her own. Is there something we can do to maybe help her to go without pressuring her? I tell her she can go whenever she wants but I know she has to really go.
Hi Katlin,
Will she go if she has a diaper?If so, have her use that. Obviously it’s important she doesn’t hold it in indefinitely. Has her doctor suggested Miralax or something similar to really make her poops soft? This makes is difficult to keep in. Sometimes it takes a couple of weeks to get the dose right. Talk to the doctor.
Also, I don’t think it’s realistic to hope that she will “want to go on her own” at this point. I think now that’s it’s gotten to this level, she needs to experience first hand that the poops will come out — and that it won’t hurt her or be too scary. Sometimes, toddlers just need to go through it a few times to see that it’s going to be OK when it comes out. So this becomes a process of encouragement and a building sense of inevitability — you as her parents want her to master this herself. If she can’t, then you will have to take steps into your own hands via the suppository etc. Don’t use it as a threat, but instead a simple, matter-of-fact process of needing to monitor her health. The whole time, though, reassure her you want HER to take over this as her job — when she is ready.
Other toddlers have the fantasy that they can “wish away the poops” — because in a way it’s true — if they ignore the urge long enough, the sensation does fade. Obviously not what we want either. Talk about how the garbage must go out of our bodies so we can stay healthy, even if she wishes the poop away. It still needs to come out.
Try these things and give us your update! You can also bring this to my new Potty Page (the link is at the top of the page), where folks who buy my book “Let’s Get This Potty Started! The BabyShrink’s Guide to Potty Training Your Toddler” come to discuss their potty questions. Join us!
Heather I have let her wear a diaper when I noticed that she really has to go. I have given her miralax every morning and she is eating very good foods which will help her go also. Last night she fell alseep and then jumped out of bed and started pacing again ran into my room knowing she has to go. This morning she had a little poop in her diaper but just a little smear. I kepted telling her the poop needs to come out to keep her healthy and that it is not good to keep the poop inside our body but she is in control. my husband is getting frustrated and wants to give her something but I told him that if she relaxes then she will go. She is not contipated but just holding it in. Sooner or later she will not be able to keep it in and she will realize that she did it on her on without our help.
We have a similar situation to all of the others. Our 3 year old had some constipation problems before we even began potty training. We made sure that was all clear before we started. He has mastered peeing and wants to every time he sees a toliet. He pooped three times and then never again. He started withholding it again and we worried about going back to the problems before so we stayed with Miralax and backed off as you suggested. That was a few months ago. When should I try again to get him on the potty?
He watches his older brother all the time, we have dumped the poo in the toliet when he goes in his pull up and he flushes. We have tried to explain that he will feel better when it is all out, almost all of the suggestions…But he shows no interest. Any suggestions?
Ok I have pretty much the same issue has everyone else, my DD will be 3 in a few weeks and has been “pee potty” trained for about 8 months but as for pooping no such luck. After a few very hard constipated/suppository situations she is now holding it for days on end. Miralax and pro-biotics help but still will not go on the potty. My question is doo we put her back in a pull up until this is under control or keep buying new panties?
Jessica,
How old is he exactly? MANY boys master the pooping in the potty process sometime between 3 and 4. Something somehow kicks in that helps them make the choice themselves, and it often happens rather suddenly — as long as there is not undue pressure. You can try low-key small rewards, as long as the rewards don’t seem to trigger resistance in him. If he’s on the young side of 3, try again — gently. Suggest the potty at the time when he usually goes. Ask him where he would like the potty to be. See if he wants to try at the same time his brother goes. If he’s 4 or nearly there, make sure your pediatrician knows about the intermittent constipation, and see if there needs to be a behavioral or developmental evaluation — sometimes a speech/language delay can complicate things.
Shannon,
She’s still fairly young, so you have some time here. Let her decide — the main thing is to AVOID CONSTIPATION. It really hurts, and she won’t forget. So if she’s more comfy with the pull-up, so be it. When she seems interested in the potty, try again, and support her — but let her know it’s her decision. You can offer and suggest — but let her decide. Check back in with me again if you don’t see any progress in a few months!
My 2.5 year old son is in almost the same situation as Stephanie’s original post, the only difference is he cries when he is holding it in and keeps saying “it hurts” (we’ve had constipation issues in the past that have hurt a few times). We also have a 2 month old baby which has made my son more sensitive to the situation, and now when he cries he only wants mommy. Our ped has told us to increase his miralax dosage, my question is how do we try to remove all emotion from the issue but still try to reassure him that it won’t hurt when he is so upset?
Trina,
I know it’s hard to de-escalate the emotion when he’s hurting, but take a deep breath and go slow and quiet when he’s panicking. Then try to prevent the crisis by seeing if he will “try” the potty before it gets painful. Talking to him when he’s in a panic won’t work, because he’s upset. You want to talk about it when he’s calm. Then talk — a lot — about how his body hurts because the poops want to come out. Try being silly — my toddler thinks it’s hilarious to say that the poops are pounding on her tummy, saying “Let us out! We want to go for a swim in the potty! Get us out of here!” And they won’t stop pounding until you push them out for a swim. THEN your tummy feels SO MUCH BETTER!” Follow his doctor’s advice, and try everything you can to encourage him to let it out. Hold his hand while he is trying, let him watch a video, give him rewards for going — see what seems to have traction for him, what really motivates him uniquely, and go with it. Try these things and check back in with me if you like!