Once your kids are toilet trained, you may think your days of dealing with poo and pee are over. But it’s not uncommon for some school-aged kids to avoid using school bathrooms—which sometimes doesn’t end well.
“It’s about the toilet paper,” says Lisa Avram*, a Toronto mom whose kids, Liam, 5, and Kendra, 9, both refuse to poo at school. “They use wet, disposable wipes at home, so that’s what they’re used to, but I got the ‘No way, Mom’ look when I suggested taking wipes to school.”
“School is still a relatively new place for children between the ages of six and nine, so they may not be comfortable yet,” notes Joanne Cummings, a child psychologist with a private practice in Toronto. Past kindergarten, the bathroom is most likely located outside the classroom, so kids might be shy about having to raise their hand to ask to go or worried about finding their way there and back. They may be grossed out by the smells coming from multiple stalls, embarrassed by the sounds they make or anxious about a noisy toilet or hand dryer.
Sarah Tremblay discovered that for her six-year-old daughter, Maggie, the issue was FOMO, kindergarten style: Not wanting to miss a second of class, she was putting off peeing until the last possible second, resulting in small leaks and wet undies.
Medical problems can crop up when kids regularly hold on to pee or poo. Aside from causing irritated skin caused by wet underwear, disregarding the body’s signals to urinate can eventually lead to an enlarged bladder, says Janice Heard, a paediatrician in Calgary. “Over time, kids can lose muscle tone in the bladder, so when they pee, they don’t always empty the bladder, which can cause urinary tract infections. Constipation is the most common side effect of not pooing when you need to. Avram’s daughter had a couple of bad tummy aches caused by being backed up. “Constipation can also lead to bladder control problems, because the stool builds up and presses on the bladder,” adds Heard.
If the problem is ongoing, a visit to your healthcare provider will help rule out medical issues, like undetected constipation or a structural issue with the urinary tract. But if the situation appears behavioural or anxiety related, here’s what to do.
Punishing and shaming will only create anxiety. Instead, laugh about it, and remind your kiddo that everyone toots, pees and has stinky poops, says Heard. Simple praise for going at school or some cool new undies can go a long way with younger kids, too.
Schedule bathroom breaks
Though not the case for everyone, the body naturally wants to have a bowel movement 20 minutes or so after a meal, says Heard, so encourage a bathroom visit after breakfast or dinner to get out of the pooping-at-school trap. Avram’s kids both go like clockwork after dinner now. Similarly, remind your kid to pee at recesses and lunch.
Do a practice run
Go with your kid to the school bathroom to practise locking and unlocking the stall door or to see if the flushing noise is scary. “This desensitizes an anxious child so they feel more comfortable,” says Cummings. Touch base with the teacher to see if there’s an issue with the rules. For example, in a French immersion school, if they have to ask in French, could that be the problem?
Tremblay used props to help her daughter understand how important it is to go when you feel the need. “I said, ‘If you’re drinking and peeing enough, your pee should be light yellow like this crayon and not dark yellow like this crayon,’” explains the Thunder Bay, Ont., mom. She also used a balloon filled with water to explain what a bladder is, and to illustrate how pee needs to come out when it’s full. When Maggie returns home with a pee leak, her mom takes her to the laundry room to help her wash her underwear. The idea, she says, is to make the connection that if you don’t stop to pee when your body tells you to, you’re going to have to stop to change and wash. “It seems to be working, fingers crossed,” says Tremblay. What a relief.
It’s helpful if kids who chronically “hold it in” understand how their bodies work and can picture the different organs involved in using the toilet, says Janice Heard, a Calgary paediatrician. Check your library or bookstore for See Inside Your Body by Katie Daynes (Usborne Books) and First Human Body Encyclopedia (DK Books).
*Names have been changed
A version of this article appeared in our September 2016 issue, titled “Hold it,” pg. 56.