Is your kid afraid to poop? Peeing in the toilet is no problem for your four-year-old, but he’s suddenly developed an aversion to pooping there. He hasn’t gone Number Two for two or three days.
It’s quite common for a preschooler to withhold their poop, says Fabian Gorodzinsky, a community paediatrician and an associate professor at Western University in London, Ont. Often, the problem quickly becomes a vicious cycle: Your little guy probably got constipated and had an uncomfortable bowel movement. But now, not keen to repeat that experience, he fights the urge to go — which worsens his constipation. And if you do manage to coax him back onto the toilet, another painful episode reinforces his fear.
Not quite ready? Gorodzinsky says withholding often happens after an attempt at toilet training when children just aren’t ready, emotionally or physically. So it may be that simply backing off for a bit and giving your child more time with diapers will solve the problem.
If a child who’s resistant to having BMs on the toilet asks for a diaper, give it to him, Gorodzinsky advises. Quite often, children who have had a bad experience need to take another run at toilet training. Let him sit on the potty with his diaper on. Then, as he gets used to this, try removing the diaper and having him go on the potty. Once he’s comfortable on the potty, try moving to the toilet and take the same gradual approach.
Read more: Afraid of BMs>
Just too little? Kids are often reluctant to use the toilet because they aren’t big enough to sit comfortably and bear down effectively; they’re too busy holding themselves up or their feet are dangling in mid-air. “You have to retrofit your toilet for your child,” says Gorodzinsky. A toilet seat insert and foot-stool will help a child feel more secure and at ease.
Not enough bulk? A diet low in fibre or containing too much milk can contribute to constipation, says Gorodzinsky. Encourage your child to eat lots of fruits, vegetables and whole grains. And make sure he’s drinking enough fluids, too. “Fibre, with inadequate liquid, will worsen the problem,” he says. Preschoolers should consume about two cups (500 mL) of milk a day.
Is it a medical problem? Rarely, says Gorodzinsky. If constipation is a persistent issue, see your child’s doctor rather than resorting to mineral oil or laxatives. The doctor can prescribe an appropriate medication. You should also see the doctor if problems with bowel movements continue longer than three months; your child is four years old and still not toilet trained; or if you see blood in the stool.
Finally, figuring out what could help your nervous kid relax might do the trick. It could be a warm bath, or even a little levity. One mom we know says, “We turn on the tap and encourage her to make what she calls poo-poo faces, which are what she does when she’s bearing down. It helps to have a little fun with the situation.”
Chronic constipation When preschoolers poop their pants, it’s usually a result of chronic constipation, says Gorodzinsky. A buildup of hard dry stool distends the bowel, which causes the nerves to lose sensation. The child actually stops feeling the urge to go and, when he does poop in his pants, he may not notice. “Kids quickly lose the ability to smell their own feces,” Gorodzinsky explains. “Of course, other people do smell it and this causes a difficult social situation.” Avoiding this kind of accident most often involves relieving the constipation, so talk to your child’s doctor.
The toilet monster and other troubles Lots of different factors contribute to setbacks for toilet-training kids. Evelyn Robert, 3, was adapting well to using the big toilet until the temperature dropped — along with her enthusiasm. “Our bathroom and toilet seat were cold,” laughs her mom, Jane McMullen of Toronto. Many young children are leery of dark or empty rooms, says author Elizabeth Pantley. “There’s nothing scarier than the cavern of a dark bathroom at the end of an empty hallway.”
Other common problems include a child’s fear at seeing her poop go down the toilet, fear of seeing or hearing the toilet flush, and, as mentioned, fear of painful bowel movements caused by constipation. Try to figure out what’s turning her off using the potty. She may have been scared by the auto-flush in a public bathroom, or the size of your toilet might also be an issue.
Banish other “toilet monsters” with a well-placed night light and a few flushing sessions together to reassure your child that she won’t disappear down the toilet along with her poop. But if she continues to resist, don’t push it, say the experts. Take a break and let her use diapers until she’s ready to try again.
Accident shame Kids in the process of potty training may feel mortified if they wake up soaking wet in the morning. It won’t help if you, or a family member, say something like, “you’re far too big to be wetting the bed.”
Being scolded for accidents can erode confidence, says Mia Lang, an Edmonton paediatrician. “Even one episode of teasing can be emotionally harmful.” Don’t dismiss your child’s feelings, she says. Acknowledge that he’s upset, and reassure him that these accidents can happen to anyone. If your child has a public accident and decides he wants to go back to wearing training diapers temporarily, make sure no one knows about the switcheroo. You don’t want to set him up for any more humiliation. Always keep a change of underwear and clothing handy, especially at school or daycare. And whenever your child says he has to go, take him immediately.
This article appeared as part of a Potty Training insert in the June 2013 issue with the headline "Setbacks and challenges," p. III.