It’s an undeniable fact: everybody poops. However, if you’re a parent of a toddler who is reluctant to poop, it may not seem like a natural behavior at all.
In general, toddlers have a daily bowel movement. It’s not unusual for children to become constipated, which can prevent them from pooping no matter how much they try.
Refusing to poop, though, is a different story. Children who refuse to poop are not constipated. Rather, they fight the urge to go, even when they really need to. This is known as stool withholding, and not only is it frustrating for parents, it can lead to health issues for the child.
“If stool is not released when it needs to be, it can collect and harden in the rectum and cause a blockage,” says Annemarie Selaya, MD, a pediatrician at Scripps Coastal Medical Center Hillcrest. “Softer stool can leak out around it, and if the behavior continues, over time the child may lose control over the muscles that control bowel movements.”
More common in boys than girls, stool withholding typically develops during toilet training. Though some medical conditions may contribute to it, this is rarely the case.
Often, children who withhold stool have had a painful bowel movement due to a hard or large stool. They begin to associate pooping with pain and refuse to poop in order to prevent the discomfort.
In some cases, the child isn’t yet ready to transition to the toilet, or are daunted by the way the toilet looks, feels or sounds. Children who poop at home may not be comfortable doing so away from home or in a public restroom. Some kids will use stool withholding as a way to get attention or create a power struggle with parents. Others simply don’t want to stop what they’re doing to use the bathroom.
You can’t make your child poop, but you can make changes to help encourage them to feel comfortable using the toilet when they need to. Try the following toilet-training tips:
Make sure your child is ready to begin toilet training. Not all kids are ready at the same age — some can learn at 18 months, while others may take longer. Putting too much pressure on toilet training too early can create fear and resistance.
If your child seems apprehensive about pooping, talk about it. Ask what they’re worried about and address their concerns with compassion and understanding.
Create a safe, comfortable environment for your child. Use a child-size toilet seat and place a small stool under their feet so they can push if they need to. Don’t rush your toddler; give them at least 10 minutes to get the job done. Try reading a story or playing music to help them relax.
Encourage your toddler to use the toilet several times during the day, especially after meals or whenever they feel the need to go. Reward success with stickers or a favorite treat or activity.
Include high-fiber foods, such as fruits, vegetables and whole grains in your child’s diet, as well as non-dairy fluids (limit milk to two glasses a day). This can help make stools softer, increase the need to go, and make pooping easier and painless.
Aim for 30 to 60 minutes a day of active movement. Physical activity helps with regular bowel movements and overall health.
“If it’s been a couple of months and you’re still having issues with getting your child to poop, or your child is vomiting or seems ill, make an appointment with your pediatrician,” says Dr. Selaya. “We may suggest a stool softener or have other recommendations, but don’t use any medications without talking to your doctor first.”