How to Help Your Toddler Overcome Stool Withholding

Toddlers usually have regular bowel movements. However, some children start to hold in their poop. This can cause discomfort and health problems if not fixed.

Stool withholding happens when a child deliberately avoids having a bowel movement, even when they feel the urge to go.

Over time, this can lead to chronic constipation and painful stools. In some cases, it can lead to accidental leakage due to a stretched rectum and reduce bowel control.

“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.”

Stool withholding is more common in boys and usually starts during toilet training. Some medical conditions can contribute to stool withholding, but it is mostly a learned behavior.

The most common causes include:

• Pain from a previous bowel movement: A hard or large stool can be painful, causing your child to associate pooping with discomfort and begin to withhold poop.
• Fear or resistance: Your child may not be ready to sit on the toilet or may fear the bathroom, especially if it’s unfamiliar or intimidating. Kids who poop at home may not feel comfortable doing it elsewhere, like in a public restroom.
• Seeking attention: Some toddlers may withhold stool as a way to create a power struggle with their parents.
• Reluctance to interrupt play: Sometimes toddlers avoid the toilet simply because they don’t want to stop what they’re doing.

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 go. Try the following toilet-training tips:

Toilet training should be done when your child is ready. Some children may be ready at 18 months, while others may take longer. Pressuring your child to start too early can cause anxiety and lead them to hold in their poop.

Watch for signs that your child is ready. These signs include staying dry for at least two hours at a time during the day, which would suggest their bladder muscles are developing enough to hold urine. Also, notice if they show interest in how adults or older siblings use the bathroom. Finally, see if they are able to understand and follow simple instructions.

If your child seems apprehensive about pooping, have a calm conversation. Ask about their concerns, whether it’s fear of the toilet or previous pain during bowel movements. Address their worries with empathy and reassure them that pooping in the potty is a normal, healthy part of life.

Make the bathroom a calm, inviting space for your child. Use a child-size potty chair or a toilet insert seat with a step stool. It’s important that your child’s feet are flat and supported, either on the floor or on a footstool, to help them feel secure and encourage effective pushing.

Give your toddler plenty of time, at least 10 minutes, to sit on the toilet without rushing. Playing soothing music or reading a favorite story can help them relax and feel more at ease.

Positive reinforcement can go a long way. Celebrate successful potty visits with small rewards, such as stickers or extra playtime. Encourage your toddler to try using the toilet several times a day, especially after meals or when they feel the urge to go.

A diet rich in fiber can help regular bowel movements and make pooping easier. Include fruits, vegetables, whole grains and non-dairy fluids. Limit milk to no more than two glasses a day.

Also, make sure your toddler drinks water throughout the day to help soften stool and prevent painful bowel movements that could trigger withholding.

Aim for at least 30 to 60 minutes of active play every day. Regular physical activity, such as running, jumping and climbing, helps stimulate the digestive system and promotes regular bowel movements.

If your child has been withholding stool for a couple of months or shows signs of illness (like vomiting or lack of appetite), it’s important to consult with your pediatrician.

“We may suggest stool softeners or other treatments,” Dr. Selaya advises. “But it’s important not to use any medications without first talking to your doctor.”

In some cases, stool withholding could be linked to other health issues, such as constipation, or it could indicate an underlying condition. If you’re concerned, don’t hesitate to reach out to your pediatrician for further guidance.

Helping your toddler overcome stool withholding requires patience and understanding. By creating a safe, supportive environment and offering the right tools, you can encourage healthy potty habits and help your child become more comfortable with pooping on the potty on their own.