Poop Withholding and Poop Soiling

3 minute read…

For some parents, potty training proves to be one of the trickiest elements of child rearing. It feels a little complex and of course the stakes are high. We really want to ensure that our child goes off to school clean and dry. Parents will tell me that their greatest fear is their child having an accident in school and then being bullied. I have taught children under the age of 5 for many years and I can offer some reassurance in this age group that the other children don’t often notice. The very nature of being under 5 is, children are mostly concerned about themselves and what they will play with next. However the fear is real for parents and my heart goes out to any family facing frequent accidents in children aged 3-5 years, but particularly poop challenges. If you have successfully managed to convince your child to pee on the potty with any sort of consistency, you may find it rather upsetting when your toddler won’t poop on the potty. Even worse, if your child starts resisting the act of pooping all together. This is known as poop withholding. If you’ve ever dealt with a toddler who won’t poop you know how stressful it can be. Many parents will resort to giving them nappies to poop in as a short term fix, only to find themselves still doing this years later. I have worked with families up to the age of 7 who have struggled in silence for years.

There are a number of reasons that a toddler won’t poop and might resist eliminating their waste – some physical, some psychological. If you’ve ruled out any physical reasons (constipation, intestinal blockage, etc then it might be time to consider a holistic approach to problem solving around this issue.

It is very common and in the space of one year I have met and helped over 50 families overcome this challenge through a variety of bespoke methods. There are many reasons why children need help and support in this area and some of the changes we will make together are very small, yet effective. In my experience as The Potty Queen this condition is most common among children between the ages of 2-4.5 years old possibly triggered by an episode of painful constipation or delayed/stressful and possibly rushed toilet training. We are sending children to school earlier and this has placed extra pressure on parents. Many parents will tell me they waited and waited for a full set of potty readiness skills to emerge before training their child at three years, then they found themselves with just weeks to go before school starts. In the UAE, where I am based children will enter formal education called FS1 at the age of three years. Schools are often unable to cope with soiling aside from the odd occasion due to staffing ratios. The child themselves struggles on and the family will feel lost on who to turn to.

Poop Withholding and Poop Soiling is a frustrating behaviour for parents, which can result in heightened emotions and concerns. The child may be exhibiting behaviour such as holding on to poo for days at a time or only pooping whilst wearing nappies. Some children will only poop in a nappy and will actively ask for one to poop in. They will often hide away to poop under coffee tables etc. They may have frequent soiling episodes at nursery and come home with poop in their pants and school bags. They may be on long term laxatives. Parents will have tried everything by the time they reach me and they are feeling pretty desperate. They have tried bribes, treats, rewards, scolding, begging, shouting. They will have spoken to a variety of professionals and had tests which have ruled out any medical issues. They have seen psychologists, yet their child is still pooping in their pants and or they are trapped a cycle of constipation and laxatives.

This is a complex issue with many elements that need to be unpicked and understood. No one is at fault here, least of all the child and their well-meaning parents who often exhausted by the issues. My first step is to dig a little deeper into family life and start working with the family to make shifts across multiple areas. If I am doing a home visit I will meet the child and the family and I’ve been none to arrive in a full blown poop costume to add in some fun to the situation. Children love that I know lots of other boys and girls who are struggling just them. One little girl named me as The Poop Fairy and thought that my poop was probably glittery like a unicorn. This little bit of magic and fun really helped this 4 year old to overcome what her parents described as a full blown poop phobia. It is an area I work in every day and my experience has taught me that it is not an easy and quick fix.

My plans last 3 weeks as a minimum. It works best when families work with me alongside their doctor and or nutritionist so we can work as a team, especially if there is medication such as laxatives involved. Its very important that families seek medical advice if their child is constipated and withholding for any reason. I will frequently work with a nutritionist also. My role in the multi-disciplinary approach is to work on family life such as routines, emotions, parenting approaches and practicalities. This is something that doctors may not have time for. I also find that my daily WhatsApp support to the family makes a huge difference.

My personal belief is this is not laziness, naughtiness, or wilful, stubborn behaviour. The more empathy and curiosity we can muster the better. The children are stuck in a behaviour that everyone finds unappealing and when they can overcome it their self-esteem lifts and it sets them free. They need empathy and understanding and It asks for parents who are going to be patient and consistent; secure in their knowledge that this will be overcome.

I work with families all over the world and I hope the families who are struggling with this will find me, The Poop fairy and my giant poop costume.

For further information: Encopresis – Symptoms and causes – Mayo Clinic