What to Do When Your Child holds their poop because of constipated

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A reader wrote in asking for advice with her 3 year old. The child was potty trained to use the toilet to pee but had issues with being regular for her bowel movements. The child had memory of constipation and the pain had stayed with her. It was now preventing her from learning. She was, in fact, afraid and would hold herself till she had an accident. What positive parenting advice did I have for her.

I am not a doctor and my advice is only a ‘been there, tried this’ approach. You should always consult your doctor to rule out a medical as well as a physical reason.

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What Potty Training Really Means:

Potty training means the child’s ability to independently use the toilet for both her movements. Many children have a problem with going to the toilet for one or the other reason.

Potty Training is not an instant process or that which takes a few days or weeks!

You may teach her to get used to using the toilet in a few days but continuing to use it for the rest of her life is something that your child will have to learn and make a habit out of. The child who has been in diapers for two years or more and had no reason to think in that direction is now being made to realize her movements and also the need to go use a toilet for them. It is something your child will be anxious about. If amongst all that chaos, she has previous trouble with her movements like pain or constipation, it becomes a challenge.

A child who is ready to be potty trained requires a level of maturation to have the patience to first sit on that potty and then (don’t laugh!) have to concentrate to have that movement. Getting them to sit is the first step and then, getting them to do the job is the next thing. Mostly, with the first step, peeing becomes easy. But, sitting on that potty to have a bowel movement requires that patience. If they have memory of pain or if they have constipation then it becomes scary. They may not sit and the whole thing will become an ordeal.

Sitting on that potty to have a bowel movement requires patience. If they have memory of pain or if they have constipation then it becomes scary. They may not sit and the whole thing will become an ordeal.

If you have gotten your child to cross that first step of learning to use the potty to even pee then, congratulations! You’ve won half the battle. The other half requires a lot of dedication on the mom’s part. Teaching your child, encouraging them and then rewarding them too.

How do I get my reluctant child to use the toilet?

There are two steps to solving this problem.

1. Why won’t my child sit on the potty?

Why she doesn’t want to go. Is she in pain? May be she is scared of the toilet or the seat?Is it possible she is bored? Could she be constipated? May be she is anxious? Is there some other medical or physical reason that you may not be considering?

2. How to make your child sit on the potty longer.

 What can you do about the problems you found? How can you make her sit on the potty longer? Whatever it takes is okay in the first few days, I feel. Give them candy, exclusive potty time toys, books, technology… sing to them, make that potty interesting… or play games. Whatever it takes. You will need to be a master at the art of distraction to get them to sit for as long.

Related: Here is what to do When Your Child Won’t Poop on the Potty

Discuss the matter with her doctor to rule out any medical issue and ask for his advice too. Find ways to alleviate her constipation.

3. Is your child really ready to be potty trained?

Sometimes parents potty train their child too soon. You need to first confirm that your child is really ready.

Next, Shop for a toilet seat that she will love to sit on.

Look out for her curiosity or any interest she is showing when you or a family member goes to the bathroom.

No matter at what age you start, your child will not be independently trained to use the toilet till age four or even five. You will still need to assist them at public toilets or while traveling and even regularly to wipe or wash himself. So you see, this is a long time.

What is Encopresis and Regression in potty training?

Most parents think that a child has 'relapsed' when he or she starts soiling or wanting his diaper after being considered 'trained'. This 'regression' could be for various reasons but most often it is due to some sort of anxiety. Sometimes, a child starts to have accidents or becomes anxious enough to hold his potty.

After the age of 6,  this condition is called as Encopresis. It is a condition where in a child will hold his toilet, sometimes even for days, till he has an accident. The condition is only labelled that if your child is over the age of toilet training, i.e at least 4yrs of age but more appropriately 6 years old and still having trouble. Under the age of 4 years, it should be treated as a Potty Training Hurdle.

The first thing every mom should do when potty training the hurdles is address the issue. If you are reading this post then you are already taking steps to do that. The reason I am saying this is because if you don't accept that there is a problem, you will never solve it. There will be no reason to.

If your child starts to regress or has never actually potty trained, here are a few things to consider:

What to do when your child holds their poop for days

The first thing you should do before you look at the tips below is ensure that your child has a proper routine where in he/she uses the toilet everyday. If they are not used to sitting on their seat at fixed times through the day, they may feel that going to the potty is some novel idea.

1. Does your child have a good everyday routine?

In order to ensure that it become a habit, fix your morning, afternoon and evening routines. What time does your child wake up, sleep/nap, eat, play and snack. these things matter too. Here is an example of routine for a toddler.

Once you have your child's routine in place, look at the list below to see what else you can change.

2. Constipation - an easy way to relieve it

Make sure your child is not constipated. Constipation causes not only pain but also a problem with the colon.

The colon enlarges when matter collects for too long, there by increasing its capacity to hold. When your child holds for too long, the muscles will be stretched making your child lose his feeling too. He will not know that he is holding and it will leak out. This is what can lead to encopresis (that i mentioned above) as your child grows. Signs that his colon is being stretched is finding streaks or spots in his underwear.

An easy way to relieve constipation is to offer Orange Juice and prunes. If your child doesn't like orange juice try diluting it 1:1 with water. Prunes and apricots also are great to help with constipation. I like to add apricot puree to my kids cereal. You can also give them apricot fruit leather.

3. Don't wait for too long to potty train your child..

If you wait longer, your child will learn to say 'no' and then will start the battle of wills. You will be bribing, pleading and rewarding them for sometime then. If you start early, it becomes easier.

If your child thinks it is a big deal to poop, it will give her anxiety. That means a fear of going to the potty itself. She may not feel the pain or discomfort as much as you are making the issue seem.

4. Consult your doctor and ask for a Stool Softener.

Give her stool softeners either medically approved by your doctor or as food alternatives to aid her. My advice would be to go to the doctor first. Sometimes there is fecal impaction that needs to be eliminated before your child can become regular.

A glycerin suppository and an oral laxative when your child goes beyond 3-4 days or something to keep her regular may be needed.

5. Fixing Constipation through diet

My third child had trouble with constipation almost since birth. We still have a problem sometimes even though she is eight years old now.

What works, is that I give her juice with her meals and atleast one fruit (that is non constipating) daily. When she was a baby, we were asked to give her an oral laxative to keep her regular. Even then, when it went beyond 4 days we had no choice but to use the suppository.

Always remember that the first few days are the hardest. Once she goes for a few days in a row, it will become easier and natural to her. Her fear will diminish too once she realizes how natural it is.

Avoid gas and gassy foods. Gas cause dryness if she hasn't gone for a while and it will cause her pain.

The encouragement that she needs should come in her size and often. Little bit of encouragement and love, a bit of one on one time getting know what is on her mind or her fears can do wonders. Children as small as 18 months old can tell you what they fear. Well timed reassurance and treats to sit, try or even when she cooperates.

Treats when she has a success and reassurance when she doesn't work magic. Just let her know that you are with her through this. Sometimes a star chart helps to encourage too. Here is a free printable star chart for you.

Ignore the accidents. I know how hard that is but when you ignore with a mere 'uh-uh' but focus on the success instead with lots of praise and treats, it will make her want to be better and try harder for that kind of reaction from you.

Don't talk about her accidents to other people. Children that age can understand and you will only make her more anxious by talking about her in front of others. Do talk about how hard she tries and the little success she is having though.

6. Make a time for her to sit on her potty for the bowel movement.

It can be after a nutritious high fibre breakfast. Most children have their bowel movements in the morning. Most people feel the natural need to go at sometime during the day. You can train your child by making him/her sit on the potty at that exact time everyday. Make sure that she has had a good breakfast though.

Some cereal with milk, a boiled egg for protein and some juice will help her have her movement naturally. Wait a few minutes after breakfast and then take her to her potty.

Gina Ford in her book on Toddlers, The Contented Toddler Years mentions making the child sit on the potty after breakfast. It helps to have a routine for your child. I can never stress enough the need for your child to have a routine to follow but even if you don't have one, this is a good time to start one.

Find an example of a Toddler routine here.

Resources to help you Toilet train your child

The Toilet Training Book offers a developmental look at potty training for kids of ALL needs. This book was written by Occupational Therapists and experts, so you will get more detailed information. It comes with additional resources and checklists to help you.

The Toilet Training Book is perfect for:

• Parents wondering where to begin with the potty training process. 
• Therapists working with families of young children.
• Those looking for suggestions on how to meet specific physical or cognitive needs when it comes to toilet training.
• Occupational therapists seeking out data collection forms to screen for baseline and functional levels. 
• Families who are just getting started with potty training. 
• Professionals looking for practical tips and strategies to pass onto families.
• Caregivers challenged by difficult obstacles when it comes to potty training.
• Parents wondering what to do next when potty training isn't working.

You can get it here.

My favorite book on this topic is Potty Training in a Weekend by Becky Mansfield where in she has a step by step technique to potty train a child in 3 days or a weekend if you like. The book is an excellent resource for mums trying to Potty Train their toddlers. I highly recommend this book if you see that your child has no other developmental problems. It talks about regression in detail so this may be enough for you.

Becky Mansfield is a mum of four and she is a Play Therapist who potty trained her kids before they were two years old. She has helped many mums since. She talks about hurdles, regression and easy ways to solve potty training problems too. You can get your copy here.

Here are a few books I find helpful for the children!

A reader wrote in that these books helped her child. Books can help children understand things better and also help lessen the fear. Do check the book out and consider it if your little one is having a problem.

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