REFUSING TO HAVE BOWEL MOVEMENTS ON TOILET
"My son is three-and-a-half. We started toilet learning four months ago, and he's done OK with peeing in the potty, although if he has something more interesting to do, he'll just go where he is. He's worn underwear for four months, and except for just a very few times, he's pooped in his underpants every day. I am despairing. His bowel movements are soft, but not at all regular at any time of the day. I've tried rewards, praise, etc. and nothing works. Today I got upset, and that's why I'm writing for new advice. I know it was wrong to yell, but after washing out 100+ poopy underpants in a row, I don't know what to do. Thanks so much for your help"
Answer: I just shared this frustration with my son, so I know what you are going through. This is not an unusual problem, it happens in about twenty percent of children. It usually resolves by age 4½, but I have seen some six-year-olds that still need to use a diaper for bowel movements. Most kids learn to control their bladder before their bowels. Like your son, these kids will use the toilet just fine for urinating but keep soiling their underwear. After washing 100+ poopy underpants ourselves, we just started buying pull-up diapers again. This usually is the best remedy. When frustrated parents throw away the diapers and force the child to wear underpants, children often start withholding their bowel movements, which leads to constipation and painful bowel movements. Now you have a much bigger problem. Until your child learns to sense the need for a bowel movement and to control the urge to poop, your best bet is to keep him in a diaper. Letting the child run around naked (outside, of course) is a good way to help them learn when a bowel movement is happening. Usually, it is just a matter of waiting until they develop this sense on their own. When their bowel movements are somewhat predictable, you can have them wear the diaper just when it is time to poop. My son, Jonathan, would usually put on the diaper after breakfast to have a bowel movement, then change to underpants for the rest of the day (of course, he was also in a diaper for sleeping, too). Many kids will ask to put the diaper on when it's time for poop. If this bothers you, remember it is just better to let them use a diaper. I can't stress enough how important it is to avoid pressuring the child into doing something that he is not ready for. Believe me, you don't want to deal with a four-year-old that refuses to poop because it hurts! Once the bowel movements are predictable, you can start working on getting the child to use the potty instead of the diaper. Be sure to look at this from the child's point of view: sitting and pooping on the potty can be awkward or even scary. Let them go through a series of steps that brings them closer to using the toilet.
You might start with having the child use the diaper for bowel movements but he must empty the diaper into the toilet and then throw away the diaper (with supervision, of course).
The next step might be the child stays in the bathroom to use the diaper, and continue to help with clean up.
Then the child uses the diaper but must be seated to have a bowel movement. He can choose to sit on the toilet with the seat up or down, or maybe a chair. Eventually the steps lead to the child having bowel movements sitting on the open toilet with the diaper on.
You then might be able to remove the diaper. If not, then you and your child can make a "magic diaper" that has a hole cut in the rear so that stool can fall into the potty. Children can usually quickly graduate out of the "magic diaper".
The child earns a reward each time he advances to the next step. I found it helpful to have a visible reminder of the reward near the toilet. When accidents happen, he is required to be involved with the unpleasant clean-up. Remember, don't put too much pressure on the child.
Subscribe to our FREE House Calls Email Newsletter!
Get parenting advice, special product offers and nutrition tips. Learn more.