My 3 year old daughter refuses to go poop on the toilet. She has been urinating on the potty a while, but she refuses to poop in the toilet. She will hold it in at school and then get really constipated and it is becoming a huge problem. At home, we have to put a diaper on to encourage her to go. What can we do to help her get over her fear of going #2 in the toilet?
Withholding is a super normal phenomenon that many children endure while potty training. It can lead to constipation, further discomfort, and a cycle of potty refusal. Emotions run high for some kids when potty training, as their whole routine is upended. We also know there are a lot of the same receptors that are found in the gut as are found in the brain, so it is not surprising that if we feel anxious or nervous, this affects our bowel as well. When potty training, I recommend that a child drinks plenty of water and consumes high-fiber foods. Many fruits that start with the letter “P” are wonderful natural stool softeners that contain indigestible sugars and lead to softer stools: prunes, peaches, plums, and pears, are excellent options. Just remember “P” fruits lead to “poop”! The softer a child’s stool, the easier the experience will be for potty training.
The diaper can absolutely be a crutch and lead to withholding. I have had many willful toddlers wait until the very last minute before naptime or bedtime when a parent has put on a pullup or diaper, to enable their child to finally relax and stool. If your child is getting into this cycle, I recommend putting the diaper on when the patient is already sleeping to avoid them waiting for this moment and withholding. There are plenty of strategies that can help your child have a bowel movement. Using the potty 5-10 mins after solid meals utilizes the gastro-colic reflex to enable easier passage of stool and a more seamless potty time. Having your child put their feet flat on a stool so that their knees are elevated above their hips, creates a more ergonomic position for more complete bowel emptying. I also love the idea of blowing a pinwheel or blowing bubbles on the potty to relax the pelvic floor and enable easier passage of stool. Parental reassurance and a positive attitude will go a long way in making your child feel encouraged while potty training. Maintaining calm, and not showing frustration are essential in showing a child that potty training is an entirely non-punitive process, and that with time they will figure it out!
