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May 20

Potty Training Challenge: Withholding Bowel Movements

Potty Training Challenge: This series of blogs will cover some common challenges that parents run into with potty training, such as withholding bowel movements or urine for long periods of time, or a child that does not initiate potty visits (only going on a parent’s suggestion).

 

Potty Training Challenge #1: Stool Toileting Refusal (Withholding Bowel Movements)

Potty training can be enough of an adventure without a child that withholds their bowel movements.  This can be extremely agonizing for parents and often leads parents to go back to diapers so that the child can comfortable relieve him/herself.  In turn, this can make it even more difficult to get rid of the diapers.

This blog is all about poop!  Here are some of the most common reasons for withholding bowel movements, and tips for parents.

A) Constipation

If your child experiences constipation and painful stools on the potty while potty training, he/she may relate the pain to the potty, and avoid the potty next time it’s time to poop.  This causes a vicious cycle: holding poop in the bowel too long causes it to dry out, which can cause constipation, which can cause painful toileting and more withholding.  It can be difficult to break the cycle.

Potty Training ConstipationSeveral studies have tried to determine if constipation causes stool toileting refusal (STR), or vice versa.  In one study of 380 children, phone interviews were done with parents during the toilet training process.  Approximately 24% of children in the study developed STR, and in most cases it was reported that the child experienced constipation and painful defecation prior to the onset of STR.

 

B) Age of Potty Training

Another study showed that STR was more common when children were being trained at a later age.  Experiences with my own children and those of families I have assisted with potty training seem to support this theory.

For a long time it was believed that early toilet training could result in refusal to go to the toilet. Taubman published a conflicting result, reporting that children who were late to start toilet training were more likely to refuse.

 

C) Negative Terms & Embarrassment

Between 15 and 24 months of age, a child becomes much more self-aware and is capable of feelings of embarrassment. A child may start to hide when passing stools.

One study attempted to determine if parents referencing poop as “stinky” or “yucky” played a role in children withholding bowel movements.  One group was directed specifically to avoid using any negative terms about defecation, and another group received no such direction.  The children whose parents avoided negative words and terms had shorter episodes of STR and completed toilet training earlier.  It seems that children felt ashamed of their eliminations when they were told that they were stinky, and as a result tried to prevent future bowel movements.

Several common potty training methods recommend a pre-training period where you tell your child that their poop is “gross” or “yucky”.  Please do not follow this advice.  I have had families approach me for help after having major issues of STR.  In several cases, pediatricians have recommended embarrassing the child about the fact that they still use diapers and shouldn’t be a “baby” anymore, which caused significant potty training setbacks.  I cannot stress enough how harmful these approaches can be.  It is harder to undo a potty training issue than to prevent it in the first place.

What Can You Do?

1) Diet

When you begin potty training, your child’s diet needs to be watched carefully.  Plenty of high fiber foods or even a fiber supplement (talk to your doctor) are recommended to prevent constipation.  Our favorite high fibre foods to prevent constipation are:

  • apricotspotty training high fibre broccoli potty training high fibre pear
  • pears
  • broccoli
  • green peas
  • pumpkin
  • artichoke
  • lentils

2) Age of Potty Training

In my experience and based on the results of several studies, younger children (20 months to 2.5 years) are less likely to withhold.  If potty training can be completed before children reach an age where experimentation, independence and stubbornness take hold, STR is less likely to be an issue.

3) Avoid Negative Terms About Elimination

Everybody poops.  Sure, it’s not pretty, but telling your child that their bowel movements are “gross” or “yucky” will likely not assist with your potty training experience and may cause significant setbacks.  In moments of frustration, take a big deep breath, think positively, and choose your words carefully.  Ensure that everyone who interacts with your child during potty training is on the same page about words to use, and those words NOT to use.  Also, remember that children should never be punished for accidents during potty training.

 

Conclusion

Benjamin Franklin was right: “An ounce of prevention is worth a pound of cure”.

Unfortunately a lot of parents don’t know about this issue until they run into it themselves.  Do a friend a favor… share this blog and help prevent potty training issues before they happen!

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