Happy Tushies: How to Manage Poop Problems During Potty Training

Welcome to Toddlers Made Easy where there's no fluff, just practical research based 15 minutes or less parenting lessons to help you calmly manage these crazy, awesome toddler years. For those of you who don't know me, I'm Dr. Catherine, a pediatrician with more than 33 years of experience. I'm the author of two parenting books and the mother of four amazing adult kids. And there's also Smudge Our great big goldendoodle. Today we're going to talk about br poop problems that can happen during potty training. These can be really confusing and overwhelming, like what happened to Jillian. Here's an email I received from her about her almost three year old son. Marcus began toilet training two weeks ago. I used a no pressure approach. I wanted to give him all the space he needed to learn at his own pace and things were going really well. I was so impressed. He was having very few accidents. He's peeing on the potty and even sometimes on the toilet now without any problems. And, and it's only been a few days. But here's the thing. He's refusing to poop on the potty. In fact, he's refusing to poop altogether. He's going five or six days now without a poop and the only time he's having one now is in his sleep. Help. I don't get it. Well, thank you, Jillian, for sharing your story. And let me assure you that you're not alone. Pooping problems during potty training are very common. In fact, one of my kids would drag her bum along the floor in an effort to avoid pooping. Clearly, Jillian approached potty training with the gentle no pressure approach, which is really great. But unfortunately, there are other reasons besides external pressure for a child to start holding their bowel movements. If your child was pooping perfectly well in a diaper and the problem began with toilet training, then most likely something about the process is upsetting your child. It could be fear or anxiety. For example, let's say your child used the toilet at school and when it flushed it was really loud. When. Well, now, your child may be afraid that pooping is always going to be scary. Or your child may have passed a big poop that hurt and now he's afraid it'll hurt again, so he's trying to avoid it. And by the way, this is the most common reason for children refusing to poop. Or it may be that holding bowel movements is how your child is maintaining some control over his or her life. If they want to hold their bowel movements, they can and they will. Some kids just feel physically uncomfortable, especially if they're using a toilet without adequate support. Or the problem may be related to wanting more privacy, especially if your child had the tendency to hide when having bowel movements in a diaper. Going from pooping in a diaper to pooping in a potty is a big change. All your child's known this far is the feeling of pooping in a diaper with the poop being felt snugly against his bum, and the change can really be scary. Plus, for anatomic reasons, pooping sitting down on a potty is harder than pooping standing up. Plus, we know that toddlers love routines and rituals and we're changing their for no obvious reason, at least from their perspective. So what can you do to help your child feel more comfortable about pooping on the potty? Well, no matter where you are in the process, teach your kids about poop and pooping. Say something like poop is how our body gets rid of the food we eat that it doesn't need. Also explain Everyone poops. Grab some books about pooping like this Oldie but Goodie Everyone Poops by Taro Gomi. Avoid using terms like dirty or yucky or stinky when talking about poop, as this can confuse, confuse and embarrass or maybe make your child feel self conscious. If you're using a toilet, consider switching to a potty. Consider whether privacy is an issue and offer to step out of the bathroom. Just talking about poop and pooping will raise your child's comfort level. Now while toilet training, aim to keep your child's stool soft, give your child extra fiber and water in their diet, and make constipation smoothies. There's so many great resources for recipes for this on Instagram, and I'll leave a few in the show Notes in general, assume a no pressure approach. And by the way, if this interests you, I'm just putting the final touches on my upcoming online course, Potty Training Made Easy. I'm excited about this course because I bring the psychological and medical perspectives to potty training, which is missing in many other potty training courses. I'll let you know when it's available. Now back to this no pressure approach. The way to reduce the chances of your child holding bowel movements is to assume a no pressure process and that means playing it cool whether or not your child pees or poops in the potty. Focus on the process over the outcome. You didn't push your child to start walking and the same concept should be applied to potty training. Encourage your child to listen to her body, so say something like, your job is to listen to your body. When your body tells you it's time to pee or poop, go sit on the potty. When your child pees or poops on the potty, play it cool. Say something like, oh, nice, you had that feeling and you went pee on the potty. This step is really challenging because you'll feel like jumping up and down and celebrating, but a huge response can boomerang on you as a big reaction can feel like pressure for your child. I call accidents lessons as that's how a child learns to read and listen to her body. So let's stop calling them accidents altogether as it just causes frustration and stress and may even send the message that your child is failing. I like a term I learned from Montessori and that's calling an accident a miss. So when your child has a miss, just say something like, oops, you didn't make it to the potty. No biggie. I bet that feels wet. Let's go get some dry pants. Accidents are going to happen and they'll most likely happen a lot. But when we think of Mrs. As part of the learning process, they're easier to respond to peacefully. If a child is resisting using the potty for pee or poop for an extended period of time, it's likely he or she's not really ready yet. This would be a conclusion to reach after excluding fear or anxiety as the cause. Remember, your child can be physically and cognitively ready, but it also takes emotional readiness, which can be more difficult to recognize. But if a child is resisting, especially with a no pressure approach, he may not be emotionally ready. So you can put potty training on hold and come back to it in a few weeks or even months, depending on depending on the age of your child and their readiness. What if your child asks for a diaper? Well, in my opinion, and this is based on the problems I see coming into my office, that come from a child being pressured to use the potty. I would say give your child a diaper if she asks for one. Be careful to avoid shaming or projecting a sense of failure. Then start fresh the next day and continue to encourage your little one to listen to her body. If your child's only pooping in a diaper at bedtime, offer her a diaper close to the time she typically has a bowel movement. Movement and add fiber and water into the diet. Most kids don't get enough fiber in their diet Anyways, this next section I call Unhappy tushies or also known as constipation. This is one of the most common problems I see in my office. A child who's constipated may have large stools that are hard and dry, or the bowel movements can also be like little small pellets. Stools are typically difficult to pass and infrequent. Any child with pain during stool passage or or with lots of straining needed needs treatment. At the very least, they need a change in their diet. Kids end up constipated for a few reasons. A child passes a hard bowel movement and it hurts and then she becomes fearful of passing another and she tries not to go. The stools then become harder to pass and a vicious cycle starts. Also, a young child may resist having a bowel movement during potty training to exert her independence. This is more likely to happen with a parent led potty training approach, but it can happen with a gentle approach too. It's just less likely to happen. A child may hold their bowel movements because they don't like public restrooms or the school bathroom. Also, kids who drink excessive amounts of milk and don't have enough fiber in the diet may also become constipated. Now, if you think your child is constipated, add some natural fiber from fruits and vegetables and increase water intake. If toilet training, I'd see your healthcare provider. So a stool softener can be started if it's needed, especially if you've already tried dietary changes for a week and it didn't improve things. I decrease your child's cow's milk intake if it's excessive and ideally keep milk at no more than two cups per day. You want to also correct the position your child is sitting on the potty. Many children tend to bend over at the waist when trying to poop, which actually makes it harder to pass a stool. Consider a potty stool that corrects a child's position and makes pooping easier. I just remembered this funny moment in my office that I want to share with you. When a parent and child comes to the office with a problem, I'd like to speak directly with the child. So I was chatting away with this little guy who was complaining of tummy aches and I asked him if his stools were hard or hurt to pass. I could tell he didn't quite understand what I was saying, so I asked him if he understood and he said, well, I have a blue stool in my bedroom that I sit on. Is that what you mean? And I had to have a good laugh because you have to be so careful what you say to kids. Kids. Anyhow, a really great resource for you is the Bristol Stool Chart. That's spelled B as in Bob R I S T O L. So that's Bristol Stool Chart. You can Google it and it'll help you to understand your child's poop and whether or not he's constipated. This chart shows you the size and the shape of a normal stool versus a constipated one. Did you know that your child can actually have a bowel movement every day and still be constipated? Kids tend to be very busy, so just think about it for a minute, how they zip from activity to activity. Well, they have that tendency to poop without fully empty because they're just so busy. So over time they can become backed up. Many parents find it confusing that a child can have a bowel movement on the potty but chooses not to. Or in other words, he understands all the steps but he refuses to use the potty. In this situation, I'd make dietary changes to keep the stool soft, including those constipation smoothies. I'd use a floor potty. I'd give them privacy. I'd help them take their time by having a box of toys that are only available for pooping time, and this motivates them to sit for longer. Or you could also try just to read to your little one, which will help him relax. Although you want your child to poop on the potty, you also want a child who's feeling relaxed passing a bowel movement. So if he asks for a diaper, simply give him one and then I'd pick up where you left off the next day. Let's talk about when to see your healthcare provider. If your child has constipation that lasts longer than two weeks, it's a good sign you need to see and speak with your doctor. If you've tried dietary changes for one week and the constipation persists, that's another reason. Also, if your child is refusing to poop on the potty, please chat with your pediatrician. He or she can help sort out whether or not the cause is constipation. Other signs include blood in the stool, changes in eating habits if your child is vomiting, weight loss if the tummy is distended, or this is something that rarely happens. But occasionally something called rectal prolapse can occur where part of the intestine actually comes out of the anus. Anyhow, thank you for joining me today. Poop problems can be challenging and stressful, so remember, please chat with your healthcare provider if you've got concerns about your child's bowel movements and bathroom routines. So please share this episode with any friends who are struggling with this issue and I'll see you next week.