A listener asks how to help her toddler whose stool withholding has become painful and possibly chronic.
This week’s question comes from Sarah:
My 22-month-old daughter is an infrequent pooper. She regularly goes 3-5 days between bowel movements, but recently she's started holding it. She's been sitting on the potty to pee for the last month or two, but she'll jump up and say, "no!" when she feels a bowel movement. This means that when she does finally go, it’s… a lot. She had a bit of diarrhea a few months ago and got a rash, so maybe she's remembering that it hurt? We praise her whether she poops in the potty or in her diaper, but she gets distraught when she goes in her diaper. Sometimes she holds onto us and cries. The few times she's gone in the potty, she seems less upset, but you can tell she doesn't like going.
We don’t think this is a constipation issue. I am immensely anxious about this and worry that my anxiety is rubbing off on her. I'm constantly keeping track of the last time she pooped and wondering whether she needs prunes/Restoralax to help her go. These things have helped in the past, but I know they're not addressing the issue of her not wanting to go. How can we help her feel better about pooping without making it too big of a deal? We talk about how everybody poops and that it's okay to go, but I'm not sure that's helping.
I keep trying to tell myself that this is a phase she'll grow out of, but it's hard to see past the worry of whether she's going to poop this week when you're in the middle of it. Thanks for any advice you may have!
This is almost always a phase– but one toddlers need a little help with, especially if it's distressing them or causing them discomfort. Keep in mind that while some kids are ready to start potty-training before their second birthday, others are not ready for another year or more. (Ask me how I know.) It's also common to have a kid who pees on the potty without a problem, but finds pooping more difficult.
Sarah's overall instinct is right: if you have a reluctant pooper, you need to make it less of a big deal. Turn down the focus on the potty-training until things are a little easier. Praise sitting on the potty itself, the act of sitting and being patient, instead of the results that may or may not occur. And don't force it if your child isn't ready.
If pooping does happen in a diaper, make sure that's not being perceived as a "less-than" outcome by your toddler. Pooping in a diaper is definitely better than not pooping at all!
Keep the prunes going (we called them "giant raisins" in our house) and make sure your child is getting plenty of fluids. Ask your pediatrician before supplementing with fiber– if your kid is already backed up, it might be counterproductive. And make sure to mention diarrhea or soiling to your pediatrician as well- it can be something called "encopresis," which is a paradoxical symptom of severe constipation.
Finally, this list of potty-encouraging books from kindercare.com has all the classics. Make storytime part of potty-sitting, and pretend that what else is happening is so "regular" that it's not a big deal.
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