Refuses to Poop on the Potty

>Dear Dr. Hackney,

My 3 ½ year-old son is consistently potty-trained for pee but continues to want diapers for poop. If we refuse diapers, he soils his underwear. What do we do to help him along?

Sincerely,
Maya
Mother of one, three years old

Dear Maya,

First, realize this is NOT an uncommon problem.

Second, relax a little. The “potties without pressure” approach, which is currently supported by the American Academy of Pediatrics, suggests that potty-training progress at the child’s pace. This means if the child expresses he is not ready to move forward, then the parent slows the process.

Following this approach, the average age for successful potty-training is three years old. Three years old is described as “average” as girls tend to be ready earlier (two and a half to three), boys often later (three to three and a half). It is within normal limits to have a just turned two year old or an almost four year old.  It is not about the age but rather signs of readiness.  In this particular case, the child is well within normal limits for potty-training.

It is suggested that children who are otherwise potty-trained but continue to want a diaper or pull-up for bowel movements be given one and then cleaned and changed as usual.   Keep the stack of diapers or pull-ups in the bathroom.  Encourage him to be in a bathroom when he poops and clean and change him in the bathroom as well.  Talk about how when people need to poop, they should be in a bathroom.  By all means, applaud the successes of the child peeing in the potty but allow for diapers when they are specifically requested with as little negative emotion as possible. If you must comment, say something as mild as, “I am glad you let me know you need a diaper. I know when you are ready, you’ll poop in the potty as well.”  Once they are regularly in the bathroom, encourage them to sit for pooping, even if it is with their diaper or pull-up on.  It can be a different or uncomfortable sensation to sit but this is the next step.

Also good to give the “language of ownership,” this means once a day or so and out of the moment of potty training or accidents say something like, “Do you know you are the only one in the whole world who really knows when you need to poop.  It’s your job to let me know when you need to go.” or “You take good care of yourself when you listen to your body and go to the bathroom when you need to poop.”  When he does go into the bathroom or sit to poop or go on the potty, give descriptive feedback.  Praise by saying something like “You knew you had to poop!  You were listening to your body.” or “You got to the bathroom so fast!  That is helpful.”

You can gently encourage progress by allowing children to observe you or willing siblings in the bathroom, talking them through the process and mixing in potty oriented storybooks and videos with your other media. You can also take a wet or soiled diaper, with the child in tow, and empty the poop or place the wet diaper into their little potty while saying, “See, this goes in here.” Then empty and clean the potty as you usually would. For some children, this provides a beneficial cognitive connection between their bodily functions and the expectations of potty-training.

The potties without pressure approach defines the parent’s role as recognizing signs of readiness and offering lots of support and encouragement along the way. Signs of readiness include potty talk (“I peed,” or “I go poop.”), potty play (dolls going potty or trucks getting diapers), an awareness of body parts and functions, longer dry times or more predictable bowel movements, increased imitation in play, ability to follow three-step directions (“Go to the kitchen, get your shoes and meet me by the door.”) and an interest in learning the new set of skills.

This approach identifies several signs that children are NOT ready for potty-training. Children who resist the process and protest the practice loudly are likely not ready to proceed. Children who hide to potty are likely not quite ready. It seems to many parents that children must be ready as they are able to recognize they need to go and actually get somewhere to do it. This is seen as a sign that they are physically ready, just not emotionally ready. Children who sit for a while and then stand nearby to poop or pee on the floor may be feeling too tense while sitting on the potty. If this is the case, it is suggested that parents encourage children to “sit and relax” rather than “sit and try.” The language of “sit and try” may make children nervous and when one is nervous and has tight muscles, it is hard to go potty. Once these children get off the potty, they relax and then, unfortunately, void nearby.

Overall, recognize the signs of readiness and provide lots of support and opportunities for success at the child’s pace.
Sincerely,
Rene Hackney, PhD.
Parenting Playgroups, Inc.

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