Potty Training Regression- Bowel Movement Resistance

Bowel Movement Resistance - Not pooping in the potty!

So what do you do if you child will not go or refuses to go poop in the potty or the toilet.

Dr Alan Greene (Chief Medical Officer of adam.com and the cofounder of DrGreene.com) calls this the

D3 cycle:

discomfort - dread - delay

Children may end up in this cycle because they had a negative or uncomfortable experience with bowel movement. This may have been because of constipation or change in diet or it could be a fear of the toilet and/or flusing or simply delaying a bowel movement because they are too preoccupied with something else way more interesting.

What ever triggered the start of this - the result of this negative or painful experience is that the next time the child has the urge to poop, s/he will delay going because s/he knows that it hurts. The delay leads to discomfort. The discomfort to dread and the dread leads right back to delay.

"He vividly learns from this experiment, but it's the wrong lesson. So next time he is even more determined to hold the stool in. Discomfort lead to dread; dread leads to delay; delay leads to discomfort. The rectum stretches internally so that more stool can be held, and soon urges to defecate are not often felt. The D3 cycle becomes a powerful trap. Progress is derailed." (http://www.drgreene.com/qa/learning-poop-potty)

In order to move forward, this D3 cycle must be broken!

Because there are different reasons for this, here are some proven suggestions to help break your child pooping in their pants.

  • Going back to diapers can break the D3 cycle. The child relaxes, the stool get soft and the tension disappears. Bowel movements come regularly and without the protest. This is often when parents come looking for answers. But this also runs the risk of giving the child the connecction that: no pain with diapers and it hurts to go poop in the potty - so potties are bad.
  • Modifying your child's diet can cause the stool to soften and break the D3 cycle. Adding fresh fruits and vegetables to their diet is chore!
  • Some kids modifying diet isn't enough, they need a stool softener to take the process out of their control. This should be a temporary solution, not more than 2 weeks. Dr. Greene suggests " One excellent way to soften the stools is with Miralax. Miralax is a powder, mixed into a glass of liquid, that helps increase the water content of stool, thus reducing constipation. It works best if you also increase the amount of liquid your child drinks each day. Talk to your pediatrician for information on the best way to dose Miralax for your child. " ( http://www.drgreene.com/qa/learning-poop-potty?pagination=1)

Steps to success from Dr. Greene:

Often the quickest way to success is to make steady, little steps forward, rather than just trying again to get him to go straight from diapers back to the fearsome potty.

  1. Encourage him to do his pooping in the bathroom -- like you. He can keep his diaper on, he can be across the room from the potty, but he's in the right room. Usually this step isn't too tough. If it is, figure out why (difficulty getting cooperation in many areas, difficulty breaking away from play, defiance, etc.) and address the underlying issue. Once he has comfortably pooped in the right room for 3 days or more, he can take another little step when he seems ready.
  2. Have him poop sitting down -- like you. He can sit on the floor, on the potty with the lid down, on the potty with the lid up, or wherever he wants in the room. He still gets his diaper (or pull-up or underpants as the case may be). Again, once sitting has become comfortable, he can try another little step.
  3. If he has been sitting on the floor, he moves to the potty or toilet. If the lid has been down on the potty or toilet, now lift the lid. He still gets to wear the diaper (or whatever). This step is usually surprisingly easy. Wait until he is comfortable with each stage before he takes another tiny step.
  4. The next step may be to simply remove the diaper and have him go on the potty -- like you.

More About Dr. Greene:

"Alan Greene, MD, is the Chief Medical Officer of adam.com and the cofounder of DrGreene.com. He is on the clinical faculty at Stanford University School of Medicine where he sees patients and teaches residents. He is a founding member of Hi-Ethics (Health Internet Ethics).

Alan Greene earned a bachelor's degree in the history and philosophy of science from Princeton University. He graduated from medical school at University of California at San Francisco. Upon completion of his pediatric residency program at Children's Hospital Medical Center of Northern California, he served as Chief Resident. Dr. Greene entered primary care pediatrics in January 1993.

In November 1995, he created Dr. Greene's HouseCalls, the first pediatric Web site, where he answers pediatric questions submitted by readers from all over the world. DrGreene.com now receives more than two million hits per month from parents, students, and medical professionals.

Dr. Greene is also an author, medical expert, and a media personality. He is especially interested in developmental issues that surround child rearing. Dr. Greene is married and is the father of four wonderful children." (This excerpt came from: http://www.parents.com/baby/care/pediatricians-medicine/meet-the-pediatrician/)

Add Your Comment There are currently 22 comments on this article.
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Twins against Mom and Dad... (6/13/2013) Reviewer: JB (Maspeth , NY)

HELP!

Our twin boys are now 5. It has been battle after battle for two years. When they were 18 - 20 months it seemed so easy... They were going on their own. Buy 2 1/2 to 3 they decided they were too busy to go. Screaming and crying and fighting every time. I tried all the stool softeners and they still managed to squeeze so tight it was impossible!

They are on a mission and now think it is a game to never poo! HELP!!!

What (9/8/2012) Reviewer: Kate (Lafayette, La)

Okay, at Age 2, before even POTTY TRAINING, my DD had one and ONLY experience with a bad Constipation.

LITERALLY 2 DAYS LATER, and from then on (She's now almost 5 - in Oct. 2012) - she's gone to extremes to try to "HOLD IT IN". From, clenching her cheeks, to walking on her tippy-toes to jumping on the couch when the "urge" comes to make it stop, YOU NAME IT, we've seen it.

CATCHER!!: She's SO POTTY-TRAINED FULLY with her Peepee'ing! Actually, since the first time she sat on the Potty, and PeePee'd for her FIRST TIME, she's NEVER HAD ONE ACCIDENT!? She frequently goes, doesn't even tell /ask to use the bathroom (goes on her own), does good job wiping / washes her hands afterward, and EVEN holds urine through nights (we still use the nighttime pull-ups, due to possible accidents and this BM ISSUE), but is GREAT with the Potty in all aspects! No "Fear" of TOILETS whatsoever.

Now, OUR PROBLEM lies when she has to have a BM, like NOW as we are RIGHT NOW, Today ... SHE fears the POOP - whether Pull-Ups or Toilet, it's all about the Poop, and being afraid of it hurting due to hardness. 6 Months ago, WITH PRESSING / CONSTANT REMINDING / sometimes downright insisting because of too much time going by ... She STARTED going Poop on the Potty, though even then, NOT happy about the POOP. And at most, MAYBE every 4-5 days ... and THAT WAS AMAZING! Just last night, after 5 days of bribes, encouragement, behavior modification, sternness, talks, back to bribes and then US AS PARENTS getting scared, I took her in her room, GAVE HER THE CHOICE, Diapers or Toilet, didn't care if it was ON THE FLOOR at this point, I just wanted her to poop - she choose Diapers - and in her bedroom, begged me to not "make" her go poop, afraid it would "Hurt", etc - I then got SERIOUS with her, reminded her that she's had her "Powder" (which is Miralax she's been on since age 2 to INSURE softness, she gets 1 cap full every OTHER day and for these past almost 3 years, she's been SO "soft" that if we WERE to add anything else, it would POUR OUT OF HER-happens if we give even a bit extra), - AND THAT "IF she DOESN'T GO RIGHT NOW, Mommy is going to have to take her to Hospital because this is VERY UNHEALTHY!!". She cried and when I had had enough, moved toward her and said, "Look, Mommy's going to carry you to the car because I need to take you to the Hospital ..." - She cried, held up her hands to me, with eyes as big as softballs and a face of fear, she screamed and started to FINALLY let it out!! I PRAISED HER LIKE NOTHING YOU KNOW, hugged her, told her how "Strong" she is, she was SO RELIEVED and said, "See Mommy, it IS SOFT, you were RIGHT!!" and "It doesn't hurt at ALL!! Yea!! I'm going POOPEE!! See, I can do it, I LOVE pooping!?! Now I feel much better!!" .... And so on so forth, with all night rewards and Praise.

Problem NOW? She maybe Pooped A DAY WORTH, and was more afraid of it leaking (which, believe me, we told her NOT to worry about, and to keep going, etc) and started crying wanting us to change her and let her have a new diaper ... I KNEW this would "Stop the Process" so-to-speak, but she really WAS upset, we changed her (of course, EXTREMELY EASY, SOFT - but no leaks, not WATERY Stool, but as close as you could get to it, ya know?). The SECOND she stood up with her "Fresh and ready-for-more" Diapers, she started her famous speech about how "that's all!! There's no more!! I feel great!! - ugh. Didn't KNOW what to do, encouraged and tried to request more, but it was done. Our "Golden moment" was gone.

Now, first thing this AM, we're BACK to square ONE. We KNOW there's more in there ... She's back, literally to square 1??

Just to answer before comment / hopeful help:

NO INTERNAL / PHYSICAL ISSUES

NON-DEFIANT IN ANY WAY

NO DISABILITIES PHYSICAL OR MENTAL

NO ABUSE

GREAT AND LOVING UPBRINGING

RULES AND MANNERS ABIDES BY

Poop Resistance... (8/13/2012) Reviewer: Nana2twins (Colonia, NJ)

My twin grandson is going thru this phase.

I just purchased a beta fish that I keep in the bathroom which I thought might encourage him to sit and focus on the "Poop Fish", which he waits for the poop to come out. And the reward was giving the "Poop Fish" a flake of food. Well this is not happening.

I finally got the peeping under control and we have peeping races to see who finishes first or what color comes out. He is eager to tell me to "clean me Nana" when he has these accidents. He will come to me immediately.

School will be starting soon and we must get this under control. If he has discomfort such as hard stools he shows no sign. I will mention that he is horrible when it comes to veggies, so Mama supplements with fruits.

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