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.

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.
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.
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.
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 15 comments on this article.
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Second child (out of three) withholding poo (2/29/2012) Reviewer: Jasmine Hi this article is great, my first son with held until he was seven years old - it was only when we knew the stools where coming out soft and we could sit him on the toilet that we introduced a little mirror so he could see his poop coming out - it worked like a dream and he's okay now. Now my 3rd child is withholding and he is now just turned 4, I know exactly what to expect but this advise is new and am glad it is finally out there.

Poop fear (2/7/2012) Reviewer: Nicole (Brantford, on) My son has no problems peeing on the toilet, but refuses to poop there. He was pooing in his pants almost everyday, but has now started holding it in for 5 days or so at a time! He is 3 yrs old, and tells me that poop hurts and he does not want to poop. I have tried getting as much fiber into the kid as possible, with no luck. I am at a loss myself. He will not poop in the bathroom, even in his pants!

6 yrs and not pooping on potty (1/13/2012) Reviewer: Chrissie Slebonick (Canonsburg, PA) On Jan 8 my daughter just turned 6. To this day she does not poop on the potty. She has been peeing since she was 3 however wants nothing to do with the potty for pooping. Her ped sent us to a child psychologist and she said there was noting wrong with her. She said it was all a way for her to control me. She now sees a GI specialist. She suffered from chronic constipation. I had to give her 2 adult enemas and now she takes a laxative on a daily basis. She went back for a follow up and her GI dr said it is now a behavorial problem. All the drs say it is not our problem it is hers. She does clean herself however this needs to stop. Nothing we have done has worked and I am at my breaking point. I told her I was going to create a magic shot that teaches kids to poop on the potty. I am starting to get overwhelmed with it.........

Carolyn (8/12/2011) Reviewer: Carolyn (Denton, TX) It helps to read so many are/were in the same situation. My son is starting preschool, and they require the kid to be "100% independantly toilet trained". At 3? My son is newly 3, and is about 80% pee-trained, and about 0% poop-trained. It's like he's scared of it. Our pediatrican has told us to back off, but I'm so scared he's going to get kicked out of his school. Or... that if he does have a poop-accident in his pull-up at school, that they'd leave him in it all day.

Poo Fear (4/3/2011) Reviewer: L.N. (Nashville, TN) This article was helpful. We had just started potty training around two weeks ago. We put him in pull-ups, underwear or let him go naked depending on where we are and just ask if he needs to go every hour. He is doing well with letting us know if he needs to relieve himself and had his first BM yesterday. He got so scared of it and today refuses to BM in the potty. I think he is scared of the actual poo. I urged him with bribes and all sorts of stuff but he is so scared he begs for a diaper so he can go. Now, I am showing taking him when I go and when he goes in the diaper, I put it in the toilet and have him flush. Hopefully, this will take away whatever his imagination has assigned to his poo.

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