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/)

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help retraining my grandson (6/14/2014) Reviewer: Christina Murray (Indianapolis, In)

I have potty trained my grandson. His parents work during the day & they find it is easier to put him in pull ups now. Even the babysitter wont train him. He will be 5 in Nov. This boy cannnot go into pre-school.I am pulling my hair out.

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Twins against Mom and Dad... (6/13/2013) Reviewer: JB (Maspeth , NY)


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:







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.

Regression? (7/8/2012) Reviewer: Meghan (Ambler, PA)

My son was doing so well with potty training. We had 8 days without a single accident. He was peeing and pooping on the potty.

Now all of the sudden he started pooping in his pants. We don't chastise him for doing so, but let him know it is wrong and that he needs to use the potty to poop. He has had 3 pooping accidents in the last 3 days. And the worst part is, I don't even think it bothers him.

So what can I do to motivate him to go on the potty?? We are using a sticker chart and potty prizes.

Other Side of this Situation (6/6/2012) Reviewer: Toilet Trained ;) I'm just reading up on this stuff because I had a lot of problems learning to poop on the potty as a child and I was wondering what exactly was going on with me.

I think my issue was mainly one of fear. I was afraid that it would hurt (maybe I was going through the D3 cycle) and I was convinced that there were monsters in the toilet and I was deathly afraid of flushing! Anxiety has always been an issue for me so this seems to be just another manifestation. Hang in there :)
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.
I agree with no help at all... (10/24/2010) Reviewer: Heidi Gardner (Hilton Head Island, SC) My son is almost 5. He had no problem using the toilet at an early age for peeing. He even started to poop.... Try putting a 5 year old back into pull ups. HA! He has only pooped in his pants at school once. He does it EVERY SINGLE DAY now, but only when he's home and even after urging and bribing him to go on the potty. I can catch him clinching it in and insist he go to the bathroom, still, later, he will end up with SOFT poop all in his pants. It's driving me crazy. I've thrown away several pairs of underwear because it was just ridiculous for me to have to clean something that bad. I have bought new "cool big boy " underwear, "cool big boy" boxers, more prizes than you could imagine, tried positive and negative reinforcement, embarrassment, ... what is left?
In their own time... (9/7/2010) Reviewer: Erica I made the mistake of recognizing "the signs" and thinking age 2 was perfect for potty training. It was very stressful for my son and I. Child number 2 is now 3 years old. I really don't care if he goes in the potty or not. He will go when HE is ready. I think it's simply foolish that parents push their children to do something they are not ready for, no matter what "the experts" say. I know children who just started using the potty on their own at 18 months. I know children who were in diapers until 6. A child, unless of special need, will use the potty eventually. Children definitely sense the urgency from parents and some go against that, while others want to please their parents. It makes me sad that parents think a child is being purposely defiant. That is what is **.
This article is a Big Help for me (8/28/2010) Reviewer: Amanda (Minfordq, oh) My son indeed pees in the potty perfectly and just as expected. he can stay dry all day if I am consistent on the taking in advance of need schedule.

However, he will not dirty on the potty. Now I realize it could be because he is not relaxed. I noticed he likes to hold onto something and squat at it to dirty so I put his potty up to the arm of the couch as he peeked his head above the arm of the couch sitting on his potty he finally dirtied in his potty.

I haven't been able to get this to happen again since but I am hopeful that these "potty sits" will encourage him to relax enough to dirty on the potty too.

Thanks so much.

PTC Comments:

Your are very welcome!

Potty Help (1/5/2010) Reviewer: Bobbi (Ocala, FL)

My little one was urinating on the toilet w/ frequency - he was actually telling us he had to go and was able to "hold it" for short periods of time before we could get him to a bathroom.

About a week ago he had a BM on the toilet and now won't even urinate anymore. Every time I place him on the potty he now cries and refuses to go. I think that the BM scared him and he associates urinating with a BM.

I don't know what to do and am having trouble finding any information about little ones who go backwards with potty training.

Does anyone have any help to offer?

PTC Comments:

Have a look at our section on Potty Fear

This Didn't Work for Me (12/3/2009) Reviewer: Wendy (springfield, mo) I tried the going back to pull ups after my daughter, 3 1/2 , wouldn't go BM in the toilet and it back fired for me. She chose to stop going pee in the potty as well.

Now, she's taken it a step further and goes pee on the floor even if I'm standing right next to her. She is on a laxative (as prescribed by her doctor) and her poops are quite soft and comfortable.

She refuses to poop in the potty. I've tried every technique I have found and nothing has worked.

No help at all (8/10/2009) Reviewer: Nonny (Phoenix, AZ)

This article doesn't say anything about when the stool is nice and soft, and it's plain outright defiance.

We will take my child to the potty, and ten minutes later she will grin and announce she is pooping her pants.

It's soft as always and gets everywhere. It's not aversion - she does it on purpose. It's BS to claim that kids always want to do what the parents expect.

Although I'd love to visit that alternate dimension someday.

My child is over 3 and her preschool is about to hold her back because she won't poo in the potty. I am trying to convince her it's important and she's going to miss out if she continues to refuse. I am trying every tactic you can name.

I am desperate. Something has got to work, sooner or later.

PTC Comments:

We would suggest that you figure out WHY your child is being defiant?

Same old problem (7/15/2009) Reviewer: Mom in Texas (Irving, Tx) my two-year-old boy still poops wherever he pleases and we went back to the diaper for a while. I also didn't find this article very helpful considering that is the only tidbit of advice you gave and I had figured it out on my own.
Frustrated in New York (7/3/2009) Reviewer: Marie (Nanuet, NY)

My four year old is refusing to use the potty to have a BM.

After consulting his pediatrician we are giving him a stool softner and made changes in his diet.

However, he is refusing to sit on the toilet after each meal.

This is a very frustrating situation.

I am now putting a long t-shirt on him and no underwears.

I am hoping that will react and want to use the toilet for his bowel movements.

PTC Comments:
This behaviour of refusing to sit on the toilet is referred to as nonretentive encopresis.

Please see our whole section on Encropresis, including the causes and treatement of encopersis.

Tried this and failed! (3/28/2009) Reviewer: Andrea

I babysit my niece and she will not poop in the potty.

We have tried every method.

My sister in law recently read this and tried to revert back to the pull ups.

Well now my niece thinks she no longer needs to pee in the potty because she has on a pull up.

So for us this method didn't work as we had hoped.

please help (2/19/2009) Reviewer: sharon lawson (austin , texas)

My 4 year old grand daughter will not have a BM in the toilet. We have a seat that fits over it when she she needs to have a BM she hides and cross her legs.

I'm very worried something might be wrong we took her to doctor. They just gave laxatives.

Why does she cross her legs? All her mother has for her is medicate and and I fell the doctors are not good

I'm really worried about her

Please help