DFWChild reader Christina of Dallas asked this burning parenting question about kids potty training troubles: “I have boy-girl twins who are 3 ½ years old. They’ve both been “pee-trained” for a year (him) and a year and a half (her). Both wear diapers at night, and they hold their poop till then. Why is this happening, and how can I address it?”
So we reached out to DFWChild Mom-Approved Pediatrician Norah Randles, M.D., Richardson Pediatric Associates for answers:
Norah Randles, M.D.: I have daily conversations with parents over varying scenarios of potty-training troubles. Stooling when placed back in the diaper is a common topic.
Potty training is frustrating for many parents. You are ready to be done with diapers and move on to bathroom independence. Historically, potty training occurred around age 3, but I have noticed a trend of earlier ages being encouraged to use the potty. So the problem may be that your child is just not ready yet.
Potty training is typically mastered in stages: daytime, naptime and then finally nighttime dryness. Stooling continence can occur at any time, or be the very last stage. Using a combination of diapers with big kid underwear is common due to the emerging stages of potty training and should not cause confusion for your child.
There is some thought that it is all or nothing, but this is not practical for either parent or child. Some children can be motivated with the idea of “big kid underwear,” but many are not enticed to use the potty with this technique. The parent will just be changing clothes frequently and doing more laundry.
There can be many obstacles when potty training. Stool holding and constipation are two common hurdles. Picky eating tends to cause a change in stool pattern. It can also cause constipation with large, hard and even painful stools. Painful stools are no fun and can trigger an association of pain with the potty. This leads to fear of using the toilet for “number 2” and then holding due to fear of pain. This cycle of withholding leads to even more constipation and pain for the toddler and anguish for their parents.
Although it can feel like a step backwards, I recommend talking to your child and letting them know that it is OK to still poop in their diaper. Ask them to tell you when they want the diaper, let them stool, clean them up and put them back in their underwear. If your child is not able to tell you when they need to stool, place them in a diaper after dinner or daycare pickup. Let them do their business and again clean up and place in underwear.
During this time, monitor their stool consistency and work on trying to get it softer—healthy toddler stools are like soft-serve ice cream. Make sure they are drinking a lot of water, and eat (or sneak in) those veggies. This approach takes away any pressure your toddler feels to use the big potty and will lead to healthier daily habits. After time, ask your child if they are ready to try the potty for stool, and if they are, then go! The less stress that is placed on pooping in the potty, the easier it tends to be on everyone.
Withholding stool is a common toddler behavior—but if you feel you have explored all options and are still unsuccessful at ditching the diapers, I would encourage you to speak with your pediatrician. Occasionally a medication or a referral to a gastrointestinal specialist may be warranted.
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