Pooping Anxiety and Stool Withholding in Children

Potty training is a big step for both children and parents. The reward of successful potty training is more independence and autonomy for kids and parents, but it can be a stressful journey. In the process of potty training, kids can begin to withhold stool and resist having a bowel movement, even when they are extremely uncomfortable or in pain. Even when fully potty trained, some kids simply won’t poop when they are outside their home - at camp, daycare, or school, for example - which can lead to constipation. This stool withholding can also be frustrating for kids and parents alike. Fear not, however, because pooping anxiety and stool withholding are common, and there are steps you can take to help your child work through it and get back to a regular bowel routine.

What is Stool Withholding?

Stool withholding is just what it sounds like: your child resists going poop, even if he/she is consistently and successfully going pee in the toilet. Stool withholding can be frustrating to parents, and physically painful for kids. Stool withholding is most common in kids between the ages of two and four, and is more common in boys than in girls. It can happen for physical and/or psychological reasons, but most typically occurs after a potty training child has a painful bowel movement and is reluctant to poop again as a result. Some kids withhold stool because they are “too busy” playing or are distracted by something they would rather do. At approximately three years old, children develop the ability to have more complex emotions. They understand the expectations surrounding potty training - no matter how gentle parents are during potty training - and begin to experience embarrassment, anxiety, and even fear around pooping, but they lack the sophisticated language to explain these emotions with words. As a result, they may lie about whether or not they pooped, poop in ‘secret’ (in corners or behind furniture, for example), or hide soiled underwear. Even though a child is in physical pain from withholding stool, even crying or complaining of pain, the withholding behavior continues. Other symptoms of stool withholding include a "poop dance" (wiggling, crossing and uncrossing legs, walking on tip-toes), appearing to strain to the point of becoming red in the face, and clenching the buttocks.

How to Address Stool Withholding

If your child is withholding stool regularly, they are likely in discomfort from gas and bloating which only perpetuates the cycle of being reluctant to poop. The first step is to treat the constipation that results from withholding stool. Designed for easy use at home, DocuSol® Kids is a first-of-its-kind formulation for children’s constipation. Many over-the-counter children’s constipation remedies contain bisacodyl which is a known irritant. DocuSol® Kids is a non-irritating formula which functions as a stool-softener and hyperosmotic laxative that draws water into the bowel from the gastrointestinal tract and stimulates the urge to have a bowel movement. DocuSol® Kids produces fast, predictable results, typically in 2-15 minutes.

Here are other steps to take to help your child with stool withholding:

Diet Changes: Ensure your child is getting adequate daily fiber in their diet. Keep healthy snacks on hand, and avoid foods that are high in sugar, salt, dairy, and saturated fats. Whole grains, legumes, fruits, and vegetables are high in fiber. Exercise: When the body moves, the stool moves, too! There are many ways kids can get exercise and have fun, like playing tag, backyard ball games, playgrounds, hide-and-seek, and going for a walk. Create Multiple Opportunities: Have your child sit on the potty several times a day, even if they don’t feel the urge to go. This retrains the bowel to go more regularly, and helps kids get past the fear and anxiety they experience when they have to poop. Provide fun and distracting games, books, and other engaging toys for them to play with while sitting on the potty so they don’t hyperfocus on the act of going to the bathroom. Make sure your child has a stool to rest their feet on to make them more comfortable and positioned properly on the toilet. Hydrate: Make sure your child drinks non-diuretic liquids multiple times per day (three to four glasses at a minimum). Hydration helps moisten stool, prevent constipation, and is good for the body! Patience: Stool withholding can be frustrating, especially if your child was close to (or past) being fully potty trained. It’s important to be patient and keep your emotions in check, however, because if your child senses that you are emotional it will cause more stress. The more direct attention that is given to the problem, the more the problem will continue.

What is 'Pooping Anxiety'?

If your child won’t poop when they are outside of their comfort zone, even when it’s someplace they spend a lot of time, like at camp, daycare, or school, the cause may be pooping anxiety. Because young children often don’t have the vocabulary to explain their feelings, it can be difficult to get to the root of what is behind their anxiety specifically, but it is not uncommon for children to feel fearful or uncomfortable going poop when they aren’t in their home environment. Causes of bathroom anxiety can be something as straightforward as not liking the toilet paper to fear of missing out on something if they leave to use the bathroom. Some children are too shy to ask to use the bathroom in front of a group of people, and won’t ask to go even when the urge is strong. It’s important to talk to your child about why they are reluctant to use the bathroom, as they may be easily solvable. Your child also may not be able to tell you specifically what is creating their anxiety.

How to Address Anxiety with Pooping

Talk with Caregivers & Teachers: When bathroom anxiety happens at a place your child goes regularly, talk to a teacher, counselor, or daycare provider about the problem and get them to help out. Talk to them about ways to ease your child’s anxiety and assist them in regular bathroom breaks. Practice Run(s): When your child is at home, prompt them to use the bathroom regularly, especially about 20 to 30 minutes after a meal. Talk to your child about what they feel in their body that indicates they need to go, and remind them that their body is signaling them to use the toilet. Go with your child to daycare, school, or camp and practice using the bathroom in a low-pressure environment, like before or after school. Practice locking and unlocking the stall door, and flushing the toilet, to see if the obstacle lies in the logistics of doing these things. Patience: As with all things related to potty training and using the "big kid" bathroom, patience is essential. Use positive reinforcement and praise to prompt kids to overcome their fear, and never use discipline or punishment as it creates more stress. If a caregiver, teacher, or counselor is using discipline with your child and it is creating anxiety, work with them to be part of the solution instead.

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