Parent Q&A: Pooping Anywhere but the Potty!
Hi Rebekka,
My partner and I are beyond upset about our older son, who is now 4 years old, continuing to poop in his pants. Recently he went over a month without an accident, so I thought we were through it! But he’s now going in his pants regularly and doesn’t seem to care. He even asked for diapers again!
He’s stubborn and won’t go to the potty with reminders. We’ve tried everything from rewards to no reaction. We don’t know what to do and would love some advice. Should we get him professionally evaluated? Is this a normal behavior for a 4 year old? We did start way too young and have battled this for a long time. He was back in diapers two different times between 18 months and 3 years old. Also, we are pretty sure it’s not a constipation or physical issue.
Thanks so much for your insight!
Tired of Scrubbing Undies
Hey friend!
So nice to hear from you, though I wish it were about less tricky a circumstance. Sounds like your older son is really struggling with the toileting journey; this is something for which families often seek me out for private consultation.
Young children, who are caught in myriad developmental struggles as well as environmental changes, often lack the words to express their thoughts and feelings about what's happening in their lives. In this case, they may turn to whatever means of communication is most readily available, often an area where a parent has little control (i.e., eating, sleeping, and toileting).
It’s so hard to trust that children will eventually be ready (in all the ways they need to be ready), and we can actually make the whole thing backfire if we push our children before they're ready (but don't just take my word for it - listen to Dr. Steven Hodges, pediatric urologist, who notes that even if your child poops soft stools regularly, they may still be constipated, which can make toilet learning even more challenging). If you are curious whether your son may have medical and sensory problems related to his toileting challenges, the Santa Monica-based Child Success Center has specific occupational therapy programs for sensory-based toileting challenges.
However, if you’ve been down the medical and OT routes and confirmed that neither issue is at play here, then the next step is to consider what is my child communicating here? Some of the common themes related to withholding/poop accidents include (but are not limited to): desire for power/control, many transitions/changes in family (moving, birth of sibling), and conflict among parents/caregivers. I know that you've had a big move and a sibling birth, so those are two areas whose impact I'd be wondering about right off the bat.
Consider, what is my child communicating here?
In terms of what to do about the problem, some things to try include doing some introspection around what's most triggering for you both about the situation (beyond the objective yuckiness and inconvenience of it) - this may give insight into what struggles you're enacting with him and create opportunities for more curiosity and seeing the situation differently. You might also consider giving the responsibility for pooping over to your son (i.e., if he wants to wear a diaper) and being clear that you're stepping out, trusting that when he's ready to be a full time potty user, he'll do so. Another idea is to drop in small stories (what my mentor calls "mini-life reviews") offering a "digested" musing about how some of the big changes in your family might be affecting your older son (including but not limited to making him want to be the only one in charge of his poops). "Tell me a story," an episode of my podcast, talks about using this technique and the power of storytelling to help children navigate transitions both large and small.
My mentor Diane and I also have a podcast episode dedicated to poop and poop problems. I discussed my daughter's "developmental tango" journey to becoming a confident potty user in one of our recent episodes. I also took up a parent's question on the topic on my blog here, and share some of my favorite children's books (aka "potty propaganda") here.
There are just a few mindful ideas to get you started - I hope this helps!
Rebekka
Dear Rebekka,
Thank you so much for the thoughtful response. I will listen to the podcast when I have a few minutes to sit down! I do agree he’s been through a lot of transitions since he was almost 2: starting preschool, new brother, moves to new homes… plus the two failed attempts to potty train to begin with.
I think we get so frustrated because we know he knows how to do it! In fact, after I sent the email to you last weekend, we had left him pantless. He went into the potty pooped and wiped himself.
Anyways, we will look at your links and go from there. Thanks again!
Still Tired of Scrubbing Undies
Hello again!
It's confusing, isn't it? Your son's journey speaks to the complexity of the toilet learning process. It's not just about ability! In fact, I tend to articulate the toileting journey in terms of at least three separate competencies:
Interoceptive (inner body awareness) - Is the child aware that he/she needs to use the toilet? Can he/she sense the inner sensation of "fullness" or "pressure" that indicates the "need to go"?
Physical/Gross Motor - Can the child physically maneuver themselves to the bathroom, remove the necessary clothing items, get themselves onto the toilet seat, remain in place long enough, wipe thoroughly when finished, replace clothes, flush, wash hands, with minimal to no assistance?
Emotional - If the child can do #1 and #2, are they willing to use the toilet when they need to go, to stop whatever they're doing if necessary?
Even if a child possesses competencies #1 and #2, it doesn't mean #3 is fully or consistently developed! And as I tell parents, if your child is not at capacity with any one of these three competencies, that means you are in charge of managing whatever shortfall they may possess. If they don't know when to go, you are cueing them every 20-30 minutes. If they can't physically navigate the bathroom, you are helping them with their clothes, wiping, etc. If they are not emotionally ready to go, you are locked in a power struggle every time you think they need to go to the bathroom.
As you can see, it's not an all or nothing ability. Just because your son can go and knows what to do doesn't mean he will. He needs your empathy and partnership to build this final competency! It is indeed frustrating, and perhaps some of the frustration you feel mirrors his frustration at all the big changes in his life, none of which he had control over or a say in. In fact, that would be such a generous and kind thing to reflect to him - it must be so frustrating to not have a say in some of the big grown up decisions that are making so many changes around here!
More food for thought - I hope it's helpful! Good luck!
Rebekka
Rebekka Helford is a licensed marriage and family therapist in private practice in Los Angeles, California. With over a decade of experience working with parents and young children, Rebekka specializes in short-term intensive parenting consultation, using a variety of tools including home, office, and school visits to help families navigate developmental hiccups and get back on track. Virtual visits now available!
Click here to schedule an appointment or contact Rebekka with a question – who knows, she might even answer it in her next post!