potty training

Behavior & Development • May 19, 2015

When your child will only poop in a pull up, not the potty…

A parent brought up this common potty-training issue in the live parenting chat I do on STLToday:

“My 3 1/2 year old son will urinate in the toilet but will not poop. We put a pull-up on him and THEN he goes. Is there anything to help speed his toilet training along? Thank you.” 

3 1/2 — isn’t that a bit old for this? Actually, no. 3 1/2-year-olds have better things to do than poop. Not wanting to poop in the toilet is a very common problem. It’s rooted in attention span. Usually, the child just doesn’t want to sit on the potty and wait for the poop to come out. Most toddlers just hold the poop in, which causes constipation and can lead to a medical condition called encopresis. Encopresis occurs when kids hold their poop too long, get constipated, and often have pooping-in-their-pants problems. We see kids with this problem into their teens! Encopresis is common, hard to treat, and very annoying.

Your son has come up with a pretty good solution on his own — he doesn’t hold his poop, which is the most important part. He recognizes that he doesn’t want to sit on the potty, so he poops in a pull-up instead of holding it. I’d be grateful for that!  Asking for a pull-up when he needs to poop is actually a healthy compromise. So just staying the course and letting him decide to have a bowel movement in the toilet when he is ready is an acceptable plan. He won’t do this forever. When he is old enough to have a good attention span to sit on the potty he will do it himself. This is perhaps the most gentle approach, but you are still buying pull-ups…

Of note, there are many toddlers who will only poop in a pull-up or diaper. You are not alone.

Another option is to help your child have a good attention span on the potty. You can try interventions like giving him the iPad on the potty when he is waiting to poop, or reading books on the potty. When he asks for a pull-up, say, “Instead of a pull-up, why don’t we read this book together while you sit on the potty until the poop comes out.” The one-on-one attention you are giving her will help reinforce healthy pooping habits. Keep a basket of books handy in the bathroom. I also recommend a positive rewards systems for pooping in the potty. Personally, I give my kids two Skittles when they poop in the potty. (They even get the pick the colors).

Some people recommend the “cold-turkey” potty training approach, where you just throw away the pull-ups or diapers and only wear underwear. You can try this, and it will work for many children, but lots of kids will just hold their stool instead of going when they need to go. You can end up with long-term constipation and encopresis, which just isn’t any fun at all. The healthiest approach is to praise your child for listening to his body and telling you when he needs to poop, and then either work on toilet attention span or just wait for attention span to come with maturity.

My fellow mom-pediatrician, Dr. Kirstin Lee, shares her true confessions and tips for successfully potty training 3-year-olds here. She also wrote a great article on staying sane as the parent of a bed-wetting toddler.

Comments

  1. Hi. I have a 4 1/2 year old son who refused to poop in the toilet. He urinates fine in the toilet and wears an underwear through out the day but he just fears to poop in the toilet. I tried just about everything (treats, bribery, reading, iPad, hole in the diaper) but nothing works. Whenever I try to sit him on the toilet he yells and screams like someone is trying to hurt him. I seriously don’t know what else to do and just feel like giving up. He’s going to start pre-school this August and I’m really desperate. I feel like he’s never going to learn. Any suggestions?

  2. I don’t buy it that keeping wearing pull-ups is a reasonable approach or that rewarding pooping in the potty is a great idea. Verbal affirmation sure, and maybe a one-time small prize such as a piece of candy for the very first time they poop in the potty. But overdo it and they are in control and will develop a sense of entitlement for doing the right thing.

  3. Did you ever find a solution? I’m in the same boat with my 4 year old right now… Been at this struggle for a very long time now.

  4. Omg thank you !!!! My son is 4 and going through the same thing. I’ve been told how my son will miss out on PK because he is not going #2 in the toilet. Was made to feel so guilty tried everything he will not put on a pull up or diaper so he goes in his big boy underwear and I have to clean them plus his pants or socks if he has a loose BM. I have felt so alone and thought my sweet boy was abnormal.. Thank you for letting us into your life and now know my son is normal and will get through this together ..

    Mom in Flagstaff

  5. 4.5 with us too. tried everything, seemed excited when poop fell in potty with hole in diaper, then held it for 3 days and wanted a strong diaper. I give up!

  6. My son is 5 and refuse to poopp in the potty. I’m at my wits end. We’ve tried a lot of things too. Any help would be appreciated.

  7. I disagree. My just turned 3 year old, just started potty training, I had to come from the East Coast to do, she refused do it. It took me a week to accomplish it. However, she will not poop, but she knows exactly what she’s doing. She will leave the room, go to her room and come back and would have pooped. Ridiculous. She gets spanked for every time she does it. 3 years old is too old to not be potty trained.

  8. What a horrible way to treat your granddaughter! If you use this approach you will end up scarring her for life and she will end up with all sorts of bowel movement issues, such as what this article refers to. You will only make the problem much, much worse by spanking her. She is THREE for goodness sakes! Shame on you for not giving her the love and support she needs during this scary and new time her her young, young life. You should rethink your approach.

  9. OMG. I was looking for some explanation and help for potty training a 4 year old that has come to live with me. Sorry, letting them poop their pants because they are too busy to get on the toilet is a non-starter. Good lord. If this is the kind of advice docs give now no wonder kids are acting the way they are!!

    I think I’ll go back to trusting my own instinct and experience…and set the timer for every hour until we have this under control.

    Do these idiot doctors understand the kids can’t even to go preschool or school loading their pants?

  10. I too am in the same position. Did anything work for you? I’ve tried everything with my 4 year old, rewards, cold turkey, a hole (he looks for holes now) He was so proud of himself when he went about 3 times with the hole and then when it came time to go again, he was terrified that it’s going to hurt. Did anyone ever figure out something that works? We have spent hours in the bathroom and it’s emotionally stressful for me and him.

  11. Yes. Finally. I gave him a tablet to play on while he pooped. And now he will, but needs a toy, tablet or book to play/read.

  12. I tried this too and he still withheld. It’s a power struggle every time. It’s killing me

  13. Do you guys know what to do with a 4 1/2 year old girl who has been potty trained for well over a year, has gone potty in the toilet many times, is fully capable of doing so, is not afraid to do so, but simply does not WANT to do so most of the time? She has flat-out told us she just doesn’t want to. Sometimes she will, but most of the time she won’t. She will just go in her pants and then put a new pair of pants on. She just doesn’t seem to care. We’ve tried everything: bribery, rewards, reasoning with her, leaving it alone for weeks at a time, etc. She has been seeing a counselor since last summer for ADHD and the counselor has given us various ideas to try and none of it has worked at all. Our daughter just doesn’t care! I don’t know what to do anymore! She can’t go to preschool because no one will take her. I’m sick of buying pull ups but I’m also sick of her clothes hamper reeking of poop and pee every day!

  14. After 6 months, my 3 year old grand daughter is potty trained. Nothing was working. I took drastic measures.

    This child is highly intelligent, and knew exactly what she was doing.

    I finally took all of her toys a way, got every single book in the house, sat her at her table and all she did day in and day out was READ.

    After almost 2 months she said, I dont want to read books anymore, Im going to poop on the toilet.

    For those of you that said I was being mean, get over it. When I child is feet from the rest room but will go in her room, poop and then come back, she knows exactly what she was doing. She wasnt afraid of anything, she simply chose not to adhere to the rules.

    Now that thats all done, now shes eating paper. For the record, she missed going to school bcz she wasnt potty trained.

  15. Well, she said she doesn’t like books and books are printed on paper. Makes sense that she would decide to eat paper.

  16. Spanking and sending her to bed early!
    If only I’d thought of being really mean!

  17. They go a half day to prek. Make sure they use the toilet beforehand. Use pull ups. They are unlikely to have an accident if they are at school just for the morning. You save the child embarrassment. No wet pants or changing pull ups for the prek teacher or aide.

  18. The grandmother is the only one with any sense! Get it together people! It is parenting not counseling… At times, there will be scars (as you all prefer to refer to IT as) – really DISCIPLINE your children early (bend the sapling while it is young). Moreover, I doubt that any of us (or our children for the following) remember a few taps to the hind leg for failing to follow rules at two/three years of age, no instead we associated unacceptable behavior with undesirable CONSEQUENCES. The previous is essential for LIFE DEVELOPMENT… Going to the toilet is not intended to be SO INTENSE, however varied the little individuals that we’ve been blessed to RAISE, UNFOLD, PROTECT, CHERISH, DISCIPLINE – PARENT!

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