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.

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