3 year old refuses to poop on the toilet

[Anonymous]

Our 3 year old son (turned 3 two months ago) refuses to poop on the toilet. He does this thing where he crunches up when in diapers as if he’s either trying to hold it in or he’s letting some out but it’s rare that he lets a lot of poop out.

His issues with #2 started around 15-18 months when he must have had a harder stool and cried like crazy. So every time he’d go he’d cry and scream and my wife would have to hug him.

He’ll go through periods where it seems better and then he’ll go a few days without pooping.

We started potty training a week ago but have decided to pause because he would keep going #2 in underwear and didn’t tell us.

Anyway not sure where to go from here. We’ve tried fiber in his water but it doesn’t seem to do much. Pediatrician advised miralax but we’re not keen on that until it’s a last resort.

Any advice would be greatly appreciated!

[Anonymous]

As a person who has been dealing with this for years, Miralax should not be a last resort.

You actually missed the time to act when the issue first cropped up. Don’t worry! I did the same thing. I did prunes and more fiber and blah blah.

Let me save you a trip to the specialist, the first thing you need to do is a clean out, and then miralax and bribes.

Miralax is terrific because it doesn’t cause cramping, it just pulls water into the stool so if your kid holds it, you won’t end up with a big hard turd that is painful and reinforces the cycle.

The child psychologist told us to do bribes and to keep changing them up. She said kids this age get bored of bribes quickly. We did chocolate, little toys, stickers, rhinestones for some reason were a huge hit. Rocks.

[Anonymous]

This is the PP and one more thing about the miralax as “last resort.” Your child has been chronically constipated for more than a year. Don’t feel bad. It happens to a LOT of kids. But you just need to wrap your head around what’s happening and get over this “until it’s a last resort” stuff. You’re way past that.

[Anonymous]

If he's able to withhold it until a time of his choosing then he can be trained, it's just a psychological problem. In my experience, it's because pooping on the toilet is a bit different and unfamiliar than going in the diaper. I gave both of my kids mineral oil (though that is meant for short term, some prefer other things like miralax for longer term) that made it impossible for them to withhold it, eventually everyone figured it out. I found once they had success on the toilet once or twice then it was a lot easier moving forward.

[Anonymous]

The longer you leave this untreated the more damage and healing time that will be needed. The stool ends up impacted, eventually leading to encopresis. End result of stalling tends to be doctors prescribing the child be on Miralax for nearly a year and sometimes combined with stronger laxatives if to be used anytime they don't go in a few days while on the Miralax. Attempting to potty train without treating the chronic constipation pretty much always backfires and leads to them trying to hold it in more making matters worse. Getting the Miralax going now likely means a lower dose for a shorter duration of time, and a child that will be potty trained earlier. Once the damage has healed and the fear of the pain they experience fades, then you will be on your way to potty training.

[Anonymous]

Anonymous wrote:If he's able to withhold it until a time of his choosing then he can be trained, it's just a psychological problem. In my experience, it's because pooping on the toilet is a bit different and unfamiliar than going in the diaper. I gave both of my kids mineral oil (though that is meant for short term, some prefer other things like miralax for longer term) that made it impossible for them to withhold it, eventually everyone figured it out. I found once they had success on the toilet once or twice then it was a lot easier moving forward.

Fwiw this was not my experience, and it took a solid year to really get over the problem. I don’t think this problem comes in “physical” or “psychological,” I think they interact. In that year we did miralax and bribes for trying to go after meals and for pooping. There were a lot of tears. Now we’re in a good place, but I just think it’s critical as with all things to understand that there is a huge range of normal. Same kid “trained” for pee in a day and hasn’t worn pull ups at night since third birthday.

I spent a lot of time thinking about whether this was new or caused by diet or something and from my own memories and talking to relatives, I think a) a lot of kids were just running around chronically constipated b) we used to drink a LOT of juice, which probably helped and c) my grandmother was notorious for caster oil which was so unpleasant that her children learned to hide their problems really well, really quickly.

You don’t want to get to the point where you have megacolon and problems with accidents in elementary school. It’s much better to deal with it now.

[Anonymous]

Wait a month.

[Anonymous]

This is a pretty common occurrence. You could try prunes if you don't want Miralax. You need to break that association between the pain he had and pooping on the potty. Creating positive associations with bribery, maybe letting him watch something while sitting on the potty to relax etc. But this happens a lot and it turns out okay.

[Anonymous]

Anonymous wrote:Wait a month.

This would be fine if the kid was pooping normally and then got hung up on potty training. That’s not what’s happening. The kid has been chronically constipated in diapers for a year.

[Anonymous]

When he was constipated at 15-18 months, he learned that when he eventually poops, it HURTS! So he's learned to hold it in until he can't any longer.... and he's constipated. And now toilet training has added extra stress and has him back to doing it.
And, YES, infants and toddlers CAN learn to hold it in, I've seen it in children as young as 10 months.

Miralax (just a small amount, like 1/8 tsp in his morning or a water bottle that he drinks - have this be the only liquid he's drinking, not juice, milk, etc.) Start slowly or you'll have diarrhea for days and that isn't controllable. You can always increase from 1/8, but their bodies are small, they don't need much.

I'd take him to a specialist to make SURE he doesn't have a fecal mass (think poop ball) that poop is managing to go around. I'm hoping it's not true, but it might be. If he has diarrhea or really soft poops (instead of nicely formed, normal, not too hard balls) then it means his poop is squeezing around the fecal mass. And he needs a specialist who will supervise a cleanout (more than miralax in water)

If you want, while you are going through all of this, you could certainly train him for pee - just tell him that he should poop in his diapers, but can you keep your diaper dry and pee in the potty? Let's try! (he might pee a little when he poops, that's normal, we all do it, but the multiple pees throughout the day he can take his diaper off and put it right back on. ) But keep the diaper on so he doesn't worry about having accidents in underwear and continuing the withholding.

If that works, great - otherwise, just go back to diapers for everything until you/he gets the constipation under control.

Once he gets to pooping daily (in diapers) even if it's with Miralax, then you can move him to underpants BUT you tell him, when you need to poop, tell us and we'll put a diaper on. Then leave it on until he poops (some kids need to move around a bit, others can poop fairly immediately.) Once he's pooped, praise him for that (because you are the point that pooping anywhere is the goal and better than constipation) then clean him up take off the diaper off (for ease, keep the underpants on over the diaper so you can just take off the diaper, clean him and the underpants are still there, easy peasy)

When he's gotten into the routine of asking for a diaper, not being constipated (you may need to keep the miralax going for this period of time) THEN you can start the transfer from diaper to potty. That might take a few months.

THEN, You tell him you are going to start helping him to learn to poop on the potty like the other kids do, but we'll do it slowly, and at his rate.

The routine: he asks for a diaper but this time he must stay IN THE bathroom to use it, he can jump, twist, stand, squat, doesn't matter, and you don't need to stay there (some kids like to have you there to sing songs or read books and be a support, others want "privacy" because it's stressful to try to poop when someone is sitting and staring at you!).

Then when that's easy, (might take a few days or weeks for him to poop fairly quickly - he shouldn't need to be in the bathroom for tool long) the next step is he sits ON the toilet while wearing the diaper to poop. This might take the longest to get comfortable with if he's been a "standing pooper" in his diaper, but he'll get it eventually. (make sure you have a high enough stool that his feet are planted firmly on it so he can push or balance and not feel like he will fall in - remember, they are small children and could fall in, which is scary for a child. I'd change out my toilet seat for one that has sa child-sized toilet seat (see link at very bottom of this post)


When sitting on the toilet with a diaper on (this part might last days or weeks until he's really comfortable sitting to poop) is easy, the next step is that he learns to use the potty without a diaper. He might just take it off and be good, but if not, you can cut a hole in the bottom of his diapers so that when he poops while sitting the poop falls away from his body, which is a weird sensation for children who have been in diapers. Gradually the hole gets bigger and then you keep doing that for a bit and then one day, no diapers!

Don't take the Miralax away until you get through all of this or he'll go backwards - he's developed a great system for never pooping and he'll use it becuase he's a little guy who doesn't know any better, plus it HURTS when you poop, so why do it?

Also, do start getting him into good habits (without telling him what you are doing) as in lots of water throughout the day (if he's a milk drinker 24/7 then get him onto water), and perhaps as you decrease the miralax in the future you add prune juice to water once/day and getting him to lots of fiber, etc. But just doing that now isn't going to cut it.

https://www.toiletseats.com/p/mayfair-nextstep2-childadult-elongated-toilet-seat-in-white-with-sta-tite-seat-fastening-system-easyclean-whisperclose-and-precision-seat-fit-adjustable-hinge/?gad_source=1&gad_campaignid=22716454752&gbraid=0AAAAAD9LH7USHR5I_TXBj_ud0r0y0fdoe&gclid=CjwKCAjwyb3DBhBlEiwAqZLe5KzI5ABBmgacDgZhjBlvrkOvUW09_R9ARrWEb5O8o_0FpOS8v6MntRoC0eUQAvD_BwE

[Anonymous]

You cannot potty train a constipated kid. I understand why you wanted to hold off on Miralax but it's been a year. You're AT last resort. And you're setting him up for failure with the potty training.

Do the Miralax, get to the point where he's pooping normally and not painfully in his diaper consistently for a couple months. Then you can come back to potty training.

[Anonymous]

My now 3.5 year old went through this phase. It’ll pass. Eventually she was just more open to it. And what ultimately helped is her older sibling encouraging her to- I give credit to my 6 year old for poop training her, haha.

Didnt want to create a power struggle so it was a sensitive balance and I couldn’t even tell you what I did

[Anonymous]

DS also refused to poop in toilet instead of diaper before starting pre-k1 (almost 3), eventually another adult, not me nor DH but the grandma helped him during our visit, grandma complimented DS and encouraged him to poop in toilet and DS did after 1st try.

[Anonymous]

Anonymous wrote:This is a pretty common occurrence. You could try prunes if you don't want Miralax. You need to break that association between the pain he had and pooping on the potty. Creating positive associations with bribery, maybe letting him watch something while sitting on the potty to relax etc. But this happens a lot and it turns out okay.

+100

[Anonymous]

+1 for MiraLAX. I don’t understand why it’s a last resort. My doctor said the goal was 1 bowel movement a day with a mashed potato consistency. It needs to be easy for your kid for several weeks. Potty training can come later.