Withholding Behavior

I got upset at my three-year-old for having so many accidents, and now he withholds his stool for four or five days at a time. What should I do?

First, talk with your child to make sure he is not withholding stool out of fear or anxiety regarding toilet use. (As they grow older and their imaginations develop, some children become afraid of eliminating into a bowl, sitting on an adult toilet, flushing the toilet, or being alone in a bathroom.)

If it seems that a specific fear is the reason behind his behavior, demonstrate clearly in several different ways—through conversation, physical “experiments,” and imaginary play—that his fear is unfounded.

If he seems anxious about surrendering physical control enough to let go of his stool, suggest putting him in training pants until he feels more comfortable with the idea. If he consents to wearing them, you can continue to reinforce the stool-potty connection by having him watch you transfer his stool from his training pants to the potty after each bowel movement.

If, on the other hand, his withholding of stool seems to have come about as a result of a power struggle over potty use, it’s time to transfer responsibility for bowel control over to him.

Refrain from asking him whether he needs to poop, and don’t comment when he has not had a bowel movement in several days. Soon, as his withholding behavior ceases to be an issue between you, he will relax his hold.

Meanwhile, be sure there is sufficient fruit, other food sources of fiber, and liquid in his diet to keep his stool soft, and consult your pediatrician if his toilet use does not normalize.