When children engage in stool withholding, they purposely avoid passing a bowel movement by contracting their bottom muscles.
Causes of Stool Withholding
Stool withholding commonly occurs after periods of constipation, triggered by factors such as illness, large stools, starting potty training, changes in routine, or discomfort with pooping at school. It can also be caused by emotional factors such as stress, anxiety, or changes in the child’s environment.
Signs of Stool Withholding
Various signs indicate that a child is trying to withhold a bowel movement, including straining on the toilet, refusing to sit on the toilet, making unusual facial expressions, or hiding when sensing the need to poop.
Breaking the Cycle of Stool Withholding
To break the pattern of stool withholding, it is crucial to address constipation first and then focus on providing reassurance and building confidence in the child.
If a child experiences difficulty with bowel movements, they may be dealing with constipation. Watch out for signs like large or painful stools, poop accidents, straining during bowel movements, or frequent accidents.
It is important to encourage the child to eat a balanced diet rich in fiber, drink plenty of water, and engage in regular physical activity to help regulate their bowel movements. Parents can also consult with a pediatrician or healthcare provider for guidance on appropriate treatments or medications to relieve constipation.
In addition to addressing the physical aspects of constipation, it is crucial to provide emotional support to the child. Reassure them that it is okay to have bowel movements and praise them for their efforts. Building confidence and trust will help the child feel more comfortable and less likely to withhold their stools in the future.
By taking a holistic approach to addressing constipation and providing emotional support, parents can help break the cycle of stool withholding and promote healthy bowel habits in their child.
Functional Constipation
Functional constipation, the most common form in children, occurs without underlying diseases or anatomical issues in the digestive system.
Common Misconceptions about Constipation
Contrary to popular belief, most cases of childhood constipation are functional, triggered by factors like illness, diet changes, or habits such as stool withholding.
Recognizing Chronic Constipation
- Less than 2 BMs per week
- Accidents involving poop
- Pain while pooping
- Passing large stools
- Avoidance of pooping
- Inability to recognize the need for a BM
- Decreased appetite
- Feelings of tiredness
Dispelling Another Myth about Constipation
Children can still experience constipation even if they poop daily, depending on the size of the stools.
Dispelling Myths and Supporting Children
- It’s normal to feel anxious about bodily functions not working properly.
- Support and encourage children facing constipation.
- Chronic constipation can occur at any age.
Understanding Key Terms
Definitions of terms associated with constipation, including BM, chronic constipation, cleanout, encopresis, fecal matter, functional constipation, gastrointestinal tract, and incontinence.
Stool: Feces.
Toilet avoidance: Deliberate postponement of bowel movements due to pain or anxiety.
Getting unstuck
First steps
Parents can encourage healthy gastrointestinal systems by:
- Increasing fiber: Fiber intake should align with age plus 5 (in grams) spread across 3 meals.
- Staying hydrated: Ensuring kids consume 6 to 8 glasses of water daily.
- Staying active: Physical activity assists in moving waste through the large intestine.
- Establishing a toilet routine: Regular bowel movements help relax the gastrointestinal system.
Unstuck myth #4
Enhancing fiber and fluid intake can alleviate constipation.
Myth: Severe constipation may not be fully addressed by dietary changes alone. Read on for more information.
The cleanout
If diet and exercise prove insufficient:
A doctor might recommend a “cleanout” to unblock the bowel and reset colon muscles.
The process involves:
- High doses of laxatives for 2-3 days.
- Maintaining a dosage chart for the follow-up appointment.
- Concluding the treatment with unblocked, liquid stools.
Unstuck myth #5
Resolving constipation takes time.
Myth: Treating functional constipation requires consistency and patience, including post-cleanout daily laxatives to prevent reaccumulation.
Cleanout tips
Although challenging, cleanouts break the cycle of blockage!
Tips for smoother cleanouts:
- Focus on the process: Set aside other tasks for the procedure.
- Maintain positivity: Offer encouragement after each dose or bowel movement.
- Support by hydrating together.
- Be vigilant: Supervise the intake closely.
- Vary the approach: Creatively mix laxatives for better acceptance.
- Provide incentives: Reward treats for each step completed.
A new routine
Aid children with painful constipation in reestablishing a regular toilet routine.
Develop an Unstuck Routine:
- Set a schedule: Strive for consistency to facilitate adjustment.
- Begin gradually: Progress from short sitting periods.
- Be encouraging: Encourage sitting without direct questioning.
- Stay positive and offer praise: Support completing a sitting session.
- Provide rewards: Offer rewards for sitting, irrespective of bowel movement.
- Use distractions: Employ books, toys, or engaging activities.
- Manage disruptive behavior: Wait for calmness and exhibit patience.
- Maintain consistency: A consistent approach yields the best results.
Still stuck?
If at-home remedies and consultations prove ineffective:
BRICK Clinic offers comprehensive care for functional constipation.
Patients must be:
- At least 3 years old.
- Ready for toilet training developmentally.
Is your child eligible? Consult your pediatrician for guidance on a referral.
If the criteria are met, the initial consultation lasts an hour, with follow-ups of 30 minutes each.
Let’s conquer constipation together!
healthdirect Australia allows free access to medical professionals for advice.
Key facts
- Children’s bowel patterns differ.
- Address bowel concerns causing distress.
- Seek medical advice for pain or blood in stool.
- Simple diet modifications can aid in alleviating constipation.
- Encourage physical activity to promote regular bowel movements.
- Stay hydrated by drinking plenty of water throughout the day.
- Fiber-rich foods like fruits, vegetables, and whole grains can help prevent constipation.
- Establish a regular bathroom routine to train the body for bowel movements.
What is constipation?
Signs of constipation include hard stools or difficulty passing stool.
Common in infants and during toilet training, it typically resolves by age 4.
What is normal for children?
Constipation is prevalent in children without severe underlying causes.
Most children have bowel movements every 2-3 days, with variations in frequency.
Breastfed babies may exhibit irregular bowel movements.
What are the symptoms of constipation in children?
Signs of constipation in children:
- Discomfort or pain during bowel movements.
- Behavioral changes or refusal to sit on the toilet.
- Intermittent stomach pain or reduced appetite.
- Straining during bowel movements or soiling accidents.
Constipation can lead to anal fissures and dry stools, especially in infants.
CHECK YOUR SYMPTOMS — Utilize the Symptom Checker to assess if medical attention is necessary.
It is important to encourage children to drink plenty of water and eat a diet high in fiber to prevent constipation. Foods such as fruits, vegetables, whole grains, and legumes can help regulate bowel movements. Regular physical activity can also aid in promoting regularity in the digestive system.
If a child continues to experience constipation despite dietary changes, it is important to consult a healthcare provider for further evaluation and treatment. In some cases, stool softeners or laxatives may be recommended to help alleviate symptoms. It is essential to address constipation in children promptly to prevent discomfort and potential complications.
In some cases, additional tests may be ordered to help diagnose the cause of constipation in children. These tests may include:
- Abdominal X-rays to check for blockages or abnormalities in the intestines
- Anorectal manometry to assess anal sphincter muscle function
- Colonic transit studies to evaluate how long it takes for food to move through the colon
- Anorectal ultrasound to examine the muscles of the anus and rectum
- Stool tests to check for infections or other underlying conditions
These tests can help healthcare providers determine the underlying cause of constipation and develop an appropriate treatment plan for the child.
When should my child see a doctor?
Contact your doctor if your child:
- Hasn’t had a bowel movement in a week
- Experiences involuntary stool passage
- Shows extreme tenderness in the anal area
- Exhibits reduced food and fluid intake
For infants under 12 months, seek guidance from a healthcare professional if constipation is suspected.
When to seek urgent care
If your constipated child displays alarming symptoms such as severe abdominal pain, vomiting, or blood in stool, seek urgent medical attention.
FIND A HEALTH SERVICE — Utilize the Service Finder to locate healthcare providers in your area.
Fluid intake
Encourage your child to drink plenty of water to help soften their stool and make it easier to pass. Dehydration can worsen constipation, so make sure they are drinking enough fluids throughout the day.
Physical activity
Regular exercise can help stimulate bowel movements and prevent constipation. Encourage your child to stay active and engage in activities that promote good digestion.
Toilet training
If your child is still in the process of toilet training, ensure they have a comfortable and supportive toilet seat. Establish a routine for them to sit on the toilet at the same time each day to encourage regular bowel movements.
Seeking medical advice
If your child’s constipation persists despite self-care measures, or if they experience severe pain or bleeding during bowel movements, it’s important to consult a healthcare provider. They can recommend appropriate treatment options and rule out any underlying medical conditions.
Remember, every child is different, so it may take some trial and error to find the most effective treatment for your child’s constipation. Stay patient and consistent in implementing these strategies to help alleviate their discomfort and promote healthy bowel habits.
Can constipation be prevented?
A diet rich in fiber can alleviate symptoms of constipation.
Complications of constipation
Unchecked constipation can lead to conditions such as fecal incontinence (soiling).
Resources and support
Contact the healthdirect helpline at 1800 022 222 (NURSE-ON-CALL in Victoria) for 24/7 nurse assistance.
Source s :
References: The Royal Children’s Hospital Melbourne, Australian Journal of General Practice, Royal Australian College of General Practitioners (RACGP), Therapeutic Guidelines
Last reviewed: February 2024
Related pages
Search our site for
Need more information?
To learn more about this subject, seek advice from our reputable information partners.
Kids who have constipation struggle with passing hard, dry stools, often due to behavioral issues and avoiding toilet trips.
For additional details, check out the MyDoctor website.
Children dealing with constipation find it hard to pass solid stool, but a balanced diet and regular bathroom routines can help. In some cases, laxatives may be needed.
For further information, visit the raisingchildren.net.au website.
Promote a healthy diet, hydration, physical activity, and regular bathroom habits to ease constipation in children.
To explore more, visit the Better Health Channel website.
Persistent constipation can lead to chronic soiling of underwear and requires similar treatment approaches.
For more insights, check out the MyDoctor website.
Constipation is marked by difficult and small bowel movements with hard stools. Discover various products for constipation relief.
For additional information, visit the MyDoctor website.
Constipation in infants can make passing stool challenging due to dry and solid stools. Learn more about this condition and its treatment.
Read further on the Pregnancy, Birth & Baby website.
Does IBS affect pregnancy? Gastrointestinal symptoms like constipation are common during pregnancy.
About half of anal fissure cases heal naturally with proper care and by addressing constipation.
For more details, visit the Better Health Channel website.
Urinary incontinence in children requires healthy bathroom practices and different treatment options.
To learn more, visit the raisingchildren.net.au website.
Cystic fibrosis demands specialized care for children due to its impact on multiple bodily systems.
For additional insights, visit the raisingchildren.net.au website.
Ketogenic diets show promise in treating drug-resistant epilepsy in children, but their impact on adults remains uncertain.
Read more on the Cochrane Australia website.
Failure to thrive in children under two is characterized by inadequate weight gain and may need specific interventions.
Find more information on the Ausmed Education website.
Pediatric urinary incontinence can significantly impact a child’s life and requires appropriate treatment methods.
Explore further on the Ausmed Education website.
Adequate iron levels are vital for energy production and overall health, while iron deficiencies can pose risks.
Read more on the Ausmed Education website.
Appendicitis is a severe medical emergency involving inflammation of the vermiform appendix in the lower right abdomen.
Learn more on the Ausmed Education website.
Chronic fatigue syndrome affects various bodily systems and currently lacks a definitive cure.
Get more information on the Ausmed Education website.
Most hospitalizations in Australia due to medications are preventable, underscoring the importance of safe medication practices.
Read more on the Ausmed Education website.
Around 1 in 70 Australians suffer from coeliac disease, an autoimmune condition triggered by gluten intolerance.
Get more insights on the Ausmed Education website.
Hypokalaemia is a common electrolyte imbalance that can be corrected with proper management and monitoring.
Read more on the Ausmed Education website.
Multiple sclerosis (MS) is an incurable neurological condition characterized by abnormal immune responses affecting myelin, a fatty material insulating nerve fibers in the central nervous system, disrupting nerve impulses.
Healthdirect Australia is not responsible for the content and advertising on the external website you are about to visit.
Concerned about your health? Select a symptom, answer some questions, and receive advice.
24-hour dependable health advice.
We are a government-funded service providing quality approved health information and advice.
Learn more about how we can assist and register your service.
healthdirect’s information and advice are developed and managed within a rigorous clinical governance framework.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service.
Healthdirect Australia recognizes the Traditional Owners of Country throughout Australia and their ongoing connection to land, sea, and community.
Support for this browser is being discontinued for this site.
We currently support Microsoft Edge, Chrome, Firefox, and Safari. For more information, please visit the links provided.
You are welcome to continue browsing this site with this browser, but some features, tools, or interactions may not function correctly.