Dr. Robert Needlman
Specialist in pediatric behavior and development.
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 Ask Dr. Needlman
A Toddler's Reluctance to Part with His Bowel Movements | | | QUESTION | | | Dear Dr. Needlman,
My son will be three years old in April. He will pee on the potty with no problem at all but refuses to do a BM. We have to put a pull-up on him to have him go, and even that doesn't work sometimes. What should we do?
— Donna in Hillsdale, NJ | | | ANSWER |
February 28, 2001 | | | Dear Donna,
Assuming that your child is healthy and developing as expected in other areas, what you are describing is a very common problem. Many two-and three-year-olds develop a sense of ownership about their bowel movements. They don't like losing control of them. Sometimes after watching one get flushed away, the toddler decides that he won't let that terrible thing happen again. Or he understands that his parents want to make him do something with his BM, and he has his own ideas.
Whatever the reasoning, the toddler holds on to his BMs. As a result, when they do pass, they are apt to be hard and uncomfortable, perhaps even painful. A very hard BM can cause a small crack to appear in the anus, and it can bleed. The painful BMs add another reason for the toddler to hold them in: fear.
In this situation, there are three things that can help:
- Try to keep your toddler's bowel movements soft, so that they don't hurt coming out. One pleasant way is to use the p-fruits that make you poop: peaches, pears, prunes, and apricots, packed in heavy syrup. Make sure your toddler is drinking plenty of water as well.
- Remove all outside pressure (that is, parental pressure) to use the potty. This is one power struggle you don't want to engage in.
- Try to give your toddler lots of other choices that he can safely and appropriately make in the course of the day: which of two shirts to put on; which of two cereals for breakfast; which book to start with at nap time, etc. The more power he can feel in other areas (within limits), the more likely he may be to give up control over his precious bodily products.
When he does finally use the potty (and he will, eventually) it's a good idea to wait until he's lost interest before quietly flushing his creation.
— by Robert Needlman, M.D., F.A.A.P. |
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