What is Withholding?

Stool withholding is when a child will avoid opening their bowels, by using their muscles to stop themselves from having a poo each time they feel the urge to go.

It can happen for physical and/or psychological reasons, but most typically occurs after a potty-training child has experiences a painful or spikey poo and is therefore reluctant to poo again. Some children with hold stools because they are too busy playing, or are distracted by something they would rather do. At approximately 3 years old, children develop the ability to have more complex emotions.

They understand the expectations surrounding potty-training - no matter how gentle parents are during the process, and begin to experience embarrassment, anxiety, and even fear around opening their bowels but they lack sophisticated language to explain these emotions with words. As a result, they may lie about whether they have soiled themselves, poo in "secret" (behind doors or in corners) or hide soiled underwear. Even though a child is in physical pain from withholding stools, even crying with pain, the with-holding cycle continues.

Other symptoms of with holding can be:

A "Poo Dance" - You may see your child wriggling, crossing their legs or walking on tip toes.
Clenching their buttocks.
Appearing to be straining when in fact they are with holding.
Become red in the face.
Lay in a "banana" pose.

The Vicious Cycle of Withholding

Signs of Withholding Behaviour

Asking for a nappy to be put on in order to open bowels.

Refusal to sit on the toilet or potty.

Stopping unexpectedly from playing and making facial expressions, such as grimacing.

As it takes effort and concentration to with hold, they may seem vacant or not respond as they usually would

Saying "I don't need a poo" when you can clearly see they do

Crouching or sitting when they have an urge to open their bowels and then standing quickly to prevent it

Pooing through the night. Once asleep, your child will no longer with hold, so may soil during the night,

How to Prevent Withholding

This required a 2-pronged approach. Firstly, the physical withholding and then the behavioural side effects of being fearful of opening bowels.

Breaking the habit:

You must treat the constipation first.
When your child's stools are reliably soft, you can start working on reassurance and confidence building.
Your child needs to be relaxed, reassured and comfortable in a toilet setting.
Your child needs to believe that their poo won't hurt them anymore. This will only happen when they feel it for themselves
Stay calm and do not get angry with your child.
Try to put yourself in your child's position - It is logical that your child would try to prevent pooing if a previous stools has caused them pain.

If you suspect your child's withholding behaviour is due to anxiety or fear of the toilet, or you think there may be psychological issues present, you can find booklets to help you within the Psychology section of the "Information Booklets" area on the website.