Dr Catherine
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2-4 years

Hi K.B., It is not uncommon for children who are bladder trained to continue to experience challenges with respect to bowel control. The good news is that with a little bit of help and encouragement most of these children will achieve independent toileting within a few short weeks. The first thing to do is to make sure she is not suffering from constipation. Signs of constipation include bowel movements that are sometimes large, hard or cause pain. Constipation can occur if your child’s diet is low in fibre, they do not drink sufficient liquids, is very inactive or develops a habit of holding onto their stools. Reluctance to poo or wee can sometimes stem from fear of the toilet so the more comfortable your daughter feels about the situation the more confident she will be. You can gradually introduce the concept of using the toilet for poos by first allowing your child to continue to poo in her Pull-Up, then get her to help you to empty it into the toilet. This will help reinforce the message that poo belongs in the toilet and not in her pants. Once she is comfortable with this and is no longer showing signs of fear, encourage her to go into the bathroom whenever they need to poo or wee. At this stage it does not matter whether or not they are actually sitting on the toilet. By going into the bathroom this will reinforce the idea that this is where you go to poo or wee. Once this is working well (keeping in mind she may still experience the occasional mishap where she does not make it to the bathroom in time), you can now suggest that she may like to sit on either the potty or the toilet to do her poo (she can still keep her Pull-up on at this point). The next step is to remove her Pull-Up. If she still seems unsure you can lay the Pull-Up in the bottom of the toilet or potty for the first few tries. Throughout the process acknowledge all small successes through praise and encouragement, even if it just means she is now crouching in the bathroom to do a poo instead of crouching behind the couch, or is helping empty their poo into the toilet. If you feel comfortable doing so it is also a great idea to let your child see you using the toilet for poos. Another great way to encourage the use of the toilet is through songs and books. Books like “It’s Potty Time”; a board book with built-in flushing sounds is great for young children to read while sitting on the toilet. This book also comes in a boys and girls version. Another great and funny book to share with your reluctant child is “Everyone Poops” by Taro Gomi. This book takes a close look at all different types of animals, what their poo is like and how they do it. The book also looks at how babies poo in their nappy, little children poo in a potty, while older children and adults poo in the toilet. Other parts of the book show how the toilet is flushed and what happens to the poo when it disappears down the pipes. Good Luck! Regards, Dr Cathrine