According to Eric, the children’s bowel and bladder charity, 1 in 12 children live with a bowel or bladder condition.
For many children these challenges develop, or are made worse, because of a fear of pooing. As an adult it can be hard to get your head round such an ‘irrational’ fear, but once you can put yourself in their shoes there’s so much you can do to help.
I finally addressed my son’s fear of pooing when he was three and a half. My hope that he would ‘grow out of it’ had gone. I found myself completely consumed with his daily accidents and became an expert at avoiding social plans on days I knew a poo was overdue.
His huge emotional meltdowns around pooing were, in equal parts, upsetting, exhausting, and frustrating. Despite being a Paediatric Clinical Psychologist, I felt clueless and longed for the problem to just go away.
Eventually I knew I had to act. With the help of a supportive gastroenterologist and a kind colleague, I got a practical plan in place.
After a long six months we cracked it, and it has been life-changing for both him and the family!
Why Is It A Problem?
Living with a child who is scared to poo can be extremely challenging. It can affect children’s sleep, appetite, and behaviour.
This is because the fear almost always leads to withholding. Withholding is when a child avoids pooing. This consequently leads to a lot of discomfort and constipation.
Many families describe a vicious cycle, where fear leads to withholding and withholding leads to painful poos. This of course, makes the fear worse.
In more serious cases, the lower colon expands from withholding large amounts of poo for long periods of time. This means that some children start to lose the ability to recognise when they need to poo and the muscles in the rectum are unable to push it all out.
This significantly increases soiling and wetting accidents, which can be particularly upsetting for school aged children.
What Causes A Fear Of Poo?
There are many reasons a child may be scared to poo. Some families know the exact moment, for others they watch the fear grow slowly. Some reasons include:
- Experiencing painful poos
- Going to unfamiliar toilets
- Being fearful of falling in the toilet
- Being fearful of the sound of a flushing toilet
- Experiencing big life events or changes
Having an unpleasant experience can lead children to create a negative association with their poo. The child avoids pooing to avoid this unpleasant situation happening again – even if it happened once or a very long time ago. This connection between pooing and feeling unhappy, happens subconsciously. When asked, many children may not know why they withhold, or deny they are scared.
What Can You Do To Help?
Firstly, address any medical concerns and look out for signs of withholding and constipation.
- They have not done a poo for several days
- Their poo is large and hard
- Their poo looks like “rabbit droppings” or little pellets
- They are straining or in pain when they poo
- Their underwear is soiled, or their poo is runny (this is called overflow).
- They are upset, distressed and hiding when pooing.
If your child shows these signs, take them to a GP. The treatment for constipation depends on your child’s age. The quicker you address the constipation the quicker you can address their fear.
Try and encourage a heathy diet, drinking plenty of liquid and exercise. These are essential to support regular and comfortable pooing. Eating at set times helps to develop a routine within the body, creating urges at regular times. For families whose children are scared to poo, it can be very helpful to know when they are likely to have urges, as it means you can have a plan in place.
Develop their interest and curiosity about poo. For pre-school and primary school aged children, it is essential to play and read books about the body and poo every day.
Personalised books such as My Poo, are ideal, as it shows their character being brave and overcoming their fear. You want to ensure the child feels no shame about pooing and can find the subject funny and interesting. Avoid referring to poo as disgusting or punishing the child for accidents. You want curiosity to outweigh their fear!
Finally, create a pushing routine. This is a time when the child is encouraged to sit on the toilet and try to push. Ensure the toilet or potty is accessible and comfortable for pushing, with a step for their feet.
Try to weave these moments into your child’s normal daily routine. For example: Breakfast, brush teeth, potty pushing. Do not to expect a poo at first, simply celebrate the attempts made. If your child resists visits to the potty or toilet, use rewards. Make them age appropriate, instant, and sustainable (don’t promise big toys!).
When your child experiences urges and you notice withholding behaviour such as hiding, or holding themselves in a particular way, try to avoid being too direct with a ‘I know you need to poo’. Instead, entice them with the offer of a reward or fun toilet game. Be patient. Be repetitive. One day they will take you up on the offer and you will be well on your way to overcoming their fear of poo.
More information and support:
ERIC, The Children’s Bowel & Bladder Charity, is a UK charity for families affected by bedwetting, daytime wetting, constipation and soiling.
The UK charity Bladder & Bowel UK has produced a range of booklets and leaflets covering bladder and bowel problems in children.
Dr Cleo Williamson is a Clinical Psychologist and provides private consultations within the Queen Anne Street Practice. She can be contacted on c.williamson@qaspractice.com.