Have you got a potty training nightmare? Toddler refusing to poop on the toilet or potty? I'm here to save your sanity from a potty training disaster.

This is far more common with boys than girls and strong-willed toddlers.

It might have started by one episode of going to the loo and passing a hard poo. This felt sore and hurt your toddler setting up a negative feedback mechanism. Every time they are needing to poo they are reminded of the past painful event. Poo holding on becomes a reality. Encopresis (severe poo holding on) is somewhere you really do not want to end up. Toddlers and children with encopresis are so constipated they end up impacted. Having a bowel movement so infrequently that overflow results needing a bowel washout.

It is easy to prevent and so hard to treat.

In my nursing and health visiting career I've met many of these children. A mum from the UK I met via Instagram, Colette, posted about her little boy and his poo holding. This blog is for you and your little boy Colette.

Most parents start toilet training too early, when the body and toddler are just not ready and this is how the problem starts. As most of you who follow my blog know I'm a big believer in toilet learning. Allowing your child to take the lead and know when they're ready.

Fabian Gorodzinsky (a community paediatrician and an associate professor at the University of Western Ontario in London, Ont.) says,

"Withholding often happens after an attempt at toilet training when children just aren’t ready, emotionally or physically."

Age of readiness for toilet learning is anywhere between 18 months and four years. Simply backing off a bit and giving your child a few more months with nappies or using the potty will sort the problem. If your child asks for a nappy for a poo give him a nappy. Really, please. It's not giving in, you are helping them I promise.

Children will often save up their “number two’s” for when they had their nappies or pants on. They can often be found hiding in a corner, behind the curtains or a sofa straining only seconds after you’ve given up on the potty session.

My top tip is to lay toilet roll over the potty or toilet seat before they sit on it. Use around three squares and leave them attached to each other so they drape slightly over the sides of the potty or toilet seat but are flat across the top part. Then when they sit they can feel the paper under their little bottoms.

Having something there seems to help them get over their potty poo phobia. It's creating them the security the nappy has given them for the past few years. You should only need to do this a couple of times before they will happily perform without the paper.

What else can you do?

• Increase fibre in their diet - wholemeal foods, Weetbix, porridge oats, beans, pulses, chickpeas and lentils. Add extra fluid and water to the diet to help the fibre work.
• Pears and prunes help the gut.
• Increase water intake.
• Care with white refined foods, yoghurt, cheese, milk, white bread, bananas - all of these will constipate.
• Chia seeds pre-soaked and added to meals.
• Exercise helps the gut.
• Use a gradual approach to using the potty or toilet. Week 1 nappy on for all poops. Week 2 nappy on sitting on potty or toilet. Week 3 nappy on but loosened. Week 4 nappy lining potty. Week 5 sat on the potty with no nappy. Use a reward system and labelled praise to imprint the learning.
• Ignore poop accidents or non-compliance.
• Labelled praise for all successful poops on potty or toilet.
• Using a footstool for the toilet helps reduce pressure on the anal sphincter and makes pooping easier.
• Try a funky potty with voice recorded motivation and bells and whistles. Get your toddler to choose their own potty.
• Use the iPad on the potty or toilet or drawing book and crayons.

When preschoolers poop in their pants, it’s usually a result of chronic constipation, says Fabian Gorodzinsky. This needs medical and behavioural psychology help. They've probably got faecal overflow as a result of severe constipation.

Laxatives and stool softeners are a necessity to stop constipation. Use Coloxyl, Lactulose, Parachoc (parachoc.com.au), Osmolax, polyethylene glycol, mineral oil, magnesium hydroxide, Movicol. Here's a link to read more from Medscape on Pediatric

Constipation Medication: http://emedicine.medscape.com/article/928185-medication

https://www.todaysparent.com/toddler/potty-training/is-your-kid-afraid-to-poop/