How Do You Treat Stool Withholding in School-Aged Children?
Unlike regular constipation, which is purely about managing the physical symptoms, stool withholding requires tackling the underlying emotional issues. On a physical level, your GP or paediatrician can provide education around administering laxatives for your child. This will help to keep the stools soft, making them easier to pass.
Tackling the Emotional Issues
Tackling the emotional issues around stool withholding are crucial to moving forward.
Try the following:
- Liaise closely with your child’s teacher: Close communication with your child’s teacher is essential. Arrange a meeting and provide the teacher with information detailing the issue. Come up with a plan of how to help your child at school – this may include preparing a ‘pack’ of wipes and spare underwear to be kept in a private bathroom, coming up with a subtle signal system that your child can use with their teacher, or providing regular bathroom visits.
- Focus on pushing out the poos – not toilet training: If your child is withholding, going back a step to focussing on pushing poos OUT can be very helpful. For now, at least, pack the potty away and forget the toilet – passing bowel motions in these places are LONG TERM goals for your little one. Start by supporting your child to have repeated exposure at pushing out pain-free poos. This can be into a nappy or a pull up standing up, or whilst wearing undies – anything that helps your child feel at ease.
- What rewards will work? Find your child’s internal motivator – is it that new box of Lego? A pretty barbie doll? Create a “Points Chart” with your child – for every poo they push out, they get 5 points on their chart. When they reach 15 points, they get that reward.
- Use a social story: Social stories are simple stories personalised for your own individual child. They help to explain different procedures and social situations in simple, everyday language. A free, editable social story relating to fear of toileting and pushing out poos can be found using the link at the end of this article.
- Seek additional support: Stool withholding can be an all-consuming, daily struggle for the entire family. It can be very helpful to seek the advice from an objective outsider. A psychologist can provide some wonderful strategies to help your child work through their fears relating to stool withholding and help to talk about the issue openly.
Stool withholding in children is a confusing, silent condition that can be extremely challenging for families to navigate.
The good news is that there can be light at the end of the long, dark tunnel and with the right resources, we can help support our little ones to feel calm, feel safe and ultimately thrive.
References:
Ferguson, Sophia J. (2015). Stool withholding. What to do when your child won’t poo! London: Macnaughtan Books
https://www.childrens.health.qld.gov.au/fact-sheet-faecal-incontinence/
Originally published here.
Melissa Yapp is a speech pathologist and a former special education teacher. When not at work or spending time with her husband and two spirited children, she can be found creating resources for professionals and families. You can access your free Stool Withholding Social Story HERE. For more resources, competitions and giveaways, follow Melissa on Instagram.
