Some toddlers find learning to pass stool without a diaper challenging. They may have had a large or painful bowel movement previously and be afraid to defecate again, so they begin withholding stool, causing them to appear as though they are straining. They may also be afraid to defecate in public or on a new toilet in a strange location.
Toddlers can usually recover from this anxiety with patience and support. When infants have difficulty coordinating their muscles to push stool out of the body, doctors refer to it as “dyschezia.”
This article will examine why a toddler might struggle to poop, the symptoms of the condition dyschezia, how to differentiate dyschezia from constipation, how to help a toddler with dyschezia, and frequently asked questions.
Young children who are struggling to poop but are not constipated may be withholding their bowel movements for fear of a large or painful stool.
They may also be struggling with potty training and may withhold bowel movements if they are unfamiliar with the new toilet process.
These are typical aspects of a child’s development. Children will usually grow out of it without much intervention. However, while it may be common to occasionally withhold stool, doing so frequently often leads to constipation.
Providing support and encouragement when a toddler uses the toilet may help them overcome their fears.
If a person is worried about their toddler’s bowel movements, they should contact a pediatrician.
The following image shows the Bristol Stool Chart, which can help a caregiver understand whether a child’s stool is a healthy consistency and whether they are constipated:
Toddlers may appear to strain when passing stool due to a lack of learned muscle coordination, fear associated with bowel movement, and other factors.
Lack of learned muscle coordination
Infants may not have developed the correct coordination between relaxing their pelvic muscles and increasing the pressure in their abdomen to release the stool.
They increase their abdominal pressure by crying and may learn to strain instinctively until a soft bowel movement emerges.
This is common, and the infant needs to learn to coordinate these muscles on their own in order to pass stool.
Fear associated with bowel movements
Toddlers deal with many changes in their environment. They may be struggling to learn how to use the toilet and to adjust to these new habits.
Additionally, they may experience public toilet facilities for the first time and find them frightening, which is not uncommon.
Furthermore, experiencing a large and painful stool can cause a child to avoid pooping. It can also cause an anal fissure, which may make it painful to poop and
Once a child withholds stool for a few days, it backs up into the large intestine (colon). The colon cannot properly function to move stool through and retains even more.
Further defecation becomes more painful, so children
Other reasons a toddler might begin to struggle with poop
- Diet changes: Making the move from breast milk or formula to solid foods can cause a toddler’s stool texture to change. This can lead to dry, hard stools that can cause anal fissures and pain.
- Toilet training: Pressure from caregivers to use the potty may cause anxiety in the toddler, leading them to withhold bowel movements.
Dyschezia is a condition that causes difficulty passing stool due to underdeveloped muscle coordination.
Infants with dyschezia may appear to be straining or grunting, and they may cry when they go to the toilet. However, when they do poop, their stool may appear soft.
If they pass hard and pebble-like stools, they may have constipation.
However, struggling to poop
If a caregiver is worried about a toddler’s bowel habits, they should contact a pediatrician.
Withholding bowel movements due to a fear of passing stool
Often when children withhold poop, they have had a painful bowel movement because of a large or hard-to-pass stool. They then associate the pain of that experience with the toilet and fight to prevent pooping to avoid more pain.
Dyschezia may be found in infants — usually under
To pass a bowel movement, an infant needs to relax the pelvic floor muscles and flex the abdominal floor muscles to pass stool through the anal sphincter. Infants with dyschezia are not yet able to coordinate their movements.
By crying, they increase abdominal pressure until, by chance, their pelvic floor muscles relax, and they produce a bowel movement.
Dyschezia typically appears in infants, marked by at least 10 minutes of crying and straining before the passage of soft stool.
A person may consider the following tips for helping a toddler with dyschezia pass a bowel movement:
- being sure they are ready to start toilet training
- talking openly about it with them
- using a child-size toilet seat and a small stool to create a safe space for them
- rewarding success
- including high fiber foods in their diet
- including activities in their day
If a child is not pooping and vomiting or has been through several months of behavior modification and still is not passing stool in a healthy way, a parent or caregiver should consult their pediatrician.
Below are some frequently asked questions about toddlers struggling to poop.
How do you help a toddler poop when they hold it in?
The following tips may be useful for helping a child pass stool:
- setting up a regular toilet routine if a person has a child who will agree to sit
- having the child sit for 5 minutes following meals, especially after breakfast
- if the child is holding back a stool, joining them in the bathroom for a few minutes of encouragement
- being a coach and encouraging the child to relax and allow the stool to come out
- telling the child that once they pass a normal-sized stool, they do not need to sit on the toilet any longer that day
When do toddlers grow out of infant dyschezia?
Infants typically grow out of dyschezia by
Some toddlers go through a period where they withhold poop and refuse to defecate. This is different from both dyschezia and constipation and may be due to fear associated with passing stool.
Some toddlers experience a large or painful bowel movement that leaves them afraid to poop again. They may then withhold poop, which can lead to discomfort and constipation.
Dyschezia is a condition in infants that occurs when they cannot coordinate their abdominal and pelvic floor muscles together to push poop out. This usually resolves by the sixth to the ninth month of life.
Some cases of toddler inability to poop may be dyschezia, but many may be withholding. Talk with the pediatrician to determine the proper course of treatment.