Child Afraid to Use Toilet
read •
Hi Dr. Laura,
I've been struggling with an issue involving my 3 and half year old son and potty training - he has been potty trained since his 3rd birthday, but about 5-6 months ago, he no longer poops on the potty. He waits until he's in the comfort of his bed with a diaper on to go number 2. My family physician said that he may have been constipated once and it scared him back to the pre-potty days. I have tried literally EVERYTHING to get him to be comfortable with pooping on the potty again. I know his schedule, so we give it a try every night before bed. He'll read, we'll do flash cards, sing songs, hold hands. I'll leave the room to give him privacy. I have put a diaper under the potty seat, no go. I have taken away favorite toys, no go. I have enticed with ice cream parties, lollipops, and Michael Jackson dance offs. Nothing. He gets so close and then starts to cry - says it hurts.. and then won't go.
My final attempt is to try a child-safe laxative or stool softener to ease any tension or pain he may have. Do you have any suggestions or helpful tips - anything that I haven't tried yet, to help with this dilemma? Any help would be greatly appreciated.
Thank you,
Sarah
Sarah,
This is such a common and exhausting pattern. And the good news is: it’s very workable.
When a child who was previously using the potty suddenly begins withholding stool and only poops in a diaper in bed, the first thing to consider is pain — even if it happened only once.
Your physician may be exactly right. If he had one hard or painful bowel movement, he may now associate the potty with discomfort. Once that association forms, many children begin holding their stool to avoid the experience. Unfortunately, holding makes stool harder and larger, which increases discomfort — and the cycle continues.
Before treating this as behavioral, I would treat it as physical.
I’m a psychologist, not a medical doctor, but in cases like this I strongly encourage parents to work closely with their pediatrician to ensure stools are consistently soft and easy to pass. A child-safe stool softener, used under medical guidance, can often break the pain cycle. When pooping no longer hurts, fear often fades.
No amount of ice cream parties or consequences can override a child’s fear of pain.
A Few Important Shifts
1. Drop the pressure completely.
Even loving attempts — sitting with him, reading, singing, encouraging — can feel like performance pressure when a child is anxious. Pressure increases muscle tension. Muscle tension makes stool harder to pass.
For now, your goal is not “poop on the potty.”
Your goal is “relaxed body.”
2. Allow the diaper temporarily — but change the location.
If he feels safest pooping in a diaper, that’s information. Rather than battling the diaper, you can gradually move it closer to the bathroom. For example:
- First: diaper on, but sitting in the bathroom.
- Then: diaper on, sitting on the toilet.
- Eventually: diaper with a hole cut in it so stool drops into the toilet.
This keeps him feeling safe while slowly reshaping the association.
3. Use play to reduce fear — not to persuade.
Play is helpful when it releases tension, not when it’s used as a strategy to “get him to go.” Silly potty humor, stuffed animals being “afraid,” exaggerated giggling — all of that lowers anxiety. But it should feel light and pressure-free.
If he starts to cry and says it hurts, that tells us his body still anticipates pain. That’s a physical issue first.
What I Would Avoid
- Taking away toys
- Adding bigger rewards
- Weekend “no diaper” showdowns
- Framing this as defiance
When a child is withholding stool, he is not being stubborn. He is protecting himself from discomfort.
The Bigger Picture
Many children who go through this phase are otherwise strong-willed, sensitive, or very body-aware. Once the pain cycle is interrupted and pressure is reduced, they often move forward quickly.
It can feel alarming when months go by. But this is one of those developmental detours that almost always resolves when we address the body first and calm the fear second.
Work with your pediatrician to make sure stools are soft and painless. Lower the emotional stakes. Move gradually.
He will not go to kindergarten in a diaper.
You’re not failing. This is a solvable loop.
warmly,
Dr. Laura Markham
