Sophia Ferguson, author of a book on stool withholding, shares her experience of raising a child that doesn't want to poo.

Sophia Ferguson and her son Max
Sophia with her son Max

My son, Max, started stool withholding at the age of two and a half, after an episode of severe constipation. I’d never heard of stool withholding so had no idea he was holding on to his poo. I decided not to bother my doctor, thinking this was simply a bad case of constipation which I could surely solve by myself.

Four days, no poo

After several months, we were making no progress. Max was now going three to four days without a result on the toilet.

His emotional distress in the days leading up to a bowel movement was extreme and my endless attempts at persuading and reassuring him weren’t helping.

Lactulose prescription

A trip to the doctor led to lactulose, but there was no mention of stool withholding. Six months of ever increasing doses of lactulose, and lots of fruit and veg brought no improvement. Things were actually getting worse.

Max was now managing up to a week at a time without a poo. The emotional roller-coaster was unbearable and the problem was now dominating family life. Unless you’ve been through this with your own child, it’s hard for anyone else to imagine how distressing it can be.

Stool withholding

At my wits end one day, I turned to Google and after lots of searching, and some visits to the ERIC website, I finally discovered the term ‘stool withholding’. Suddenly, Max’s strange behaviour made sense. Armed with this information, I returned to the doctor. This led to a prescription for Movicol and six months later we were well on the road to recovery.

After going through this ordeal, I felt strongly that I wanted to write a book passing on everything I’d learnt and giving parents a straightforward approach to tackling the problem.

Stool withholding is still a very misunderstood issue. Most parents, it seems, have little or no knowledge of it. And, unfortunately, many health professionals are not up-to-speed on the subject. Finding the correct advice, as early as possible, is essential but can be challenging.

It’s incredibly sad to hear of parents and children who have been battling, needlessly, with this issue for years. Many children have the additional misery of encopresis or soiling, a very unpleasant side-effect of stool withholding.

With the right approach and lots of patience, however, this is a treatable problem. Max made a complete recovery and the transformation in him was wonderful to see. He’s now a lively six year old and has little memory of the ordeal he went through several years ago.

Strategies for treating stool withholding

Getting the right laxative, at the right dose, is very important. Low doses may help straightforward constipation but are unlikely to help a long-term stool withholder. That’s why I’ve included information about doses in the book.

But it’s not just laxatives which can help. There are a number of strategies, outlined in the book, which can also make a big difference.

In an ideal world, we want to prevent stool withholding and encopresis from happening in the first place. Constipation is the most common trigger, so catching it early in children could prevent many, if not most cases of stool withholding.

In my parents’ day, there used to be a great emphasis on keeping children ‘regular’ which seems to have fallen out of fashion. It would be wonderful if all new parents could be made aware of the importance of spotting the signs of constipation and catching it early.

There’s clearly a need for greater awareness of this whole subject amongst parents, health professionals and anyone else who works with children. ERIC is a wonderful resource and is doing a fabulous job in this area. I hope my book will also help.

Buy Sophia’s book ‘Stool Withholding: what to do when your child won’t poo’ from the ERIC shop.