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When can this start?

Withholding can affect children right from birth – if a baby gets constipated they may try to prevent themselves from going. It’s most common in toddlers – children aged under 5 years.

What’s happening in a withholding child’s brain?

Withholding constipation vicious circleThe urge to poo is about the poo arriving in the rectum, pushing out the bowel wall, stretching its stretch receptors. This sends a message to the child’s brain, telling them they need to poop. During toilet training children start to understand this message and act on it. Sometimes they ignore it and resist it. Then the poo stays in the rectum – and the rectum stays stretched. The feeling of needing a poo wears off and constipation begins. 

Will my child grow out of withholding?

No, not without help. Withholding and constipation go hand-in-hand and constipation is a medical condition which needs to be treated.  Treating constipation early will give the best chance of a good outcome. Our Advice for Children with Constipation explains how to treat constipation. 

Why does my child seem so angry?

Many parents report their child displaying extreme anger, particularly when parents/carers suggest sitting on the toilet, or ask if the child has pooed. The child can get quickly angry and may shout even if the parent mentions poo or using the toilet.

Remember they are not being naughty, they are showing how extreme their fear is. They, like you, are full of frustration, confusion and anger, also like you they may not know how to solve the problem.

A mum who called our helpline explained the way it affected her daughter: “We used to dread going out to day trips because she would be in so much pain – or she would save it and go into a nightmare whirlwind where she would bottle it up and mask it and then her emotional outburst at night would be terror. She wouldn’t go out, wouldn’t go in the bath, wouldn’t even let me touch or brush her hair.”

Why can my child cope with pooing in a nappy or their pants but not the toilet or potty?

When we feel the need to poo and sit on the toilet or potty, the poo will pass into the pan at its own speed. When children poo into pants or a nappy, they can control the speed and force with which it leaves their body, so it is not a surprise for them. It is about controlling that poo, so that it does not emerge so fast that it could hurt.

They might adopt a position of control, maybe standing straight, bending over the bath or squatting. 
There may also be issues for some children about being bare bottomed when sitting on the toilet; they may feel exposed and prefer the security of their pants or nappies. It’s best to let children poo in the place they feel comfortable with going rather than hold on and become more constipated. Our resource Children who will only poo in a nappy has lots more tips for moving them past this stage.

How can it affect family life? 

Many areas of family life can be impacted by a withholding problem and it can be all-consuming for the child and their care givers.

For the child there can be:

  • Pain in their tummy or bottom, fear of the poo emerging, fear of soiling, shame and embarrassment.
  • An awareness of the impact on their family - days out having to revolve around finding toilet facilities for example, but they are helpless to change the situation on their own.
  • Bullying, name calling and family frustration. This can have a negative effect on the child's learning and on their confidence, belief in and love of themselves.
  • They may be aware of the extra washing they create too. 

For care givers:

  • Some families feel unable to welcome friends into the house, due to possible smells and their child’s behaviour.
  • Financial implications due to extra laundry. Many families feel unable to deal with the washing, they throw dirtied pants and clothing away.
  • There are time and patience demands on the parents. Trying to encourage their child on to the toilet also prompting for drinks, medications and personal hygiene can be exhausting.

Relationships outside the home:

  • There are frequently difficult relationships with schools and nurseries, who may not understand or feel able to manage the child’s needs.
  • The child may sense any staff negativity and fear staff members presenting their carers with dirty washing, and reports of their ‘accidents’ in the playground at home time.
  • Children often refuse to attend nursery or school to avoid these situations. This can affect the child's learning, relationships and the parents’ work too.

What if the child with poo holding is not toilet trained?

Once the child’s poo is soft, sitting on the potty or on a toilet with a seat reducer, with feet supported on a stool, is a great position for helping poo out , so however young the child is, potty sitting may help. Cycling their legs and doing abdominal massage can also help to stimulate their bowel.