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Child thinking about the toiletAround 75% of the calls we get to our helpline involve children who are withholding their poo and/or wee. It is particularly common in toddlers. 

Stool withholding and delaying emptying the bladder are both issues which can cause a huge amount of stress and confusion to families.

Read on to find out why it happens, how to help your child overcome withholding and have a happier relationship with their wee and poo... 

What is withholding?

Withholding is when a child uses their bottom or bladder muscles to stop themselves from passing a wee or poop.

Why does it happen?
Child with stomach ache an a definition of stool withholding from NHS choices website

Passing just one painful or uncomfortable poo or wee even as a baby can mean children withhold to avoid the same bad experience.

It’s very easy for children to then get trapped in a ‘withholding cycle.’ Their poo or wee hurts or they are fearful of the toilet, they find it hard to relax and are anxious it will hurt, they try to avoid going and it hurts more.

The ‘withholding cycle’ 

Withholding poo is very likely to result in constipation. The longer the poo stays in the bowel, the harder, drier and bigger it gets. This makes it even more difficult and painful to pass.

An overloaded bowel can also lead to bladder issues such as urinary tract infections because the bladder can’t empty properly.

Withholding constipation vicious circle

Poo withholding

Around a third of all children suffer with constipation during their childhood. It’s very likely that a large number of affected children will hold on to their poo and refuse to go when and where they should.

As per NICE Guidelines, childhood constipation should be treated with laxatives to keep the poo soft and easier to pass. This makes it easier to break the vicious cycle of withholding.

Take a look at our advice for children with constipation to work out if your child is constipated and how they should be treated. 

Advice for treating childhood constipation

Wee withholding 

Stopping wee from being released can lead to bladder emptying problems and urinary tract infections. If wee is stored in the bladder for longer than it should, bugs may grow which can lead to infection. This can then make weeing very painful, and a child will struggle to relax and let a wee out. Take a look at our wee withholding resource if this is an issue for your child.

How withholding can affect a child’s behaviour

Along with physical problems, withholding can also have a significant emotional effect on a child and make it very hard for families to reason with their child. These upsetting behavioural changes can include mood swings, becoming withdrawn, tantrums and meltdowns.

“I could see she was struggling and visibly uncomfortable. She got more and more upset wanting to be cuddled and holding on to her bottom looking really distressed. I lost count of the number of times she would shout “I need a poo” so we’d rush to the potty, and she’d sit down only to jump straight off again insisting that no she didn’t need to go and so the cycle went on.” Parent of child who started to withhold during potty training.

Some children are affected just briefly, particularly if the trigger is something like potty training or a period of illness like diarrhoea.

However, for other children the withholding goes on much longer and becomes a difficult behaviour to break.

Hear a child describing their feelings about their problem in this short video: Through My Eyes.

We all try to avoid things that hurt us, but as adults we have learnt about consequences and can understand the risk of long term effects. It's really important to remember that children don’t withhold on purpose or to be naughty.

Signs of withholding

There are lots of different signs and clues to look for and some can be harder to read than others.

Here are some of the things children do when they withhold.

Why do some children withhold?

There can be lots of different reasons why a child will stop themselves from weeing or pooing. It could be just one or a combination of issues.

Withholding most commonly follows on from a period of constipation: This could be brief - perhaps the child had a viral illness, a high temperature with poorer drinking. Their poo became drier, hard and knobbly. It hurt them so they decided ‘I won’t ever do one again’. This could happen at any age, they and their family may not even recall the event, but the child develops a fear of letting poo out.

More about the triggers for withholding

Resolving poop withholding 

Breaking the stool withholding cycle needs a two pronged approach - sort the physical first and then you can work on the behavioural side effects.

Get help with breaking the withholding cycle