Q&A: poop issues with older preschoolers

Today we have two emails about older preschoolers pooping in their pants.

Samantha writes:

"I have a 3.5 year old daughter, Ariana and a 19 month old son, Blaine. Ariana has mastered the going pee in the potty but refuses to poo but only in her panties. I don't yell at her but try and promote that "everyone" (nana, papa...etc.) goes poo in the potty. Blaine comes in from time to time to see what she's doing on the potty. She doesn't mind that at all. She is actually happy to see him witness her being a big girl. I'm not sure what to do about this. I have only 10 pairs of panties and they last a day. Please, any advice would be great!"

The first thing I'll tell you to do is buy more panties.

(Seriously, though, you should buy more panties, just to save yourself the aggravation of running out of clean ones.)

I have two suggestions, and maybe one will work for you. The first is to arrange playdates with kids her age who do poop in the potty. Even if she isn't swayed by your statements that everyone poops*, she may get the urge to do what the other kids are doing. If the other kids are pooping in the toilet instead of their pants, peer pressure could work in your favor. The only catch to this is that she'll have to be there when the other kid poops, which may be tricky to arrange.

The other suggestion is to have her go bottomless at home as much as possible. When she has to poop, she'll have to make a decision. With pants on, she just goes in the pants, but with no pants she'll have to decide whether she's going to 1) poop on the floor (she's old enough to think that's gross and not respectful), 2) ask for a diaper to poop in, 3) ask for underpants to poop in, 4) poop in the toilet, or 5) not poop at all.

Your job is to watch her and help guide her into pooping in the toilet. If she starts out pooping on the floor, neutrally guide her to the toilet, then help her clean up the poop on the floor. (This means she does the cleaning and you help out, not that you clean and she watches.) If she asks for a diaper or underpants, calmly try to persuade her to "try" pooping on the toilet. If she does it once or twice, she might realize she likes not having to be cleaned up so much afterwards.

My only fear with taking the pants off for an older child is that she'll not poop at all. If she shows any signs of withholding poop, put her pants back on right away. Better to be pooping in her underpants than not at all. Which segues us into the next question.

Rebecca writes:

"My son turned 4 in July.  He still poops in his pants. Well, some background.  He had some withholding issues and has a prescription for Miralax that he takes a few times a week.  He still relapses into holding his stools, so we’ve not put pressure on him to poop in the potty.  (He’s been pee trained for a long time.)  I don’t know what to do.  Offering rewards does not work.  Sticker charts do not work.  I haven’t wanted to use punishment so as not to have him regress into more withholding.  So we decided to just kind of ignore it and not make a big deal about it.  Well, it’s almost as if that has backfired because now it IS no big deal to him to just poop in his pants.  He’ll do it and then just ask to be changed.  I’ve thought about having him be responsible for cleaning, but how well can a 4 year old wipe himself, you know?  He starts school on Monday (preschool) and I’m just hoping he doesn’t poop in his pants during the 12 hours a week he’s there.  I really thought this would just be something he’d outgrow, except now it’s as if he thinks it is fine to continue to do this forever.  I am honestly afraid he WILL be going to kindergarten in a year and still not fully potty trained.  Please help me!"

I have no idea. We have a friend this same age with almost this same problem, and I wish it could be resolved for both boys.

My instinct is to ask his teachers if they have experience dealing with this. Withholding poop is not a unique problem, so experienced teachers have probably seen it before. They may have some suggestions.

I think if it were me, I'd put him in Pull-Ups because then I wouldn't have to carry around poopy underpants, and it would be clear that it isn't a regular thing for him to do. But maybe that would make him feel even worse around the other kids?

I would ask your doctor if there's a therapist or specialist who deals with this kind of stuff (a poop therapist?) and see if you can get together some sort of meeting with the specialist and the teachers (if they have any insights) to figure out what to do.

I wish I had a magic bullet that could get him to want to poop, and to poop in the toilet. Maybe one of the readers has been through this and can give some advice.

* Please tell me I'm not the only one who imagines Michael Stipe singing every time you see the Everybody Poops book.