Stool Holding (Page 2 of 3) in pdf

stops receiving attention for nonperformance (not using the toilet and holding back stool), he will eventu-

ally decide to perform for attention.

Stop all reminders about using the toilet. Let your child decide when he needs to go to the bath-

room. He knows what it feels like when he has to poop and where the bathroom is. Reminders are a form

of pressure, and pressure keeps the power struggle going. Stop all practice runs and never make him sit

on the toilet against his will because this always increases resistance. He needs to gain the feeling of suc-

cess that comes from doing it his way.

Because stool holders are hurting their body, there are some exceptions to the no reminders rule:

• If your child complains about abdominal pain, clarify how to make it go away. Tell him: "The poop

wants to come out; the poop needs your help. Holding back causes a tummy-ache." Offer to help him sit

in a basin of warm water to relax the anal sphincter. If he refuses, tell him, "I can't help you. You have to

help yourself." Then ignore your child or put him in time-out. Tell him to come back after the poop is

out. Do not give positive attention for stool-holding behavior.

• If your child is obviously holding back a BM, initially say nothing in hopes he will do the right thing. If

he holds back for more than ﬁve minutes, give a pleasant verbal reminder. First say, "Your body is talking

to you. What does it want you to do?" If necessary, add "The poop wants to come out and go into the

toilet. The poop needs your help." Tell your child that you want sitting on the potty to be lots of fun.

What would he like to do (such as read favorite books)? If he declines your offer to provide a special

potty activity, say nothing more and let him decide how he wishes to respond to the pressure of his rec-

tum.

For stool leakage, put your child in "poop jail". If your child is leaking stool, ground him until

he passes a BM. Tell him: "When poop leaks out, it always means there's a large poop inside trying to get

out and you need time to think about how to help your body get it out." Tell your child he's grounded in

"poop jail" until he passes a big poop. He can leave "poop jail" only for essential events: meals, pre-

school or school, scheduled classes such as music lessons, or team events. Otherwise he must stay in his

bedroom with no TV, videos, computer games, or visits from friends until he completes his assignment.

Using the term poop jail keeps the intervention humorous and more acceptable for most children.

To protect your role as your child's ally, you can attribute the restriction to "doctor's orders." If your child

complains, give him a hug and blame the doctor. If this approach doesn't work, consider restricting your

child to the bathroom, informing him that he can't come out until he produces a normal-sized poop.

If your child goes two or three days without passing a BM, ground him until he passes a big poop

(at least the size of a banana). Remember that holding back stool causes it to become larger and wider.

After four or ﬁve days, it will become too wide to pass.

Give incentives for using the toilet. You must ﬁnd the right incentive to encourage your child to

go poop into the toilet. Initially err on the side of giving too much (several food treats each time). The

potency of incentives is increased by reducing access to them except when your child uses the toilet. If

you want a breakthrough, make your child an offer he can't refuse, such as going somewhere special. (See

the "Guide for Parents: Using incentives to motivate your child.") Also, give positive feedback, such as

praise and hugs every time your child tries to use the toilet. On successful days, consider taking 20 extra

minutes to play a special game with your child or taking him to his favorite playground.

Give stars for using the toilet. Get a calendar for your child and post it in a visible location.

Call it the "Good Pooper Chart". Have him place a star on it every time he poops into the toilet. Keep

this record of progress until your child has gone one month without any soiling.

Make the potty chair convenient. Be sure to keep the potty chair in the room your child usually

plays in. This gives him a convenient visual reminder about his options whenever he feels the need to

pass poop.

Allow your child to use diapers or pull-ups for BMs if necessary. You want your child to look

forward to releasing BMs rather than holding them back. If your child refuses to sit on the toilet, having

BMs in diapers or pull-ups is always better than poop holding. Give your child access to diapers or pull-

Stool Holding Page 2

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