Q How do I show my daughter her toilet anxiety is no big deal?
A My three-year-old daughter has been toilet trained since last August and has done really well. She has never had an accident. She started doing her poo in the toilet (never used a potty) but needed great encouragement. However in the last six weeks she hasn't gone for a poo in the toilet, but has been holding it for days and then going most nights in her pull-up when she's asleep. It never wakes her up.
In the morning we just change her and don't really make any comment. We always know when she needs to go as she constantly wants to sit down, then clinches her bottom and wiggles on the chair.
Every day I give her fruit and smoothies so that she eats well in the hope that she will go in the toilet but to no avail. When we ask her why she won't go to the toilet for a poo she says she's afraid and gets upset. She has no issues with her wee and she will use any toilet no problem. I am just hoping for some guidance because other than this she is a very happy and contented child.
Toileting problems are a common source of stress for parents and children. Indeed, issues about what goes into our children, by way of food, and what comes out, by way of wee and poo, are a regular feature of queries.
It is hard to look at our children when they are obviously experiencing some discomfort but seem unable to take the simple route to relieve it.
I know your daughter has tried to explain that she is afraid of using the toilet (even though she uses it to wee). It could be that, at some point, she did try to pass a painful poo and so she now is reluctant to poo into the toilet in case the same pain returns.
An anxiety such as this could easily be enough to put her off. It may also be that there is a small element of control involved. By holding her poo, she is exerting a great deal of self-control. It may be a negative expression of it, but it is self-control nonetheless.
Sometimes when children feel out of control, or over-controlled by others, they will use some kind of restriction within their eating or their toileting (the two areas they alone control) to try to bring a feeling of order or control back.
This may not be the more likely reason for your daughter, since she seems to be pretty happy and content in other areas of her life. However, if she feels that you and her dad are putting a lot of pressure on her during the day to use the toilet (when you see her squirming for example) then her refusal to do so may be simply reactive.
She is well aware, even at age three, that this pooing issue is a big deal for you and her dad. She probably realises that you and her dad are worried, annoyed or upset. Even the fact that you are deliberately adjusting her diet to ensure she has enough fibre to keep her 'regular' reinforces the notion that this is a big deal.
Assuming she does have some anxiety about pooing in the toilet you should talk to her about worries in general. Reassure her that things that can seem a worry at one time can often not be frightening at other times. Toddlers don't need anxiety-management techniques per se. What is most important is that the adults around them stay calm and relaxed.
Three-year-olds instinctively allow their feelings to be regulated by their parents. So if you and your husband appear calm and unconcerned about her toileting, she too will be more relaxed in approaching it.
It is worth having one clear conversation with her about how she is well able to make decisions about going to the toilet or not. Then, be explicit about how you and her dad are no longer going to be worried about her because you know she is capable.
From then, the most effective response will be, I believe, to stop drawing attention to her toileting at all.
Ease up on the amount of fruit you give her and allow her diet to fall back into a normal balance of fibre.
Try not to give her a message that there is anything special or unusual about her toileting behaviour, or about the way her bowels are working. It is likely that whatever prompted her reluctance to poo in the toilet will diminish over time, especially if she feels there is little stress attached to using it. By keeping a low-key approach to her toileting you allow nature the best chance of rebalancing your daughter's rhythms.
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