Toddler Constipation and Holding In Poop

What counts as constipation

• Poops that are hard, dry, large or painful to pass, or fewer than about 3 a week for a child who used to go more often.
• Toddlers vary. Going every other day with soft poop is fine. Going daily but straining with pebbly poop isn't.

The withholding cycle

1. A hard or painful poop happens, often around starting cow's milk, starting potty learning, a trip, or an illness.
2. Your child remembers the pain and starts holding it in.
3. Held poop gets bigger and harder, so the next one hurts more.
4. Holding gets stronger. You may see crossing legs, standing on tiptoes, stiffening, hiding in a corner, or squirming. Parents often mistake this for trying to push.
5. Breaking this loop is the main goal. It can take weeks to months, so steady and patient wins.

Food and drink

• Water: offer it through the day in an open or straw cup.
• Milk: toddlers 1 to 2 generally need no more than about 16 to 24 oz (480 to 720 mL) of milk a day; more can crowd out fiber and add to constipation. Ask your pediatrician what's right for your child.
• Fiber: fruits (pears, prunes, plums, berries), vegetables, beans, lentils and whole grains. Pureed prunes stirred into oatmeal or yogurt is an easy start.
• Limit foods that tend to firm things up if your child eats a lot of them: lots of white bread, cheese, bananas.
• See the toddler meals guide for portion sizes.

Daily habits

• Active play helps the gut move.
• Sit after meals. 3 to 5 relaxed minutes on the potty about 15 to 30 minutes after breakfast or dinner uses the body's natural urge.
• Feet supported. A step stool so knees are a bit above hips makes pushing easier and less scary.
• Keep it low-pressure. Read a book, blow bubbles (blowing helps them bear down), sing.

If potty learning set it off

• It's fine to go back to diapers or pull-ups for poop for a while. Many children who won't poop on the potty will happily poop in a diaper, and that's better than holding it.
• Some children poop in a diaper while standing in the bathroom, then move to sitting with the diaper on, then gradually to the potty. Small steps.
• Never punish or shame accidents or holding. Fear makes holding worse. See the potty training guide.

Medicine

• Your pediatrician may suggest a stool softener for a period of weeks or months to break the pain cycle. Use only what they recommend, dosed by them; don't use adult laxatives, enemas or suppositories on your own.
• Stopping too soon is a common reason constipation comes back.

When to check in

• Mention it to your pediatrician if constipation lasts more than about two weeks, poops are painful, or your child leaks small amounts of poop into underwear (a sign of a large blockage).
• Check in sooner for blood in poop, poor appetite or weight loss, or a swollen belly.
• If your child has severe belly pain, a hard swollen belly with vomiting, or green vomit, call 911 or go to the emergency department.