Q) Dear Dr. Gwenn,

My 4 ½ year old son is still in pull-ups because he will not poop on the potty. Peeing has been no problem. We’ve tried ignoring, bribing, punishing, letting him sit in it, putting him in underwear and hoping for the best. Nothing is working! Any suggestions?

Thanks,

LC

A) Dear LC:

This is a tough situation and I know how frustrating it is when potty training goes on for so long, especially on the 11th hour of kindergarten. Please know you are very much not alone – there are many parents of preschoolers in the same situation. This is not at all unusual.

When a potty training situation reaches this tempo your son’s age  treatment is tricky and almost always has a behavioral cause at the core.  For this reason, most pediatricians and pediatric gastroenterologists (GI doctors) suggest the input of a behavioral psychologist. That person will help you not only de-escalate the intense power struggle that has become part of the situation but teach you and your child some strategies that will work better in the long run.

The behavioral psychologist will also work with your child around any fears about using the potty that may be at play and contributing to the situation. It is not at all unusual for some preschoolers to have concerns about using the potty for bowel movements and those fears and concerns can become quite amplified over time.

With dedication and commitment, and a huge dose of patience, your son will master the potty completely and you’ll feel the stress in the family melt away.  As you tackle this as a family, just remember that because it took considerable time to get to this point, unraveling the issues and resolving it will take time, too.

While you are seeking out a behavioral therapist or working with a therapist, there are some simple things you can do at home to help temporize this situation and put your child more at ease. Pull-ups are fine but undies are better if he’ll wear them. Some children at this age will wear undies for most of the day and then ask for a pull up when they have to poop. Just go with what he’s willing to do. The key is not to engage in a power struggle. Look at eash small victory for you and your child as an inch closer to the final goal which is for him to ultimately wear undies all day and to use the potty appropriately for poop, and for you to not feel so frustrated and helpless.

Your pediatrician as well as your insurance company can help guide you to the behavioral services in your area. You can also get great referrals from trusted friends as well as your son’s school.

Hang in there and know this will get better!

Dr. Gwenn

(originally published March 2009, Updated March 2010)

Disclosure:

I have partnered with Pull-Ups® to serve as a Pull-Ups® Potty Training Partner. I have been compensated for my time commitment to the program, which includes writing articles for Pull-Ups.com, offering tips and advice on the Pull-Ups® Facebook page and holding “Potty Training Talk Office Hours” on the Pull-Ups® Facebook page during February and March 2010. However, my opinions are entirely my own and I have not been paid to publish positive comments or endorse the product.