Ask Dr. Missy, Ph.D., Child Counselor & Feelings Helper
Dear Dr. Missy:
My daughter refuses to go number two at the bathroom this year at kindergarten. She either poops her pants at school every other day or holds it in and becomes constipated at home. I have to leave work and go to her school to clean her up and change her pants. I’ve tried bribing her with new toys or trips to the park, but nothing works. I can’t keep leaving work in the middle of the day. When I ask her why she won’t poop at school, she cries
I’ve talked to the teacher and the school nurse. She poops at home, at grandma’s house, and on vacation. She has no problem with peeing at school, but she won’t poop at school. Help!
-A Pooped Out Parent
Dear Pooped Out Parent:
Step off the frustration rollercoaster. Try to enter your child’s world. Empathy is putting yourself into your child’s shoes and understanding the problem as she sees it. A new school or class with a new bathroom, a new toilet, and a new sink is change and can be downright petrifying for some children.
Yes, I am suggesting a parent take time to go to the daycare, preschool, or school bathroom (without the child). Of course, ask the school for permission. Stand outside the bathroom and look around. Bend over and walk into the bathroom. Reach up and turn the light switch. Is it bright or dark? Look at the ceiling, walls, and windows. Is it spooky? Smell. Do you sniff bathroom cleaner, stale urine, or stinky poop?
Shut the stall door. Is there a lock? How do you know others won’t barge in while you’re dangling from the toilet seat? Peer down into the toilet bowl. What’s there? Set on the toilet. Is it cold, warm, slippery, or sticky? Is it clean or grubby?
Listen. CLATTER-PATTER STOMP. Do you hear hallway noises? Pull your elbows to your sides tightly (obviously children have short arms) and grab some toilet paper. Is it soft or rough or in-between? Reach around to wipe while balancing on the toilet? Is your bum area clean enough?
PLOOOOP-KAPLOP-RRRIIIIIPPPP. Do you hear bodily sounds of others using the toilets? Do you feel embarrassed when others hear you? Slide off the toilet (remember to stoop over) and pull up your pants. Flush the toilet. Listen. Is the SWOOSH-WHOOSH-WHIRRRL loud? How fast does the water spin and empty? Younger children fear they may be flushed away.
Open the stall door and walk to the sink. Turn on the water and wet your hands. Which knob is for hot and which is for cold? Or is it an automatic facet? Reach for soap from the dispenser. Wash hands. Pull the paper towels from the dispenser. Do they clump together? Put paper towels in trashcan. How do you dry your hands if the paper towels are gone? Push the door open. Is it heavy? Does it make a creaky, creepy sound?
Then imagine the bathroom is full of kids and noise. Imagine you are scurrying to get a stall, pull pants down, defecate, wipe, pull pants up, flush, wash hands, dry hands and get back to class, to lunch, to the playground, to the bus or elsewhere. If you don’t wipe properly, does the middle of your bum feel itchy or icky for the rest of the day?
Now imagine you are an adult with diarrhea and you defecate in your pants at work. After you sprint to the closest bathroom, what do you do? You don’t have extra clothing. You need to clean your bum. How do you feel? Frustrated, embarrassed, disgusted, or helpless. What do you do with your soiled underwear?
Research studies report the following school bathroom issues for children:
1) lack of privacy in public restrooms which causes embarrassment or fear of public pooping
2) bullying in the bathroom by others kids due to no adult supervision and limited monitoring 3) experiencing a soiling accident and feeling humiliated when the teacher or school nurse talked about it in front of others
4) another child touched his/her genitals in the bathroom and it produced fear
5) fear of not being able to wipe sufficiently and smelling like feces and others may express disgust
6) being overly shy or self-conscious and not asking to go to the bathroom
7) afraid of the loud sound of the toilet flushing, afraid of the automatic flush, afraid of the toilet, fear of drowning in the toilet or being flushed down the toilet, fear of a snake being in the toilet pipe and biting the buttocks
8) afraid of being in the bathroom alone when it has poor lighting, afraid of walking into a dark bathroom and not finding the light switch, afraid of the bathroom being haunted
9) fear of germs on the toilet seat
10) fear of not being able to button or zip pants after bathroom use and afraid to ask the teacher for help
11) being embarrassed if other kids hear the sound of her defecation plops or passing loud gas
12) too busy playing or socializing to go to the bathroom or not wanting to miss anything
13) fear of being accidentally locked in the bathroom
14) fear of accidentally barging in on another kid on the toilet or being barged in on
15) withholding due to fear of pooping pain
16) filthy and horrible-smelling bathrooms
17) fear of clogging the commode with toilet paper
18) teachers limit use of bathroom during class, testing, lunch, or recess
19) anxiety due to being rushed in and out of the bathroom
20) afraid of telling school staff or parents about bathroom incidents and problems
Understand your child’s fear feelings. Fear is a primary emotion. It’s a survival mechanism that kicks in when we feel threatened. The body’s usual reaction to fear is called the “fight, flight, or freeze” response. Validate feelings of worry, anxiety, and fear. “I understand you’re worried about using the bathroom at school.” Offer calm communication and unconditional support. “Let’s work on this together.”
Find out what the bathroom problem is and how to help your child solve it. Shaming produces shutdown and anger produces meltdown.
Approach the problem with curiosity. “Hmmm, if that school bathroom could talk, I wonder what it would say.” The key ingredient is ongoing communication with your child about toileting dilemmas. Most children do not poop in their underpants at school because of attention-seeking, laziness, or being malicious.
Some children may temporarily regress to poop accidents due to a new sibling, divorce, moving, attending a new school, loss of a loved one, illness of a parent, abuse trauma, or other psychological issues. Consult with your pediatrician and a child therapist or psychologist as needed.
Parents, teachers, and the school nurse need to work together to help solve bathroom problems.
Melissa Martin, Ph.D. is a Licensed Professional Clinical Counselor, Registered Play Therapist, and Behavioral Health Consultant. Email your questions to the Scioto County Candor at firstname.lastname@example.org and put “Dr. Missy” in the subject line.
Ask Dr. Missy is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Seek the advice of your physician, mental health professional, or other qualified health provider with any questions you may have regarding a medical condition.