Overcoming a 4-year-old's refusal to use the toilet for bowel movements may require addressing fears, offering encouragement and giving your child control over the process. Toddlers are often potty trained by age 2 or 3, according to the Healthy Children website, but some take longer to master all aspects of using the toilet.
Make It Easy to Go
Reluctance to poop on the toilet often starts with a painful or negative experience, according to the Parents magazine website. For example, a child might have hard stools that are painful and difficult to pass. He then avoids using the toilet because he associates it with pain, which causes his stools to continue being hard.
Sometimes kids are afraid to sit on a toilet or are afraid they will be flushed down the toilet. Others forget to use the toilet because they get too involved in playing. Your child's developmental level may also cause fears or anxieties that interfere with toilet training.
Allowing him to go back to diapers may help him relax enough to have soft stools. You can then switch him back to wearing underwear all the time. Adding fiber or bran to your child's diet helps keep stools soft and bowel movements frequent. If the dietary changes don't help, stool softeners or laxatives may be an option, according to the American Family Physician website. Check with your child's health care provider first.
Ease Toward the Toilet
If your 4-year-old resists the potty, ease her toward it by creating a positive feeling toward the bathroom. For example, you might allow her to have bowel movements in her diaper but only in the bathroom. Move on to sitting on the floor in the bathroom, followed by sitting on the toilet with the diaper still on. When she feels comfortable sitting on the toilet, take off the diaper and have her poop directly into the toilet. Give her the chance to use the potty without making it a huge deal. Over-emphasizing potty training sets you up for a power struggle with your child.
Even if you feel frustration with your 4-year-old, keep the potty training experience positive. Punishment when your child has an accident may make the situation worse, according to Dr. Laura Markham on the Aha! Parenting website. Instead, focus on positive aspects. For example, say, "You really tried hard to get to the bathroom in time. I'm proud of you."
Instead of lecturing your child about needing to use the potty, help him tune in to how his body feels. You might say, "Does your body feel like it is ready to poop?" Your 4-year-old might respond well to a reward system, such as a sticker chart or a special treat after having a bowel movement on the toilet. Another supportive strategy is to schedule regular times to try to use the potty.
Give Child Ownership
A 4-year-old has the physical and cognitive skills to handle most parts of using the potty. Instead of entering a power struggle, let him take over his potty training, suggests the HealthyChildren.org website. Don't force him to use the potty. If he poops in his diaper or underwear, have him help with the clean up. At first, he may regress, but eventually the natural consequences, such as having soiled underwear, encourage him to use the toilet.
Having your child wear underwear may help get him on the toilet. Pooping in underwear is much messier than pooping in a diaper, and many children quickly learn to avoid the mess by pooping in the toilet.
Everyone who cares for your child should be on board with the strategies you use. Ask your child's primary day care provider to use the same strategies you use to encourage bowel movements, reward your child, have your child help clean up accidents and not punish your child for accidents. If your child continues refusing to use the toilet for bowel movements or you think the cause could be medical, contact her health care provider. A physical examination from the doctor rules out any medical causes and allows you to focus on changing her behaviors.