Potty Training and Constipation with Dr. Steve Hodges

Potty training and constipation… did you know they go hand in hand and that your potty training problems may be related to constipation? This blog is an excerpt from the Turn Autism Around® podcast number 158 on potty training and constipation with Dr. Steve Hodges who is an M.D. who wrote The M.O.P Book which is a guide to stop potty accidents due to constipation. 

Here we’ll cover potty training problems, signs of constipation, when to start or restart potty training, and what to do if you are potty training and your child will pee but not poop on the toilet. This is important information if you are ready to start or restart potty training.

Signs of Constipation

Knowing and being able to identify the signs of constipation in a young child is important. Dr. Hodges points out that pooping is a natural reflex controlled automatically in the brain. An example of this is that even young babies can associate straining or struggling to poop with pain and may begin to withhold in order to avoid it. If you notice a young toddler or preschooler who is straining or hiding to poop or having large bowel movements, these may be signs that they are dealing with constipation and may need to be treated. By knowing the signs, constipation can be treated quickly as soon as accidents or other potty training problems begin to arise.

When to Start Potty Training

In Dr. Hodges book, he discusses that a big cause of constipation is actually potty training too early. He says, “It’s a physiological process. Like walking or sleeping or, or, you know, being hungry and eating. You can’t force any of this, right? You can’t make your child sleep. You can put them in the right environment. You can’t make them crawl or walk any faster than they were going to. And you can’t make a child potty training any faster than they were going to.”

So, he suggests waiting until a child is 3 or 4 before beginning potty training. That doesn’t mean we can’t start pairing up the toilet or potty as a fun place to be earlier on like I suggest in my No More Diapers free potty guide, but we don’t want to place expectations on young children. Before the age of 3, you can “pair up” the potty by having your child sit on the potty in the morning when they first wake up or before bath with items, they really like but not expecting them to do anything. Placing the expectation to pee or poop on the toilet too early and/or getting rid of diapers abruptly can actually make a child hold in their poop, therefore causing or contributing to constipation.

Potty training and constipation photo of girl on toilet, smiling to teddy bear
Potty training and constipation photo of girl on toilet, smiling to teddy bear

On the other hand, waiting too long to potty train can cause the opposite issue as kids who get too comfortable pooping or peeing in diapers (even ones with elastic waistbands) can be harder to potty train and often potty train late. So, especially when potty training children with autism, you want to start introducing the toilet as a positive place as early as possible. Also, I highly recommend all boys sit on the potty or toilet to pee until they are fully pee and poop trained. 

I have even seen many children who may be pee trained, but will hold their poop and come home from school and ask for a pullup because they are so comfortable with going in a pullup. So, I asked Dr. Hodges what can be done about this? 

To get started or restarted with potty training check out my free potty guide!
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Photo of a child feet pulling up pants during potty training
Photo of a child feet pulling up pants during potty training

Potty Training: Won’t Poop in the Toilet

Dr. Hodges says there are ways to treat toilet avoidance, when a child will pee on the toilet but not poop, and one is to use the book, The Ins and Outs of Poop, which outlines a graduated process where the child can have a diaper if they stay in the bathroom to poop in a diaper. Over time (days or weeks), the expectation would be made more difficult for the child to have the diaper on but only if they sit on the toilet while pooping in the diaper. Eventually, the diaper is slowly removed. But again, if a child is able to hold his BM all day to ask for a diaper, he or she is likely constipated and would benefit from Dr. Hodges books, paid Facebook communities and other resources.

For more information on potty training and constipation, the causes of constipation, more signs and how to treat a range of potty problems, watch or listen to the full podcast at www.marybarbera.com/158 or wherever you listen to podcasts.

Frequently Asked Questions About Potty Training and Constipation:

How do I start potty training my young child with autism, special needs, or other delays?

Potty training for any child can be challenging but for children with any special needs including autism and speech delays, it can be even more difficult.  Before focusing on potty training, a child should be walking, sitting at a learning table willingly, accepting reinforcement from his or her parents, washing hands and pulling up and down pants with help and following simple directions.  Learn more by downloading the free No more Diapers guide today.

How do I know if my child is constipated?

If a child is straining to poop, hiding to poop, is going more than a day or two without having a BM in a diaper or on the toilet, and/or having very large bowel movements in the potty, these are signs of constipation.  If you are having any potty problems (difficulty potty training, daytime or nighttime pee or poop accidents) there is a good chance your child might be constipated.  Download the No More Diapers potty training free guide and listen to a podcast with Dr. Steve Hodges all about constipation and autism.

Are there some older children with autism who cannot be potty trained?

Most children over the age of 5 with autism and/or intellectual disability (without physical impairments or other medical conditions) can and should be potty trained.  If your child is constipated and/or he has had failed potty training attempts, you will need a plan to get re-started. The first step is reading the No More Diapers free potty guide (link potty guide) and you can also listen to a podcast with Dr. Steve Hodges all about constipation and autism. Independent toileting is one of the most important skills for children with autism or other developmental delays so never give up!

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To get started or restarted with potty training check out my free potty guide!
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