Medically Reviewed by Bahee Van de Bor, RD, BCAPSc PGDipDiet, Specialist Paediatric Dietitian, former specialist dietitian at Great Ormond Street Hospital, with over 20 years of clinical experience in paediatric digestive health.
Your child is doing everything they can to avoid going.
Crossing their legs. Rocking on the spot. Standing on tiptoe. Squatting in the corner behind the sofa.
You have seen the look on their face. That mixture of discomfort and something that looks a lot like fear.
And then the relief, finally, when they go. Followed by you wondering why on earth this keeps happening, and whether you are somehow making it worse.
You are not making it worse. And this is not stubbornness.
Something made it hurt. And your child is doing the most logical thing they can: trying not to let it happen again.
In Many Children, the Fear Began With Pain
One part of the picture is often overlooked.
Toilet anxiety tends to be treated as a psychological problem. Your child is scared, so the solution must be comfort, distraction, sticker charts, patience.
And those things can help around the edges.
But if the fear of pooing started with a painful experience, no amount of distraction will fix what is fundamentally a physical problem.
In many children, the anxiety is not the starting point. It is the consequence.
The most important thing I can tell you is this: if passing a stool hurts, your child will avoid passing a stool. That avoidance is not a behaviour to manage. It is a pain response. And the only way to break it is to make the stool soft enough that passing it does not hurt anymore.
That is where everything else begins.
What Is Actually Happening in Your Child’s Gut
A child becomes scared to do a poo because they are caught in a physical cycle, not a behavioural one. When passing a stool is painful, a child learns to hold on to avoid it. That held stool becomes harder, drier, and bigger, which makes the next bowel movement even more painful, which makes the holding stronger. This is what clinicians call stool withholding, and it is one of the most common drivers of constipation in children.
Here is why the cycle is so hard to break without help.
When a child holds on to avoid pain, the stool stays in the bowel for longer. The longer it stays, the more water gets drawn out of it. It becomes harder, drier, and bigger.
So the next time they eventually go, it hurts more than it did before. Which makes them hold on even longer. Which makes the stool harder and bigger again.
Over time, the bowel stretches to accommodate the build-up. The normal urge to go becomes muted. Some children reach the point where they genuinely cannot feel the urge anymore, which is one reason why waiting for them to say “I need to go” often stops working.
You can read more about what different stool types tell you in our guide to understanding children’s poop.
Why Sticker Charts and Encouragement Do Not Fix It
You have probably already tried the obvious things.
Sticker charts. Rewards for sitting on the toilet. Extra prunes. “Just try and see what happens.”
And the pattern has not shifted.
Here is why.
Imagine being asked to do something painful every day, and being given a sticker for trying. The problem is not motivation. The problem is fear. And until passing a stool no longer hurts, the fear has something real to hold onto.
Sitting on the toilet when you are genuinely scared of pain does not make the pain go away. It makes the toilet into a place associated with dread.
Rewards and praise can also feel like pressure to a frightened child. They know you want them to go. They do not want to let you down. That adds another layer of stress on top of the fear, and stress tightens the gut further.
What Actually Helps a Child Who Is Scared to Poo
The goal is simple, even if getting there takes time.
Make passing a stool soft enough that it does not hurt. Once the pain is gone, the fear has nothing to feed on. And the cycle starts to break.
Soften the stool first
This is the single most important step, and the one most often skipped in favour of behavioural approaches.
Making sure your child drinks enough through the day is a good starting point.
Kiwi fruit (one per day) has evidence in adults for softening stools, and most children will eat one without complaint. You can read more about kiwi and constipation in our dedicated post on green versus golden kiwi for constipation in children.
Whole pear is also useful, as it contains sorbitol which helps draw fluid into the bowel.
Some parents are advised to try prune juice, and it can help short-term because of its sorbitol content. But national guidance recommends no more than 150ml of juice per day for children, because of the free sugar content and the associated risk of tooth decay. It is not a strategy to sustain beyond a few days.
If dietary changes are not making enough of a difference, our post on natural approaches to constipation in children covers what the evidence actually supports.
If withholding has been going on for weeks, your GP may prescribe a stool softener such as Movicol, which helps clear the build-up and keeps the stool easy to pass while the fear cycle changes. If your child then becomes reliant on laxatives to go, a paediatric dietitian can look at the gaps in their diet and help balance the right nutrients to soften stools naturally over time.
Get the toilet posture right
Most toilets are not designed for small bodies.
When a child’s feet are dangling, the angle of the pelvis makes it harder to pass a stool and increases the sensation of straining.
A simple footstool under the toilet so the knees are level with or slightly above the hips changes the angle completely. It relaxes the puborectalis muscle, which is the muscle that needs to let go for a stool to pass.
This is a small change that makes a real difference.
Remove the audience
No commentary. No “are you doing a poo in there?” No countdown. No celebration when they come out.
The bathroom needs to feel calm, private, and completely unpressured.
A book, a small toy, some quiet music. Whatever makes it feel normal rather than monitored. Some children do better if a parent is nearby but not watching. Others do better entirely alone. Follow your child on this.
Time it with the body
After a meal, especially breakfast, the bowel naturally becomes more active. This is called the gastrocolic reflex, a normal response to eating that pushes things along.
Sitting on the toilet for ten to fifteen minutes after breakfast, when the bowel is most likely to want to move, gives your child the best chance of feeling an urge.
Make this a quiet, unremarkable part of the morning. Not a challenge. Not a reward opportunity. Just a calm ten minutes with a book.
But My Child Keeps Having Accidents. Is That Related?
If your child is withholding and also having what look like diarrhoea accidents or skid marks, it may not be what it looks like.
When a large, hard stool has been sitting in the bowel for some time, liquid stool can pass around the blockage and leak out without warning. This is called overflow soiling, and it is often mistaken for loose stools or poor hygiene. It is actually a sign that the bowel needs help.
We have a dedicated post that explains this in full: Is My Child’s Diarrhoea Actually Constipation?
When to Talk to Your GP
If your child has been withholding for more than a couple of weeks, it is worth a GP appointment.
There are also specific alarm features that mean you should contact your GP promptly, regardless of how long the problem has been going on.
The Rome V diagnostic criteria (Di Lorenzo et al., Gastroenterology 2026) highlight a number of alarm features that warrant prompt medical assessment. Seek review if you notice any of the following:
- Blood in the stool that cannot be explained by a small anal fissure
- Unexplained weight loss or your child is not growing as expected
- Fever alongside the constipation
- Vomiting
- Significant abdominal distension
- A family history of Hirschsprung’s disease
- Symptoms that started in the first month of life
- Delayed passage of meconium after birth
- A sacral dimple, skin tag, or tuft of hair over the lower spine
- Any abnormality around the anus or an abnormal anal opening
- Signs of abnormal thyroid function
These are not common. But they matter, and they need investigating before anything else.
When This Has Been Going On for a Long Time
If the withholding has been going on for months, the picture is more complex.
The bowel may have stretched considerably. The urge to go may be significantly reduced or absent. There may be overflow soiling that looks like diarrhoea.
At this stage, dietary changes and a GP prescription are often not enough on their own. A structured approach is needed, one that looks at what the bowel is doing, how the pattern developed, and how to safely retrain it over time.
As a paediatric dietitian specialising in children’s gut problems, this is the work I do in the Happy Belly Club®. It is not about food lists. It is about understanding what has happened in the gut, working alongside your GP on the clinical management, and helping your child build a new, pain-free experience of going to the toilet.
Bahee is nothing short of a miracle worker! My 13-year-old son had been suffering from ongoing stomach pain for the past year, along with a persistent cough and itching that had been part of his life since early childhood. After months on Laxido for an impacted bowel and constant abdominal pain, we were stuck in a cycle — every attempt to reduce the medication led to the same problems returning. Then we found Bahee. Her guidance was transformative. She quickly identified that my son wasn’t getting enough fibre, and within just a month, we were able to stop the Laxido completely. The itching vanished, and the cough improved dramatically. After a year of my son barely being able to attend school due to pain, he’s now thriving. I can finally relax, knowing he’s happy and healthy. I can’t thank Bahee enough!
When School and Public Toilets Are Part of It
The fear of pooing is also sometimes connected to broader anxiety around toileting: school toilets, public toilets, or going anywhere other than home. If this is part of the picture, it is worth mentioning to your GP.
If your child is also experiencing regular tummy pain, you might find our post on why children get tummy pain when tests are normal helpful.
You Are Carrying a Lot With This
If your child is scared to poo, you have probably been worrying about it for longer than you let on.
Wondering if you caused it. Dreading the school trip. Anxious every morning about whether today will be another difficult day. Watching other children seemingly do this without a second thought.
That mental load is real. You are not overreacting. And your child is not being difficult.
They have learned that something hurts, and they are protecting themselves the only way they know how. The challenge is working out what is driving the fear, softening the stool so it stops hurting, and helping the gut feel safe again. That is something you do not have to figure out alone.
We chose to work with Bahee after our daughter suffered some extreme digestive issues, and we felt a more holistic approach would be better. Whilst working with Bahee we didn’t need to reintroduce laxatives, and by the end of the programme our daughter was pooing regularly and appropriately. But the best part — she has gone from a pretty restrictive diet to not only eating a varied diet but being confident in trying new things. As well as sharing her extensive knowledge, she also taught us as parents how to better help her daughter, as well as alleviating some of the parental mental load. Thank you, Bahee — together, our hard work has made an incredible difference.
Working Through This Together
In my 12-week 1-to-1 clinical programme, the Happy Belly Club®, I work with families through a structured process.
If you would like to understand whether this approach is right for your child, you can book a free 15-minute Discovery Call. No pressure. Just a clear conversation about what is going on and whether I can help.
Frequently Asked Questions
Why does my child hold in their poo?
Children typically start withholding because pooing hurt at some point. Once the connection between pooing and pain is formed, the avoidance becomes automatic. The longer it continues, the more entrenched the pattern becomes, because the held stool gets harder and the next bowel movement hurts even more.
What causes poop anxiety in children?
In the children I see, poop anxiety almost always starts with a painful experience. A hard or large stool that hurt to pass is enough to create a fear response that becomes self-reinforcing. Occasionally it is triggered by a frightening experience with the toilet itself. But pain is the most common root cause, and it is the one that needs to be addressed for things to genuinely improve.
Can being scared to poo cause accidents?
Yes, and this is one of the most distressing and misunderstood parts of stool withholding. When a large amount of stool has built up in the bowel, liquid can pass around the blockage and leak out without warning. This is called overflow soiling, and it often looks like diarrhoea or poor hygiene. It is actually a sign that the bowel is under significant strain and needs clinical support.
Is stool withholding the same as constipation?
Stool withholding is a behaviour. Constipation is the clinical result. A child who withholds regularly will develop constipation as the held stool builds up and hardens. A GP or specialist can help identify what is driving the pattern and what the right approach is.
How do I help a toddler who is scared to poop on the potty?
The most important step is making the stool soft enough that passing it does not hurt. Make sure your child is drinking enough, offer kiwi fruit or whole pear daily, and speak to your GP if things are not improving within a week or two. Remove all pressure around the potty: no watching, no timing, no commentary. A footstool to support your child’s feet makes passing a stool physically easier.
Will my child grow out of being scared to poo?
Some children do improve over time, particularly if the original trigger was a one-off painful experience and the withholding has not become entrenched. But if withholding has been going on for weeks or months, it is unlikely to resolve on its own without help. The longer it continues, the more the bowel adapts to holding, and the harder it becomes to retrain without a structured approach.
My child is scared to use the toilet at school. What should I do?
School toilets are a very common trigger. They are often noisy, unfamiliar, shared, and there is little privacy. Start by talking to the school. Many will allow a child to use a quieter staff toilet or have a private time to go. Make sure stools are soft enough at home that going once before school becomes manageable. If school toilet anxiety is significantly affecting your child’s day or they are holding on for hours, it is worth raising with your GP.
About the Author
Bahee Van de Bor is a Registered Paediatric Dietitian specialising in children’s digestive health. She presented at The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) in June 2026, on Nutritional Microbiome Therapies Post Antibiotics. She has over 20 years of clinical experience, including 12 years working at Great Ormond Street Hospital. Bahee works with families whose children experience constipation, diarrhoea, tummy pain and IBS-type symptoms through her clinical programme, the Happy Belly Club®.
