Toddler Will Only Poo in a Nappy? Here’s What Helps
Your child has toilet learning sorted. Wees on the toilet, tells you when she needs to go, dry through the day, no fuss.
Then at some point in the afternoon she comes and asks for a nappy. She takes herself off behind the curtains or into the corner of the lounge room, stands very still, does a poo, and comes back to tell you she needs changing.
If that is your house, your child is not being difficult.
This is one of the most common patterns in toilet learning. It shows up in the research as stool toileting refusal, and it affects up to one in five children at some point during toilet training (Baird, Bybel & Kowalski, 2019, summarising Taubman’s prospective work). Most families have never heard of it, so most parents assume they are the only ones.
Why the nappy feels safer
A poo is a much bigger event for a toddler than a wee, physically and emotionally.
It feels like losing something. Small children do not have our sense of what is body and what is waste. A poo that was inside them and is now gone, in a bowl, being flushed away, can genuinely feel like losing a part of themselves. A nappy keeps it close and contained, where nothing disappears.
The toilet is a lot. It is high up, it is cold, it is hard, there is water underneath, and it makes a loud noise afterwards. A nappy is warm and familiar and does not involve any of that.
Their body works better standing. In a nappy a child usually stands, often squatting slightly, with both feet planted. On a toilet their feet dangle and their body is unsupported. Feet dangling makes it genuinely harder to pass a poo, which is why a step stool matters so much.
It is private. By the time they are asking for a nappy, most children have worked out that poo is a whole thing for adults. Going off behind the couch is not naughtiness, it is a two-year-old wanting privacy for something they sense is a big deal.
It is predictable. Toilet learning has changed everything about how they wee. Keeping poos exactly as they have always been is a small piece of control in a process where they have very little.
The one thing not to do
Do not take the nappy away and refuse to give it back.
This is the advice that gets handed out most often, usually with the best intentions, and it is the one thing most likely to make everything worse. A child who is offered no nappy does not simply decide to use the toilet. A great many of them decide to hold on to their poo instead.
Holding on is where the real trouble starts. Poo held in the bowel gets harder and bigger, so the next one hurts, so they hold on more. That is poo withholding and it takes months to resolve. A child who reliably asks for a nappy and then poos comfortably and regularly is in a much better position than a child who is refusing to go at all.
Put plainly: a child who poos in a nappy every day is doing something normal. A child who does not poo for three days because there is no nappy has a new and worse problem.
The nappy ladder
The way through is gradual, and every step is smaller than it sounds. Each step moves the poo a little closer to the toilet without ever removing the nappy.
1. Poo in a nappy, anywhere. Where you are now. Nothing to change yet.
2. Poo in a nappy, in the bathroom. Same nappy, same standing up, same privacy. The only change is the room. Wait outside the door if that is what she wants.
3. Poo in a nappy, sitting on the closed toilet lid. Now she is on the toilet, which is the part that used to feel frightening, with the nappy still doing its job.
4. Poo in a nappy, sitting on the open seat. Nappy on, seat open, feet firmly on a step stool.
5. Poo in a nappy with a hole cut in the bottom, sitting on the open seat. This is the clever one. The nappy is still there, still against her skin, but the poo goes into the bowl. Cut the hole small the first time and make it bigger over a few goes.
6. No nappy.
Some families move up a rung every few days. Others sit on step two for three weeks. Both are fine.
Three rules for using the ladder
Only move up when she is genuinely relaxed at the rung she is on. Not tolerating it. Relaxed. If a step produces tears or holding on, go back down one and stay there longer. Going backwards on purpose is not failure, it is the method working.
Tell her the plan. “From today we are going to do poos in the bathroom, still in your nappy, exactly the same.” Toddlers cope far better with a change they were told about than one that simply happens to them.
Never take the nappy away as a consequence. The nappy is not a reward you are withdrawing. It is the safety net that makes the whole thing possible.
What to say
Sitting is the achievement. Being in the bathroom is the achievement. If a reward chart only pays out for a poo in the toilet, you have added performance pressure to the exact thing she is already frightened of. Reward the rung, not the result.
Watch the words too. A randomised controlled trial found that when parents used only positive language about poo, avoiding words like yucky, smelly and disgusting, refusal resolved faster (Taubman, Blum & Nemeth, 2003). Poo is normal, everybody does one, that is the tone.
Let her flush when she is ready, and do not insist on it. Plenty of children want to say goodbye to it first, which is a perfectly sensible thing to want.
When it is more than a preference
Nappy-only pooing on its own is usually the gentle end of this. Some signs mean something else is going on and are worth a GP visit:
• She holds on when a nappy is not available, sometimes for days
• Poos are hard, pellet-like, very large, or clearly painful
• She goes stiff, up on her toes, or hides and looks distressed rather than private
• Days pass between poos
• Skid marks or smears in her undies between poos
• Tummy aches, a smaller appetite, or wee accidents in a child who was dry
Constipation and stool toileting refusal travel together, and the constipation nearly always needs treating first. Nothing behavioural works while poos are still hard.
How long this takes
Longer than you want and less time than it feels like. Weeks to a few months is normal, and it moves fastest in the houses where nobody is pushing.
The children who take longest are almost always the ones whose nappy got taken away early on. If that has already happened in your house, it is fixable. Give the nappy back for poo, let everything settle for a couple of weeks, then start at rung one.
She will get there.
Once poos are comfortable and the fear has settled, a calm and predictable routine is what carries the last few steps. Our Go Time, Potty Time Toilet Training System is built around that: a simple daily rhythm, a chart that celebrates the trying rather than only the result, and steps a child can follow at their own pace. It supports the routine side of toilet learning. It is not a treatment for constipation or withholding, and the medical piece always comes first.
This article is general information only and is not medical advice. Please see your GP or paediatrician about your own child.
Sources
• Taubman, B. (1997). Toilet training and toileting refusal for stool only: a prospective study. Pediatrics, 99(1), 54-58.
• Taubman, B., Blum, N. J., & Nemeth, N. (2003). Stool toileting refusal: a prospective intervention targeting parental behavior. Archives of Pediatrics & Adolescent Medicine, 157(12), 1193-1196.
• Baird, D. C., Bybel, M., & Kowalski, A. W. (2019). Toilet training: common questions and answers. American Family Physician, 100(8), 468-474.
• Tabbers, M. M., DiLorenzo, C., Berger, M. Y., et al. (2014). Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of Pediatric Gastroenterology and Nutrition, 58(2), 258-274.
• ERIC, The Children’s Bowel & Bladder Charity. Stool withholding: why and how to stop a child holding poo. https://eric.org.uk/childrens-bowels/stool-withholding/
• Royal Children’s Hospital Melbourne. Kids Health Info: Constipation. https://www.rch.org.au/kidsinfo/fact_sheets/constipation/