Helping your child poop on the toilet when they are afraid to (Diaper Fading) (2215)
Key points below
Why won’t my child poop on the toilet?
Some children are scared to poop on the toilet. It may have been hard to poop or hurt to poop in the past. They may hold poop in because they are afraid pooping on the toilet will hurt. This may be why they only poop in a diaper, pull-up, or underwear.
Why is this important?
It is important to help your child not be scared to poop on the toilet. Most children toilet train when it is right for their age (3 to 4 years or older). If they don’t learn to poop in the toilet:
- They may have poop accidents which can smell.
- Other kids might find out and tease them.
- They may get constipated or backed up with poop if they are holding poop in.
What is diaper fading?
Diaper fading is a way to help your child learn how to poop on the toilet. It uses small steps to help your child not fear pooping on the toilet. It helps stop them from holding poop in.
To help your child poop on the toilet, it’s important to use rewards. Rewards will help increase their willingness to complete these steps. Offer your child smiles, praise, and rewards such as screen time, treats, time with a parent or caregiver, or a small prize. Give that reward to your child every time they poop in the bathroom or on the toilet.
How do I help my child get use to pooping on the toilet?
1. Have your child wear underwear all day and while awake.
- When your child needs to poop, take off their underwear. Put a diaper or pull-up on for them to poop in.
2. Only put a diaper or pull-up on when they need to poop.
- Only put the diaper or pull-up on when they are in the bathroom.
- Keep them in the bathroom to poop in the diaper or pull-up.
- After they poop, take the diaper or pull-up off, and put underwear back on.
- Mark the area where they like to be when they poop in the bathroom. You can mark the area with tape on the floor, a rubber or bathroom mat, or a sticker.
3. Move the marked area 1 step closer to the toilet every 2 to 3 days.
- Once at the toilet, have your child sit on the toilet with their diaper or pull-up on to poop.
4. Have your child sit on the toilet with their diaper or pull-up on to poop for 2 to 3 days. Then, start to cut a straight line (slit) in their diaper or pull-up.
- Your child should continue to wear their diaper or pull-up when they are on the toilet. They may feel more comfortable with having it on.
- If your child asks, you can tell them their diaper or pull-up is still on and poop may or may not enter the toilet. If your child does not notice, the caregiver should not mention anything about the slit in the diaper or pull-up.
- Every 2 to 3 days cut the slit in the diaper or pull-up a little wider, so it becomes more open. This will allow poop to fall into the toilet.
- Continue to cut the slit in the diaper or pull-up wider until your child tells you they do not need it anymore, or there is no diaper or pull-up left.
- If your child is having a hard time moving through the steps, talk with your treating behavioral health provider or primary care provider for more resources.
For more health and wellness information check out this resource:
Austin, J. E. & Begotka, A.M. (2024). A Diaper Fading Protocol to Treat Toilet Refusal: Four Case Studies. Cognitive and Behavioral Practice, 31(3), 335-344. ISSN 1077-7229.