Toddler Mayhem

Toddler Constipation and the Preschool Potty Training Dilemma

Before we started potty training with our toddler six weeks ago, my husband and I discussed what the terms of failure would be. I wanted to establish the red line where we bag the whole thing and try again later. My husband didn’t have a red line. He believed that our son was ready to be out of diapers and that once we started there would be no going back. I decided that my limit was constipation.

The idea of my child getting constipated scared the shit out of me.

Constipation in little people can be a big deal. Like many things such as colds and ear infections that affect them differently, a whole slew of problems can come from not regularly pooping. I knew about the pain of trying to pass a large, dry poop (thanks pregnancy and c-section!) and that alone was reason enough for me to fear constipation on my child’s behalf. As it turns out, that discomfort is just the hard, impacted tip of the shitberg.

I had read a story about a little girl suspended from school for repeated pee accidents. In follow up stories, it turns out that this three year old girl was severely constipated. I filed this tidbit away, only to see similar anecdotes – constipation as the root cause of potty training fails – pop up on mom group threads. In many instances the advice given is to wait on potty training until a child is ready to try to avoid poop issues turning into long-term constipation.

The pressure to have a child potty trained for school is major.

We had originally talked about waiting to potty train our son until he seemed totally ready and self-iniated the process, which I assumed as a first time mother would be sometime closer to three. But then we started looking at preschools and hearing the expectations for potty training. Like three-year old Zoe in the Washington Post article, many of the schools we spoke with expect our toddler to be potty trained to varying degrees.

The public schools with Prek-3 have the lowest, or most reasonably attainable bar for toileting requirements. They don’t require three year olds to be fully trained and they will change diapers, but they state that it is desired and they will work with parents to get the kids trained quickly. The more moderate-stance schools – which tended to be a mix of higher performing charter schools and new charter schools eager to attract families – echoed this as well, but with more emphasis on potty trained as a desired skill. Then there were those that had a high bar for potty training.

One of schools, which happened to be a Montessori, told us that kids would need to be fully trained and that they don’t allow pull ups at all, even for naps. They said that if a child isn’t trained they suggest sending in lots of changes of clothes and that peer pressure will help with training. I thought that Montessori was all about respect for a child’s natural psychological, physical, and social development, but apparently that respect ends at the bathroom door. The other high-bar school, an extremely well-regarded bilingual charter, said that kids need to be fully trained, which they define as able to get pants on and off, wiping themselves, and washing their own hands. If a child has repeated accidents they are asked to leave the school.

When I hear the high expectation schools tell me that my baby – who will be a young three in his class – will need to wipe himself effectively and self-initiate hand washing, I question how in tune the school could possibly be with child development.

Potty training isn’t a milestone to be reached, though it doesn’t always feel that way. There are other things that happen with babies and toddlers that aren’t milestones either yet are often treated as such, like sleeping through the night. Any parent who has tried any and every thing imaginable to get a baby to sleep through the night and has failed at it will tell you that it happens when it happens. There are things you can do to help it along, but ultimately, your baby has to be ready to sleep.

Potty training and the accidents that come with it isn’t a behavioral issue. The ability to go to the bathroom independently and without wearing a diaper or pull up is linked to emotional readiness and physiology, as well as physical dexterity and coordination.

Our toddler was showing signs of readiness for months. He was telling us when he was pooping or had pooped, he would pee in the potty if he wasn’t wearing a diaper and a potty was nearby and he was verbal enough to tell us when he needed to go to the bathroom. We went for it.

Whether our child would have gotten constipated if we hadn’t started potty training we will never know. He is a two year old and his diet has gone from more diverse and full of fiber, fruits and vegetables, to starchy carbs and cheese. It’s possible we would have had a constipated kid in diapers anyway.

It took us a few weeks to realize that he was constipated. We were looking for what I thought constipation was, which was not pooping. Then he started telling us that his tummy hurt, but he had periodically told us this before when he was in diapers and pooping twice a day. We discussed the specter of constipation, but he was still pooping once a day. A mom friend told me that it’s common for potty training kids to go from multiple poops to just one poop a day, and that it’s still normal. I didn’t read any books on potty training and just winged it, so I have no idea if that’s true or not.

We went to the doctor for an unrelated visit but mentioned the tummy aches. She felt his belly and informed me that she could feel his poop and that yes, he was constipated.

Shit. Shit. Shit.

Ongoing constipation in children can lead to bedwetting and/or daytime pee accidents. It can lead to major bowel issues and fecal incontinence. It can mess with his emotional state. If we ever had to give him a suppository, it could violate his sense of bodily control. While I went into a panic spiral, she casually suggested starting probiotics daily and giving him a bit of Miralax to get things moving.

I went home and looked at this handy download from the fine folks at and memorized what we needed to watch from there on out.

toddler constipation, constipated child

Our toddler did have several signs of constipation like belly pain, massive poops, firm and sometimes squishy poop. I really thought that all I had to watch for was not pooping.

We now have to keep up with the Miralax every few days when he gets behind. I track his pooping like I used to track my ovulation, with the same intensity as when I’m trying to get pregnant.

Now I’ve started to worry that the constipation will be an ongoing issue, which throws school into jeopardy. It shouldn’t have to be that way. My young child’s ability to learn and grow socially and emotionally in an enriching preschool program shouldn’t hinge on his ability to wipe his own butt at three years old.




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