One of the biggest barriers to toilet training is constipation. Even a toddler's normal bowel movement — which should be shiny, smooth, and no bigger around than a quarter, with the consistency of peanut butter — requires effort to pass. Because constipation makes your child's stools hard and dry, he'll hold them in even longer to avoid any discomfort. That, in turn, makes them harder, dryer, bigger, and potentially much more painful to pass. Eventually, your child's large bowel may get so distended that he'll lose his ability to tell when it's full. Because of that, he might not be able to get a good push going. Liquid stool may start to leak around the hard, dry lumps, making it look as if he has diarrhea — and creating an uncontrollable, embarrassing mess.
What's more, since hard lumps of stool push on and compress the bladder, your child will have a harder time controlling his urination. Leaks, frequent small puddles, and a general inability to keep things under control all contribute to making toilet training more challenging than it already is.
The best way to deal with constipation is to stop it before it starts. Here's what to do:
If you've made all of these changes, and your child's bowel movements are still hard and dry, consult your health care provider. She'll be able to suggest one of the newer, gentle medicines that can help get things back on track. No matter how bad it gets, never use adult laxatives or enemas on a child.
Learn more about constipation from Dr. Loraine Stern.