Is the Child Resisting Toilet Training? Or Merely Constipated?

Yes­ter­day, a friend of mine told me about a four-year-old boy who was “resist­ing” being toi­let trained. She said that the child would uri­nate in the toi­let but that he’d “hold it” for three days rather than defe­cate in his pot­ty. I told her that I couldn’t imag­ine that any­body who eats a high-fiber veg­an diet could “hold it” for three days, even if he tried, unless he was tak­ing mor­phine or some oth­er drug that shuts down gut motil­i­ty. I said that the child’s prob­lem didn’t sound to me like resis­tance to pot­ty train­ing. It sound­ed like con­sti­pa­tion. His refusal to go on the pot­ty prob­a­bly reflects the fact that his bow­el move­ments are uncom­fort­able or even ago­niz­ing­ly painful, and it’s prob­a­bly because he’s being fed dairy prod­ucts and a lot of processed food. She admit­ted that the poor child was being fed cow’s milk and wasn’t eat­ing much fruit and veg­eta­bles or even whole grains.

Think about it. If you are a tod­dler or preschool­er and have had some painful expe­ri­ences on the pot­ty, wouldn’t you avoid the pot­ty the way you’d avoid any tor­ture device? Painful expe­ri­ences have trained the child to avoid the pot­ty. I can only hope that the poor child’s care­givers aren’t adding to the child’s mis­ery by pun­ish­ing him for fail­ing to use the pot­ty.

Bow­el move­ments aren’t sup­posed to hurt. If a child’s bow­el move­ments are infre­quent or dif­fi­cult, there is some­thing wrong. The usu­al cause of the prob­lem is the diet.

Cow’s milk and oth­er dairy prod­ucts are a com­mon cause of severe con­sti­pa­tion in chil­dren. The diges­tion of casein, which is the major pro­tein in cow’s milk, pro­duces pro­tein frag­ments that are called caso­mor­phins because they have drug effects that are sim­i­lar to those of mor­phine. Besides being slight­ly addic­tive, caso­mor­phins can cause severe con­sti­pa­tion. For­tu­nate­ly, human beings do not need to con­sume any cow’s milk prod­ucts at all, ever.

A low-fiber diet is also a com­mon con­tribut­ing cause of con­sti­pa­tion in chil­dren. Ani­mal-based foods all con­tain zero fiber, and refined plant foods con­tain very lit­tle fiber. As a result, the stan­dard Amer­i­can diet, which is based on ani­mal-source foods (includ­ing dairy prod­ucts) and refined foods, is a recipe for con­sti­pa­tion. It is also a major cause of appen­dici­tis, which can be dead­ly. If all of the foods that a child is offered con­tain fiber, the child will eat fiber.

Often, a child’s refusal to use the pot­ty is viewed as a prob­lem with the child’s behav­ior. How­ev­er, I think that when a child doesn’t poop for three or more days, it’s prob­a­bly the care­giv­er, not the child, who is mis­be­hav­ing. The care­giv­er is prob­a­bly fail­ing to feed the child the kind of diet that would enable the child to have nor­mal bow­el move­ments. Any health­care pro­fes­sion­al who sug­gests drug treatments–even over-the-counter laxatives–or behav­ioral inter­ven­tions with­out teach­ing the care­givers how to cor­rect the child’s diet is also mis­be­hav­ing, in my hum­ble opin­ion.

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