Encopresis (Soiling) in Toddlers
The short answer
Encopresis is when a potty-trained child (usually over age 4) repeatedly soils their underwear, most often due to chronic constipation with overflow leakage. The child cannot feel the leaking because hard stool stretches the rectum and dulls the sensation. It is not done on purpose and should not be punished. Treatment involves clearing the impaction and establishing regular soft stools.
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By Age
What to expect by age
Encopresis does not apply to infants. Stool leakage in babies is normal and expected as they are not toilet trained.
Encopresis is not a concern at this age. Normal infant stooling patterns are expected.
Encopresis is not applicable to babies. If there are stool concerns at this age, they are related to constipation or other infant digestive issues.
True encopresis typically begins after age 4, but the foundation of chronic constipation and stool withholding often starts in toddlerhood. If your toddler is avoiding pooping, holding in stool, or having painful bowel movements, addressing constipation early helps prevent encopresis later. Painful pooping creates a cycle of avoidance that can lead to chronic constipation.
What Should You Do?
When to take action
- Occasional poop accidents during potty training are completely normal and not encopresis
- Brief periods of regression during times of change or stress
- Your potty-trained child has frequent soiling accidents
- Your toddler is clearly withholding stool and has painful, infrequent bowel movements
- You suspect chronic constipation with overflow soiling
- Severe constipation with abdominal distension, pain, and vomiting
- Your child is significantly distressed or being bullied due to soiling
- You need help developing a comprehensive treatment plan for encopresis
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Digestive Concerns
Baby Constipation
Constipation in babies is defined by hard, dry, difficult-to-pass stools rather than by how often your baby poops. Breastfed babies can go several days without a bowel movement and still be perfectly normal. If your baby is passing soft stools comfortably, even if infrequently, they are likely not constipated.
My Toddler Holds In Their Poop
Stool withholding is very common in toddlers and is often triggered by a painful bowel movement that makes the child afraid to poop again. It can also emerge during potty training when children feel pressure or anxiety about using the toilet. The resulting cycle of withholding, harder stools, and pain can be frustrating, but it is highly treatable with a combination of stool softeners, dietary changes, and patient, pressure-free encouragement.
Safe Constipation Remedies for Baby
Safe constipation remedies for babies include tummy massage, bicycle legs, warm baths, and for babies over 4 months, offering small amounts of 100% prune, pear, or apple juice (1 to 2 ounces). High-fiber foods like prunes, pears, and peas help once solids are started. Never give laxatives, suppositories, or enemas without your pediatrician's guidance. Avoid honey, corn syrup, and mineral oil in babies under 1 year.
My Baby's Belly Looks Swollen
A rounded, slightly protruding belly is completely normal in babies and toddlers due to immature abdominal muscles and their proportionally larger organs. However, if the belly becomes suddenly swollen, feels hard and tight, or is accompanied by pain, vomiting, or changes in bowel movements, it needs medical evaluation as it could signal gas buildup, constipation, or rarely, something more serious.
My Baby Has an Anal Fissure (Blood When Pooping)
A small streak of bright red blood on the surface of your baby's stool or on the diaper is most commonly caused by an anal fissure, which is a tiny tear in the skin around the anus from passing hard stool. Anal fissures are very common in babies and toddlers and usually heal on their own with simple measures like keeping stools soft. While this is rarely serious, any blood in your baby's stool should be mentioned to your pediatrician.
Tummy Massage for Baby Gas
Gentle abdominal massage can help relieve gas and discomfort in babies by encouraging gas to move through the intestines. The technique involves gentle clockwise circular motions on the belly (following the direction of the digestive tract), the "I Love U" stroke pattern, and gentle knee-to-tummy movements. Massage also provides comforting touch that can soothe a fussy baby.