Encopresis (Soiling) in Toddlers
Medically reviewed by Dr. Sarah Chen, MD, FAAP · Board-Certified Pediatrician
Content reviewed against published AAP, NIDDK, AAP guidelines
Last reviewed:
Digestive issues are common in infants and toddlers. If your baby is experiencing encopresis (soiling) in toddlers, here is what you need to know.
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.
Key takeaways
- 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.
- Usually normal when: Occasional poop accidents during potty training are completely normal and not encopresis
- Call your doctor if: Severe constipation with abdominal distension, pain, and vomiting
- Varies by age — see the age-by-age breakdown below
“The biggest concern with vomiting is dehydration. Young children can become dehydrated quickly, so it's important to replace fluids. Offer small amounts of an oral rehydration solution frequently.”
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What Parents Should Know
According to AAP, NIDDK guidelines, 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. At 0-3 months, encopresis does not apply to infants. Stool leakage in babies is normal and expected as they are not toilet trained. It is generally considered normal when occasional poop accidents during potty training are completely normal and not encopresis. However, you should contact your pediatrician promptly if severe constipation with abdominal distension, pain, and vomiting.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
Encopresis does not apply to infants. Stool leakage in babies is normal and expected as they are not toilet trained.
3-6 months
Encopresis is not a concern at this age. Normal infant stooling patterns are expected.
6-12 months
Encopresis is not applicable to babies. If there are stool concerns at this age, they are related to constipation or other infant digestive issues.
12-24 months
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 to Tell Your Pediatrician
- Describe when you first noticed encopresis (soiling) in toddlers and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your potty-trained child has frequent soiling accidents.
- Mention if your toddler is clearly withholding stool and has painful, infrequent bowel movements.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
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
What You Can Do at Home
- Keep track of when you notice encopresis (soiling) in toddlers — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that occasional poop accidents during potty training are completely normal and not encopresis — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Keep your baby upright for 20-30 minutes after feeding. Note any patterns between feeds and symptoms.
- While monitoring at home, seek immediate care if severe constipation with abdominal distension, pain, and vomiting.
Related Conditions
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.
Related Resources
Poop Color & Texture Guide
What your baby's poop color and consistency mean, and when to worry.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is encopresis (soiling) in toddlers normal?
When should I call the doctor about encopresis (soiling) in toddlers?
When is encopresis (soiling) in toddlers normal?
What causes encopresis (soiling) in toddlers?
What should I mention to my pediatrician about encopresis (soiling) in toddlers?
Is encopresis (soiling) in toddlers normal at 0-3 months?
Is encopresis (soiling) in toddlers normal at 3-6 months?
Should I go to the ER for encopresis (soiling) in toddlers?
Does encopresis (soiling) in toddlers go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Encopresis (Soiling) in Toddlers.
Things to mention
- Describe when you first noticed encopresis (soiling) in toddlers and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your potty-trained child has frequent soiling accidents.
- Mention if your toddler is clearly withholding stool and has painful, infrequent bowel movements.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- 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
Urgent signs to report immediately
- 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
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of encopresis (soiling) in toddlers are normal. Talk to your pediatrician if severe constipation with abdominal distension, pain, and vomiting.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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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.
Can Antibiotics Damage My Baby's Gut?
Antibiotics can temporarily disrupt your baby's gut microbiome, which may cause loose stools, fussiness, or diaper rash during and shortly after treatment. However, when antibiotics are medically necessary, the benefits of treating the infection far outweigh the temporary gut disruption. Most babies' microbiomes recover within weeks to months, especially with breastfeeding and a gradual return to normal feeding patterns.