The way to approach resolving poo smearing depends on the underlying cause says Rebecca Mottram
Dear Rebecca,
This is SO disgusting that I haven’t even dared bring it up with any of my other parent friends to get advice so I really hope you can help! Recently my little one has been smearing their poo on the bathroom wall. My partner and I have no idea what to do to address this. The first time it happened I just burst into tears and cleaned it up. The second time I got angry and now I’m just worried and don’t want to leave them alone in the bathroom. Why is it happening?! How can I help them to stop?
I’m sorry to hear that you are going through this and glad you were able to connect with me so that I can help. Research on poo-smearing in children is limited, and the available literature often focuses on clinical observations, case studies, and expert opinions rather than large-scale empirical studies. However, there are some general insights that may help:
These are the common causes of poo smearing, so first please consider what your child is trying to communicate with you by doing it.
-Normal development
Poo smearing is often considered a behavioural issue rather than a medical one. It can be part of sensory exploration, and emotional expression. Young children, especially those in the toddler stage, are naturally curious and may smear poo as part of their exploration of the world around them. This behaviour is often considered a normal aspect of development for some children. If they get poo on their hands and don’t know what to do next, they might just wipe it on whatever is nearest! Intervening as soon as the behaviour starts can help reduce environmental contamination. Dressing your child in clothing that restricts the poo-smearing activity may also help but it’s important to mention that research has indicated that restrictive clothing does not change behaviour in the long-term and does not address the function of the behaviour.
– Constipation
If your child is not pooing every day, they could be constipated. Constipation can cause a variety of issues and interfere with potty training. Constipation can cause pain and generate fear. They may express these feelings through smearing. If you think your child might be constipated, or just want to check the list of symptoms, My free constipation course can help.
– Gastrointestinal infection
If your child has a tummy ache, pain in or around their bottom, or if they have soiling (poo in their pants, which is often caused by constipation), they may explore! See your GP to rule out infection and check your child is not constipated.
– Sensory Seeking activities
Sometimes, poo smearing is linked to a child’s desire for sensory stimulation. This can be more common among people with Autism, ADHD, OCD, developmental or intellectual disability and other neurodiversity. The tactile experience of smearing feces can be appealing to some children. My blog on potty learning and sensory processing disorders should provide some insight into how to provide an alternative sensory activity.
– Emotional stress or trauma
For children who are experiencing stress, trauma or big life changes, poo-smearing can feel like an outlet for their anger or frustration, or it can feel like a way of exerting control over a situation – which can be comforting if they feel a lack of control in their life. Your GP, health visitor or other trusted behavioural specialist can help you with this.
Poo-smearing, in a small number of cases, can indicate the child is suffering from abuse. It is important to know that this is usually observed alongside other signs of distress or changes in behaviour and poo-smearing alone does not automatically indicate abuse. However, when there are concerns about a child’s safety, well-being, or signs of potential abuse, it’s essential to take these concerns seriously. See my blog on abuse and potty training to help you.
Strategies
Whilst you are pursuing a long-term solution to resolve the underlying cause, try and stay calm. Poo smearing can be very triggering for you as a parent, but it’s important not to react negatively, as this may inadvertently reinforce the behaviour. Create a positive association with the toilet and acknowledge successes.
Alongside the suggestions above, try and establish and maintain consistent routines around toileting, to help increase a sense of predictability and reduce anxiety and stress. Set clear and consistent boundaries and teach appropriate hygiene habits. You will find my podcast helps give you a structure.
Remember, every child is unique, and the approach may need to be tailored to the specific needs and circumstances of the child. My podcast and my guide allows you to tailor the method to your unique child’s temperament which guarantees success.
If you feel out of your depth and would like to talk to me directly, do contact me. I’m a registered nurse who specialises in potty training and we can explore your unique situation in a one to one consultation.
References:
Bladder and Bowel (2020)Understanding Why Some Children Smear Poo. Available at https://www.bbuk.org.uk/wp-content/uploads/2020/09/Understanding-Why-Some-Children-Smear-Poo.pdf
Brahm NC, Buswell AL, Brahm RE, Brown RC. Protozoal infections in the developmentally disabled: often overlooked cause of rectal digging and fecal smearing. Ann Pharmacother. 2004 Sep;38(9):1542.
Bacewicz, A., & Martin, K. (2017). Coprophagia in an 8-year-old hospitalized patient: a case report and review of the literature. Case Reports in Psychiatry, 2017.
Hugus, K. A. (2022). Interventions to Decrease the Occurrence of Scatolia in Children with Developmental Disabilities (Doctoral dissertation, Boston University).
Josephs, K. A., Whitwell, J. L., Parisi, J. E., & Lapid, M. I. (2016). Coprophagia in neurologic disorders. Journal of Neurology, 263, 1008-1014.
Prasher, V.P. & Clarke, D.J. (1996). Case report: challenging behaviour in a young adult with Down‟s syndrome and autism, British Journal of Learning Disabilities, 24: 167-169.
Reynolds, K. E. (2017). What to Do About Smearing – A Practical Guide for Parents and Caregivers of People with Autism, Developmental and Intellectual Disabilities. Jessica Kingsley Publishers.
Sinason, V. (2002). Treating people with learning disabilities after physical or sexual abuse, Advances in Psychiatric Treatment, 8: 424-432.
If you have a potty dilemma, why not ask Rebecca? Submit your question to our Potty Talk series.
Rebecca Mottram, the founder of Little Bunny Bear and author of The Baby Pottying Guide for babies aged 0-18m, is a registered Children’s Nurse, potty learning researcher and consultant. Rebecca provides coaching to parents and carers around the world via private consultations and workshops. She also designs the Go Potty™ range of nappy belt systems, mattress protection and potty learning clothes and the Sew Potty™ range of sewing patterns.