Soiling

Helping children feel comfortable and confident in their bodies is an important part of growing up.

When families understand what causes soiling and how to respond with care, children can get the support they need to feel safe and well.

What is soiling?

Soiling (bowel incontinence) is when a child passes faeces (poo) in their underwear or outside the toilet.

Talk to a nurse continence specialist, pelvic health physiotherapist, maternal child health nurse or GP (doctor) if this happens regularly after age 3 or 4 or returns after successful toilet training.

Common causes of soiling in children

Most cases of soiling are linked to constipation. Hard faeces (poo) builds up, and softer faeces (poo) can leak around it without the child noticing. Over time, the bowel stretches and becomes less sensitive, making it harder for the child to feel when they need to go to the toilet.

Other causes include:

• avoiding the toilet due to pain or anxiety – most children are not scared of the toilet, but if passing faeces (poo) has felt painful, some children may hold on to avoid discomfort
• being distracted, too busy or ignoring the signal to go the toilet
• rare medical conditions.

Soiling is not caused by laziness or attention-seeking.

Supporting your child

Early support makes a big difference.

Steps include:

• talking to a nurse continence specialist, pelvic health physiotherapist or GP (doctor) with experiencing working with children
• keeping a diary of toilet habits and accidents
• creating a relaxed, comfortable toilet routine.

Don’t punish your children – they may not realise they’ve soiled. Kindness and patience help build confidence.

Medical support

Your health professional may:

• ask about your child’s health and do a physical exam
• recommend tests or scans
• start a toileting program and prescribe laxatives if needed
• recommend changes to food and fluid intake.

A toileting program may take 6 to 12 months and works best with ongoing support from a paediatric continence health professional.

It’s important to encourage your child to sit on the toilet with a foot stool under their feet for 3 to 5 minutes about 20 to 30 minutes after a meal, especially after breakfast, and after school.

Using a timer or playing their favourite song may help make this more enjoyable for your child.

If you’re not satisfied with the advice given by your health professional, or if they suggest your child will simply grow out of it, you have the option to seek a second opinion from another qualified health professional.

It’s best to let your child’s school or early education provider (kinder, pre-school, daycare) know so they can support your child.

Children’s Bristol Stool Chart

This chart helps identify faeces (poo) types:

• Types 1–2 – possible constipation
• Types 3-4 – healthy
• Types 5–7 – possible diarrhoea.

Use it to track patterns and discuss concerns with your health professional. You can also use it as a tool to get your child involved in their toileting program.

This content has been reviewed by sub­ject mat­ter experts in line with Continence Health Australia’s established process. Read about our clinical content review protocol.