Finding skid marks in your child's underwear can be frustrating. But before assuming they're being lazy or not wiping properly, there's something important to know: Repeated poo stains can be a sign of constipation. And your child may not be doing it on purpose. How can constipation cause skid marks? When children hold their poo, stool can build up in the rectum. Over time, the rectum can become stretched and less sensitive to the feeling of needing to poo. Softer stool can then leak around the harder stool and into their underwear. This can look like: Brown marks or smears Small amounts of poo in their underwear Strong-smelling underwear Regular accidents despite being toilet trained Your child may genuinely not feel it happening. Why do kids hold their poo? Often, it starts with a painful bowel movement. A child may then become afraid of pooing and start holding it in. You might notice them: Crossing their legs Squeezing their bottom Standing on their tiptoes Hiding when they need to poo Avoiding the toilet Unfortunately, holding on can make the stool harder and larger, creating a cycle of pain → withholding → constipation → leakage. Could the pelvic floor be involved? Yes. To poo comfortably, the pelvic floor needs to relax and coordinate with the bowel and abdominal muscles. Some children have difficulty relaxing these muscles when trying to poo. This can make emptying harder and contribute to constipation and soiling. What can parents and carers do? If your child regularly has skid marks, look for other signs of constipation: Large or hard poos Straining Pain when pooing Tummy aches or bloating Hiding to poo Toilet avoidance Frequent underwear accidents Rather than blaming or shaming your child, speak with your GP or a healthcare professional experienced in children's bowel health. A paediatric pelvic health physiotherapist can assess toileting habits, positioning, pelvic floor coordination and relaxation, and help your child develop more comfortable bowel habits. The Bottom Line Skid marks aren't always a hygiene problem. If they're happening regularly, they may be your child's body's way of telling you they're constipated or struggling to empty their bowel properly. Your child isn't necessarily being lazy—and shame won't fix the problem. If your child is regularly soiling their underwear or struggling with constipation, a paediatric pelvic health physiotherapist can help you work out why and what to do next.

Yes. Some children deliberately limit fluids to avoid using the toilet, and it is more common than many parents realise. This "drink to wee" avoidance can set up a cycle of concentrated urine, bladder irritation, toileting anxiety and even accidents or pain. Why children restrict fluids Children may cut back on drinks for several understandable reasons: Toilet anxiety or embarrassment : school toilets, noise, lack of privacy, or fear of accidents can make a child reluctant to go, so they drink less to "stay safe". Previous pain or urgency : if weeing has stung (often from concentrated urine or a mild UTI), a child may try to avoid the sensation by drinking less. Control or routine issues: some children dislike interrupting play, screen time or classroom activities to use the bathroom. Sensory or neurodivergent factors : bathroom sounds, smells, seat texture or transitions can be overwhelming for some kids. The unintended consequence is that low fluid intake makes urine more concentrated, which can sting, increase urgency, and ironically make accidents and bladder symptoms more likely. Signs your child may be avoiding drinks to avoid weeing Watch for patterns such as: Very low fluid intake – rarely asking for drinks, refusing water bottles, or only taking tiny sips. Infrequent toileting – going fewer than 4–5 times in the day, or holding for long stretches at school or during activities. Urgency, accidents or "dancing" behaviours – crossing legs, squatting, fidgeting, or rushing to the toilet at the last minute. Concentrated, dark or strong-smelling urine – a sign they are under-hydrated. Complaints of tummy or bladder discomfort , or pain when weeing. Avoiding certain places or situations – refusing outings, school trips or activities where toilet access is uncertain. How a pelvic health physiotherapist can help Pelvic health physiotherapists assess and treat bladder habits, toileting behaviours and the muscle patterns that support healthy emptying. Your child's assessment may include: Bladder and bowel habits : frequency, urgency, accidents, fluid intake, stool patterns. Toileting posture and routine: how they sit, foot support, relaxation and timing. Pelvic floor muscle function : whether muscles are overactive, tight or poorly coordinated. Breathing and relaxation strategies : to reduce guarding and improve emptying. Lifestyle and school factors : access to toilets, sensory issues, anxiety, and daily routines. T reatment may involve: Education for you and your child about healthy bladder habits and why regular drinking matters. Fluid planning – structured drink targets across the day, with school-friendly strategies. Timed toileting – scheduled sits every 2–3 hours to retrain bladder habits and reduce urgency. Relaxation and breathing techniques – to make weeing easier and less stressful. Pelvic floor down-training – gentle exercises to reduce overactivity and improve coordination. Collaboration with your GP, paediatrician or school – to address pain, UTIs, constipation, anxiety or toileting accommodations. When to seek help It is worth seeing a healthcare professional if your child: Regularly restricts fluids to avoid using the toilet. Wees fewer than 4–5 times per day or holds for very long periods. Has frequent urgency, accidents or "holding" behaviours . Complains of pain, burning or discomfort when weeing. Has dark, strong-smelling urine most days. Shows signs of anxiety about toilets at school, in public or away from home. Has recurrent UTIs, constipation or bedwetting alongside daytime symptoms. Early assessment can prevent a cycle of pain, anxiety and bladder dysfunction from becoming entrenched. Frequently Asked Questions Is it normal for a child to avoid drinking to avoid weeing? It is not "normal" in the sense of being healthy, but it is a recognised pattern, especially in children with toilet anxiety, previous pain, or sensory sensitivities. It is important to address because it can lead to concentrated urine, bladder irritation and more accidents. How much should my child be drinking? As per the guidelines from Healthdirect and the Royal Children’s Hospital (RCH) Melbourne (total fluids from all drinks and foods): 1 to 3 years : about 4 cups (≈1 L) per day 4 to 8 years : about 5 cups (≈1.2 L) per day 9 to 13 years : about 5–6 cups (≈1.4–1.6 L) per day 14 to 18 years : about 6–8 cups (≈1.6–1.9 L) per day Water should be the main drink. Limit caffeine, fizzy drinks and very sugary juices, which can irritate the bladder. When to increase fluids Children need extra drinks when: Playing sports or being very active The weather is hot or humid They have a fever, vomiting, or diarrhoea In these situations, encourage small, frequent sips before, during and after activity or illness, and use oral rehydration solutions if they are unwell. Won't more drinking mean more accidents? Initially, yes. Your child may wee more often. But regular, adequate fluids produce lighter, less irritating urine and help the bladder learn a normal capacity and rhythm. Over time, this usually reduces urgency and accidents. What if my child refuses to drink at school? Work with the teacher to: Allow a visible water bottle on the desk Use a marked water bottle with time-based targets (for example, "finish to this line by recess") so your child has a clear, visual goal. Use a reward system for sips and toilet sits Agree on a consistent routine (for example, drink and toilet at morning snack, lunch and afternoon snack) so it becomes a normal part of the day. Small, frequent sips are often easier than big drinks. Can pelvic floor physiotherapy help if my child is scared of the toilet? Yes. Pelvic health physios use child-friendly strategies to reduce fear, improve relaxation on the toilet, and retrain bladder habits. They often work alongside psychologists, GPs and schools when anxiety or sensory issues are significant. The Bottom Line Avoiding drinks to avoid weeing is a common but fixable pattern. It often stems from toilet anxiety, previous pain, or routine pressures, and it can make bladder symptoms worse by concentrating urine and increasing urgency. If your child is restricting fluids, having frequent accidents, or showing signs of bladder discomfort, a pelvic health assessment can help. Together, you can build a simple, school-friendly plan for drinking, timed toileting and relaxation so your child feels more comfortable, confident and in control of their bladder. You do not have to manage this alone. Our pelvic health physiotherapists can assess your child's bladder habits, address any muscle tension or coordination issues, and work with you and your school to create a practical plan that makes drinking and weeing feel safe and manageable again.

Encopresis is when a child regularly soils their underwear after the age they would usually be toilet trained. For many children, this happens because of long-term constipation, stool withholding, or reduced awareness of the body’s signals that tell them they need to do a poo. When stool builds up in the bowel over time, the rectum can stretch and become less sensitive. This means children may not feel the urge to go, and softer stool can leak around the blockage without them realising. This can be frustrating and upsetting for both children and parents, but it is very common and treatable. Pelvic health physiotherapy can play an important role in helping children manage encopresis by improving bowel habits, supporting healthy toileting routines, and helping the bowel return to normal function. Treatment may include: Education for both parents and children about how the bowel works and why soiling happens Helping children develop regular toilet routines, especially after meals when the bowel is naturally more active Improving toilet posture, including correct foot support and positioning, to make bowel motions easier to pass Teaching breathing and relaxation strategies to reduce straining, fear, or withholding behaviours Supporting children to better recognise body signals and respond to the urge to open their bowels Addressing pelvic floor muscle tension or coordination difficulties that may affect bowel emptying Working through sensory challenges, toileting anxiety, or distractions that may contribute to accidents Pelvic health physiotherapy is gentle, supportive, and child-focused. Appointments are designed to help children feel safe and comfortable while also giving parents practical strategies to use at home. The goal is to reduce accidents, improve bowel emptying, and make toileting a less stressful experience for the whole family. With patience and the right support, children can regain confidence and work toward long-term healthy bowel habits.