I would carefully observe when she is likely to have a BM.....and sit her on the potty and read to her until it happens....or until 20 minutes have happened.
Another option is having her clean up after herself....un zipping the diaper, dumping the poop into the tiolet ( to underscore where it belongs) and providing wet wipes for her to clean herself. She will hate that....
I have twin grandsons and one of the twins refused until he was almost 4....but dumping his own diapers helped point out to him the easiest and most pleasant way for things to happen!!
Linda C

My dd had that problem a couple of times. I added more fruit juice and fruits to her diet so it woud be easier to poop. When I thought she needed to go I pushed the juice a little harder so she couldn't hold back. I also promised a big reward at the end when she did poop on the potty. It took a while because she was still wearing diapers. We finally did it.

Another mom I know had problems with her daughter constantly being constipated. Her doctor recommended a daily dose of Milk of Magnesia. You can always call your doctor's office to see what their recommendation would be.

I had many months of this problem with DD. She would have a fit like she was straining to go. Doctor clued me in that she was straining to keep it in. We had other issues with lifetime health issue besides this, so we had no choice but to deal with it head on. It is not good for the child to hold it. If your neice is as headstrong as my daughter was, I have been there.

We used a product called Kondremul. It is emulsified mineral oil. When DD was your neice's age, I put it in a sippy cup with chocolate milk and she drank it at night before bed. End of problems. Unfortunately, for issues I won't go into, she needed to use this for years to lubricate her bowel tract.

My doctor who is on staff at the Children's Hospital in our closest city in the GI department told me at the time that he didn't care if DD had only 1 bowel movement in 5 days as long as it was pain free. Apparently, once they start holding it, it becomes painful once they go so they associate sitting on the toilet and the b.m with pain.

Whatever you do, do not use a product called Malt Supex. Our former ped. prescribed that and it caused my daughter to have a b.m. the size of a baseball, tearing the tissue in that area. That caused the change of pediatricians and also caused the need for a specialist in gastroenterology.

Perhaps mom could call the pediatrician and ask if she can try the Kondremul. It will take a few days to work its magic. It is usually kept behind the pharmacy counter as it is about $11 a bottle. It can't be used under a certain age, like 2 years, because it is mineral oil, there is a risk of aspiration if the child inhales it. I never had any problem giving to my 2 year old she drank it slowly from the sippy cup.

Best of luck to you and your neice's mom!

Yes, its obvious the child associates a BM with pain, and unpleasantries.

So, if it becomes pleasant she will cooperate.

Good advice from the above posters.

Diet is worth a look at. Plenty of fruit and fibre from breakfast cereal, without piles of sugar.

Too much fruit juice is not a good thing, can lead to weight gain. Also lots of water is a must.

Some kids do this b/c it takes longer to poo that pee and they don't want to stop playing that long or be out of the room that long. But they figure with a diaper on, they can multitask, so to speak. It might help to insist that she still goes into the bathroom for the BM and being cleaned up. If that's her reason, she might figure out it's in her interest to sit on the toilet if that gets her out of the bathroom sooner.

I also agree with starting to teach her to clean up herself and with rewards for BMs in the toilet. Whatever rewards is most valued to the child, a sticker chart or MMs or stamps on her hand, whatever is a big treat for her.

You kinda gotta figure out what her reason is and deal with the reason behind (no pun intended LOL) the behavior.

Maybe she isnt comfortable on the toilet.Is she tinkling in the big toilet? or does she have one of those cute little kid pottys that you have to empty out?
If she's tinkling on the big potty,have her go on a kid's one.Just sit her on there a couple times a day until she is comfortable being there.
When she poops in her diaper,make a comment like,"doesnt that feel yucky being smooshed"
Pooping on a big potty can be a challenge for little ones.All that concentration while trying to hold on.My daughter was the same.She would tinkle on the big potty,but wanted to poop in her little potty.At least until she got a little bigger and could manage it better.

thank you all so much for taking the time to help. please keep your thoughts/suggestions coming. i will present all of this info to her parents soon and see if we can find a mutually agreeable plan. thank heaven for sites like this one and people like you who care. sincerely, molly and family

Molly

I think you are right, formulating a plan, and sticking to it in both houses.

Let us know what you decide.

Popi