Key points about soiling
- soiling is when your child has poo accidents in their underwear
- constipation is the main cause of soiling
- soiling problems can be frustrating and embarrassing for parents and tamariki (children)
- it is a common problem for tamariki - you are not alone
- soiling can happen without your child knowing - it is usually not deliberate
- the treatment of constipation and soiling takes time - tamariki may need medicine for several months
What is soiling?
Soiling is when your child has poo accidents in their underwear. Soiling is a common problem affecting many tamariki. It can happen in any child, toddler or teenager.
The medical term for soiling is encopresis.

This illustration shows a child's digestive system, with close-ups of constipation and soiling.
Source: KidsHealth
transcribeTranscript
The illustration shows a child standing with their arms by their sides. The illustration shows the child’s digestive system, with labels for the stomach, large intestine, small intestine, and rectum.
To the right of the child, there are 2 circles showing close-ups of the digestive system with constipation and soiling.
Top circle label: Constipation. Rectum stretched and overloaded with poo.
The top circle shows the rectum full of hard poo.
Bottom circle label: Soiling. Liquid poo leaking out from around the constipation.
The bottom circle shows liquid poo leaking out from around the constipation.
At the top right is the KidsHealth logo with the website: kidshealth.org.nz.
Causes of soiling
Constipation is the main cause of soiling.
Developmental and behavioural factors also play a role in soiling.
How soiling develops
Hard poo
Hard poo is difficult to pass and can be painful. When your child next feels the urge to poo, they may hold on to the poo to avoid pain.
Overloaded bowel
If your child 'holds on' to their poo, the poo gets bigger and harder. This can fill up and overload the bowel.
More poo gets stuck in the bowel and it fills up even more. This creates a worsening cycle.
Over time, tamariki can lose the feeling or 'the urge' to poo.

Illustration of the constipation cycle.
Source: KidsHealth
transcribeTranscript
This illustration shows the common cycle that can occur with constipation.
The cycle has 3 stages connected by curved arrows:
- Pain - The starting point at the top
- Hard Poo - On the right side
- Trying to avoid pain by 'holding on' to poo - On the left side
The arrows show how this creates a cycle.
Leaking poo
When tamariki have an overloaded bowel, poo can leak out without them noticing. This can be embarrassing and upsetting.

An animation showing soiling happening with poo leaking out around the constipation.
Source: KidsHealth
When to get medical help for soiling
If your child is soiling, see a health professional. You could ask your health professional about your local public health nurses. Public health nurses can be very helpful for your child with soiling.
Call Healthline on 0800 611 116 or see a health professional if:
- your child has tummy pain
- the constipation is getting worse
- your child finds toileting very upsetting
- you are worried
Managing soiling
Treatment for soiling focuses on treating the constipation by making the poo soft and easier to pass.
Find out what you can do to make your child's poo softer and easier to pass.
Constipation Treatment For Children
How you can help your child
Soiling problems can be embarrassing and upsetting for parents and tamariki. It's important not to shame and blame your child.
You could watch the video below with your child.
'Poo hoo' is a story about Tim Thompson who is having problems with sore tummies and sneaky poos.
Source: Continence NZ
transcribeTranscript
Narrator
'Poo Hoo' written by Jacqueline Brown, illustrated by Scott Irvine.
Tim Thompson had a problem. His tummy had been sore for a while...actually since he was sick a while back, but he figured it would go away - eventually.
It wasn't until he was in the warm pool at Mr Paterson's swimming lessons that he knew he had a real problem...a big problem.
And that was just the beginning.
Soon the poo became really sneaky, and sometimes leaked out without him even knowing.
Not knowing what to do about it was the worst bit, so Tim just ignored it and hoped it would go away.
It happened in class...
It happened on the school bus...
Things got pretty lonely...especially when mean Max and his friends called him names and made fun of him.
Getting rid of dirty underpants was beginning to become a problem...
For one thing he didn't have many left, and sooner or later his mum was going to notice. Then he'd be in trouble.
The more it happened the more things seemed to spin out of control, the poos even sneaking into his dreams.
He fought them off as best he could but most of the time he was just plain outnumbered.
[Music]
Then what Tim feared most, happened...
"Tim, we need to talk..."
"I think we need to make an appointment with the school nurse."
[Music]
The nurse explained that she looked after lots of other kids that had problems with their poos too.
"What happens is that the last part of your bowel stays full of poo for too long, then you stop getting the feeling that you need to do poos. Sometimes a little bit of poo sneaks around the side of the harder poo and catches you by surprise."
"Oh" said Tim's dad, "so Tim can't help it?"
Tim held his breath.
"That's right" said the nurse, "until we get the poo cleared out, Tim can't tell it's coming."
Tim let himself breathe again.
The nurse wrote out a routine for Tim.
Then the nurse said "If Tim could have a few days off school while the medicine does its work, that would really help."
"Yes!" thought Tim, crossing his fingers.
Actually, it didn't quite work out that way...
After a few days of following the routine the nurse had given him, Tim finally got rid of all the poo.
[Applause]
[Music]
Back at school things were better, much much better...
...but then in the middle of swimming class, Tim felt his tummy squirm, then churn a little, and he knew he had to go right now.
When Tim got back to the pool, Mr Pringle announced that the school swimming sports would be on next week.
Every night Tim worried.
On the day of the swimming sports Tim's class filed into their seats around the pool. Tim's heart beat fast.
This time it would be OK he told himself, he'd been taking his medicine and following the routine.
Soon it was Tim's turn to race.
His tummy fluttered and wriggled, but this time he recognised it was just nerves.
Tim lined up with the other boys and waited for the starter's gun to fire. Bang! He was first into the water. Max was close behind.
Tim and Max raced stroke for stroke down the pool. Tim knew if he could beat the sneaky poos, he could beat Max.
Just as they reached the end of the pool, Tim gave an enormous kick, stretched out his arms and touched the wall. When he had wiped the water from his face, he could see everyone had finished.
He knew he'd got there before Max, but the others?
After the races had finished, it was time for prize giving.
Tim's name was called out first. He had done it! He had won!
[Music]
The end.
[Music]
Be supportive
Educate and encourage your whole whānau (family) to be supportive and understanding.
Stay calm and be supportive of your child. Remember the poo is the problem, not your child.
Talk to your child's school
Teasing may be a problem for tamariki with soiling. It is useful to talk to your child's school.
Acknowledgements
Animated soiling graphic by Dr Greta File. Property of KidsHealth.
References
ESPGHAN and NASPGHAN. 2014. Evaluation and treatment of functional constipation in infants and children: Evidence-based recommendations from ESPGHAN and NASPGHAN.
Royal Children's Hospital, Melbourne. Clinical Practice Guideline: Constipation.
https://www.rch.org.au/clinicalguide/guideline_index/Constipation/
National Institute for Health and Clinical Excellence, U.K. May 2010 (updated July 2017). Constipation in children and young people.