My Child Won’t Use the Toilet at School

A Silent Issue: Children’s Toilet Anxiety

For some children, the school day that begins with the morning bell is not only about lessons and friends. There is another anxiety—unseen, unspoken, yet deeply felt in the body: fear of using the toilet. Recent studies show that a significant number of primary and middle school children avoid going to the toilet at school. This avoidance is shaped by feelings of embarrassment, hygiene concerns, fear of bullying, and lack of privacy. The consequences, however, are not only psychological; they can leave lasting effects on physical health as well.

Holding It In: An Innocent Habit?

According to pediatric gastroenterology literature, prolonged stool withholding can lead to:

• Constipation

• Abdominal pain

• Loss of rectal sensitivity

• Even functional bowel disorders

The American Academy of Pediatrics reports that a large proportion of school-aged children with chronic constipation exhibit toilet avoidance behaviors. But the issue goes beyond the digestive system.

Shame Begins in the Brain

Educational psychologists explain that children’s toilet-related anxiety is often linked to perceived social threat.

“For a child, the toilet is not merely a physiological space; it is also a place where there is a possibility of being seen, heard, and judged.”

The amygdala—the part of the brain responsible for threat perception—interprets shame and fear of social rejection as real danger. In response, the body learns to suppress the defecation reflex. In a very literal sense, the child learns to stay silent with their body.

Not Eating, Not Drinking, Enduring

Mrs. Zeynep, who lives in Istanbul, realized the seriousness of the problem when she noticed her 12-year-old daughter returning home with an untouched lunchbox:

“She confessed to me. She said she didn’t eat at school so she wouldn’t have to use the toilet.”

This behavior is also commonly reported in research. Some children deliberately avoid eating and drinking to prevent the need to use the toilet. As a result, attention problems, learning difficulties, and a decline in academic performance can follow. Fear of Bullying and Silence

In middle school, the picture becomes even more severe.

Thirteen-year-old Mert never enters the school toilets. His reason is simple, yet unsettling:

“Older kids kick the door.”

Students who spend a long time in the toilet may be mocked by peers waiting outside. Bullying, especially among boys, significantly deepens toilet anxiety. Experts emphasize that what is most damaging is not the incident itself, but the possibility of it happening.

With the thought of “what if?”, the child spends the entire day controlling their body What Can Parents Do? Experts agree on one key point: This is not something to be ashamed of.

Psychologists stress that parental attitude is crucial. Forcing, threatening, or belittling increases anxiety. Empathy, on the other hand, calms the nervous system.

Some recommended steps include:

• Bringing up the topic calmly and without judgment

• Asking “What might be making this difficult for you?” instead of “Why don’t you do it?”

• Collaborating with school administration with the child’s consent

• Requesting access to quieter toilets or special permission cards

In some schools, allowing children to use the toilet during quieter class times dramatically reduces anxiety. Normalization: The Power of Science Another important step is separating knowledge from fear. When children are taught, in age-appropriate ways:

• What stool is

• Why it forms

• Why the body needs to eliminate it

uncertainty decreases. Some families even use humor. Laughter activates the parasympathetic nervous system, helping the body relax. A Silent Public Health Issue School toilets are often overlooked in terms of cleanliness, safety, and privacy. Yet experts argue that these spaces are just as important for child health as classrooms. Because when a child learns to postpone their most basic bodily needs, they may later learn to postpone their emotions, boundaries, and needs as well.

And this is not just a toilet issue.