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This may be related to this question, but I'd like a bit more advise on how to deal with delayed #2 training and pre-school.

Our son just turned 4, and he seems unable to recognize that he needs to go #2. There are no problems with #1. When we put him on a potty he does nothing, says that he doesn't need to go, and soon does it into his pants.

Question 1: how can we help him train?

The pediatrician at one point suggested to have him wear underwear instead of pull-ups at all times; I am not sure he's right because that didn't help at all in the last few months and created lots of problems. One of the problem is that his pre-school is refusing to admit him unless he wears pull-ups, siting additional work for the teachers and disruption of routine. If we comply he would feel awkward because all other kids in his group are trained and wear underwear.

Question 2: In your opinion, should the kid wear pull-ups until fully trained? Is the pediatrician right or pull-ups make no difference?

Question 3: Is the pre-school demand reasonable, even though it contradicts the pediatrician's recommendations?

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In my opinion, wearing underwear can be helpful in training for many young children. Some reasons for this are that the underwear makes it easier (and/or more uncomfortable) to feel when a mess is made, because some children may be motivated by the idea of keeping special new 'big kid' pants clean, or because there is a degree of habit involved in messing diapers, and wearing something different can disrupt this habit and remind the child that there's a new way to relieve oneself in play now. It doesn't seem like any of these factors are working strongly for your son, however, since he appears to be unable to determine when he needs to go or control his bowels.

On the other hand, I very much see the school's point. It is far more work to clean and change a child with poop spread through underwear and often the rest of the set of clothes as well, compared to changing a diaper. There is also an increased chance of leaks and mess spreading to other surfaces and requiring cleaning or creating a health and hygiene issue in the classroom.

If you feel that returning to diapers or training pants would be very emotionally or socially negative for your son, or that it would hinder his potty training progress, you may be able to convince the preschool to allow him to remain in underwear by offering a doctor's note with the recommendation in writing. You could also try a compromise on something like cloth training pants, which less diaper-like but contain the mess a bit better than regular underwear.

In the mean time, I think you should check out the encopresis tag and see if you find any similarity to what your child is experiencing.

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