Potty training puzzles
Q: “I am desperately seeking some advice for my almost two-year-old daughter. She has had a potty and toilet seat since she was 15 months old and enjoys sitting on both. However, the moment she actually needs to pass water or stools she holds herself whilst throwing a complete tantrum. She cries out for a nappy and the moment we put it on, she goes in her nappy. She even plays with her dolls on the potty and is not scared of the flush as she insists on doing it for me. She claps when I use the toilet and gives me a hug. I am not sure where we go from here. Please advise.”
Elizabeth says:
If your child seems totally clueless – she probably is. For her entire life she’s peed and pooed in her nappy and never even noticed this elimination. Now you want her to not only notice, but hold it, and then put it somewhere else! She may see sitting on the potty as a clever game but have no idea what it is intended for. It’s time to read children’s toilet training books; have a sibling or friend or parent demonstrate; give a few step-by-step lessons; and maybe even have some bare naked play-time before the bath to help her see and feel what’s happening down there. You might even have a jump-start training weekend. Pick a time you will be at home. Give her lots and lots and lots to drink and visit the potty often. Catch and reward success but don’t be too intense or demanding. Follow up with several months of relaxed but attentive reminders and teaching.
Q: “My son is 3 and we have been trying to toilet/potty train him since the health visitor said to do it when he was two years old. We had a bit of success, but now he would rather mess and wee in his trousers. He does not care if he has a wet or has messy pants. He is due to start nursery soon and we would like him dry by then, as I am really worried they will not take him on.”
Elizabeth says:
It’s possible that your child has tried, but feels overwhelmed. You may be transferring the pressure that you feel since you were told it was time to train, and even more pressure about his nursery deadline. He may have had high expectations for himself and feels he’s failed both of you. He may just need more understanding that this isn’t a one-day job, but will take some time to learn. Praise him for the things he can do, no matter how small, and build from those. Pressure to rush may be holding things back, but a positive, encouraging outlook will likely boost your success.
Q: “My son is almost four and still wears pull up nappies at night. How can we get him to stop wetting his bed?”
Elizabeth says:
I did a great amount of research on bedwetting for my books on potty training and sleep. The most important thing I learned was that the common reasons for bedwetting are biological. A child’s kidneys aren’t sending a signal to his brain when he’s asleep, or his bladder hasn’t grown large enough to last all night, or he sleeps very deeply. Most often, as children grow, all of these conditions are self-correcting.
For a bedwetting toddler or preschooler the solution is simple: allow your child to sleep in nappies, absorbent pants, or use a waterproof mattress cover until he begins to stay dry all night.
You only need to take action about bedwetting if your child is seven years of age or older, or if there are other symptoms of a sleep disorder, such as loud snoring.
You can help a child to stay dry at night by doing the following:
• Make sure that your child uses the toilet often during the day, about every two hours. This encourages normal bladder function.
• Direct your child to use the bathroom if you see signs of the need, such as squirming or wiggling.
• Avoid food or drinks that act as stimulants such as chocolate, sugar and caffeine, particularly in the hours before bedtime.
• Encourage adequate daytime liquids, and limit liquids for an hour or two before bedtime. You don’t need to cut out liquids entirely since this reduces the amount of urine, it doesn’t stop the reasons for bedwetting.
• Make several pre-bed trips to the bathroom – one at the very end, just before lights out. Make certain that your child finishes emptying his bladder by relaxing for three to five minutes. A timer can help your child know how long to sit. You can keep him company - talk, read a book or tell a story.
• Use a waterproof mattress cover on the bed. Once fully daytime trained, absorbent pants or nappies might delay the normal development process since a child can’t feel when urination occurs.
• Use positive reinforcement with a sticker-chart to help him monitor his success.
• Keep a night light on for a clear path to the bathroom.
• Avoid placing any blame on the child, and don’t make him feel guilty or ashamed. Let him know that it’s normal and will take time to change.
If these ideas don't work, and if your child is over age seven, a specialist can help direct you on the use of bed alarms, bladder-training exercises, diet changes, therapy or medication.
“My daughter is four in January and we are in her second year of toilet training. We’ve tried everything from reward charts, days out, small sweets/fruit as a reward and stickers! She loved those, but she’s now at a point where she will take it off herself and say ‘oh dear, well maybe next time.’ She’s recently started nursery, but she remains dry during the two hours she’s there, plus she is dry through the night. We’ve even tried small punishments like the naughty step, but she doesn’t mind that and takes herself to it most of the time if she knows she’s done something wrong. After two years and no improvement, we’ve run out of ideas. Any suggestions please!!”
It seems like you’ve done a great job of treating accidents as a normal part of training, and that’s where her comment of “Oh, dear. Next time.” comes from. That’s good, but at this age, and since she proves she can stay dry at nursery, it’s time to increase the expectations.
Your child may not be hearing her body when it tells her it’s time to go, or she may not be urinating often enough so her bladder isn’t reading properly. Or she may get so busy with her play that she tries to wish it away, or she thinks she can hold it much longer than she can.
You can help by setting an alarm for every hour and a half and ask her to sit on the toilet. Increase her drinking of water about twenty minutes before the ringer to make this even more effective.
At this point I’d remove the sticker chart, as she obviously isn’t motivated by this, but she does understand how it words. Change up the idea and put up a page with twenty squares and let her pen an X on each day she stays dry all day and have a planned prize for the end – such as a trip to her favourite park with an ice cream afterward.