Toilet Training Problems
TOILET TRAINING PROBLEMS Try a Worry-Free Approach
Though successful toilet training is often regarded as a milestone in a child's life, experts say parents spend far too much time worrying about it. And that can cause unnecessary problems.
''I always tell parents, 'I've never heard of a kid who went off to college carrying a diaper bag,' '' says Jeffrey Fogel, M.D., a pediatrician in Fort Washington, Pennsylvania, and staff physician at Chestnut Hill Hospital in Philadelphia. ''The point is: Even if you did nothing, your child would eventually learn how to use the toilet.''
Most kids are toilet trained by the time they're three, but it's not unusual--or abnormal--for a child of 3½ or 4 to still be untrained, notes George Sterne, M.D., clinical professor of pediatrics at Tulane University Medical School and a pediatrician in New Orleans. Boys seem to train later than girls, he adds.
If there's one word you should keep in mind about toilet training, say the experts, it's relax. ''Toileting isn't something you can force,'' says Dr. Fogel.
But experts also say you can make toilet training easier for both you and your child if you follow these suggestions.
Buy a potty chair. ''A potty chair can serve the same way as those little plastic lawn mowers parents buy for their kids. It's something that helps Junior act like Daddy,'' says Thomas Bartholomew, M.D., pediatric urologist and assistant professor of surgery and urology at the University of Texas Health Science Center in San Antonio.
''Put the child's name on the chair and have him sit on it during a favorite activity--when he's hearing a story or watching a video, for example,'' adds Barton D. Schmitt, M.D., professor of pediatrics at The University of Colorado School of Medicine, director of consultative services at the Ambulatory Care Center at Children's Hospital of Denver and author of Your Child's Health. ''You really ought to have the chair in place and the child enjoying it before you bring up the idea that this is also the place where he should go.''
Step up to a potty seat. If your child is willing, you might start him on a potty seat that goes on top of the regular toilet seat, suggests Lottie Mendelson, R.N., a pediatric nurse practitioner in Portland, Oregon, and coauthor of The Complete Book of Parenting. ''Provide the child with a stool to help him get on and off,'' she suggests.
Or maybe he's ready for the big time. ''Children who are strong enough can learn to go directly on the toilet by sitting backward--facing the water tank--to steady themselves,'' says Mendelson. Most kids want to try out the adult seat as soon as they're able, she points out.
Be a role model. Tell your child what you want him to do, but better yet, show him, suggests Dr. Bartholomew. For obvious reasons, it's best if the same-sex parent performs this particular duty. ''It's like anything else--kids like to imitate their parents,'' says Dr. Bartholomew. '' When they see you use the bathroom, they're going to want to use the bathroom.''
| Wait for Signs of Readiness The biggest mistake parents make in toilet training is to start too soon, experts say. ''All that does is set kids up for failure,'' says Jeffrey Fogel, M.D., a pediatrician in Fort Washington, Pennsylvania, and staff physician at Chestnut Hill Hospital in Philadelphia. ''They know you want them to be dry, but they know they're still wetting. So they feel like a failure, and it lowers their self-esteem. '' You wouldn't push someone who wasn't prepared out of an airplane and say, ' When you feel like it, pull the chute.' It's the same with toilet training, if introduced prematurely,'' says Dr. Fogel. '' You can't expect a child to handle a process he isn't yet capable of mastering.'' Instead, be patient and look for these signs that your child may be ready to start using the toilet. * Your child is talking well enough to communicate his needs. ''Although this usually occurs in the 1½-to 2-year age range (when a child is also walking), don't go by your child's age,'' cautions George Sterne, M.D., clinical professor of pediatrics at Tulane University Medical School and a pediatrician in New Orleans, Louisiana. * Your child is obvious about having a full bladder or needing to defecate. '' You can usually tell this if the child suddenly stops what he is doing and runs behind the couch or into a corner,'' says Robert Mendelson, M.D., a pediatrician and clinical professor of pediatrics at Oregon Health Sciences University in Portland. ''Some children may grab their genitals, others may do 'the pee-pee dance,' as some parents call it, or do a lot of squatting and grunting,'' adds Barton D. Schmitt, M.D., professor of pediatrics at the University of Colorado School of Medicine and director of consultative services at the Ambulatory Care Center at the Children's Hospital of Denver. * Your child wakes up dry fairly regularly. According to Dr. Fogel, '' You can say to your child, ' You've been dry now for a few days, and we're very proud of you. Would you like to wear your big-boy pants?' If he says yes, put him in the pants and get on with life.'' |
Skip the transition. Though it may be tempting to use the diaperlike transition pants, Dr. Fogel doesn't advise it. ''That sends a mixed message to kids,'' he says. '' We're saying to them: ' You don't like those big bulky diapers? Fine, here's something that's thin, it's light, it looks just like underwear but you can pee and poop in it.' That takes away the big incentive of graduating from a diaper into the big-boy or big-girl pants.'' If protecting clothing and furniture is a high priority, and your child stays dry 95 percent of the time, you can buy training pants that are simply underwear with a padded crotch. They don't eliminate leaking, but they do reduce it, says Dr. Fogel.
Make a fuss over success. ''Provide extra attention or play a special game if your child has a successful elimination in the toilet,'' says Cathleen Piazza, Ph.D., assistant professor of psychiatry at Johns Hopkins University School of Medicine and chief psychologist of the neurobehavioral unit at Kennedy Krieger Institute in Baltimore. She suggests that you give your child a particular toy, stickers or a favorite food item as a toilet training reward.
Find out what motivates your child. '' You can give children reasons to use the potty, but they have to be reasons that matter to them,'' says Dr. Fogel. He suggests that you listen to your child's cues. ''For example, if your kid sees the big-boy underwear in the store and says, 'Oh, look at that, the Ninja Turtles,' you can say, ' Well, when you're fully dry during the day, you can have them, too.' That way, the motivation is coming from him,'' says Dr. Fogel.
Don't let the bathroom become a battleground. Don't ever fight with your child about using the toilet. ''Fighting is counterproductive,'' says Dr. Fogel. Instead, think of toileting as a skill that will come naturally, given some time and patience. ''It's like any other developmental milestone,'' notes Dr. Fogel. ''A child has to want to do it and be able to do it. Just as you can't force a child to walk, to crawl or to roll over, you can't make him use the toilet.''
Parents who try to force the issue risk getting locked into a ''battle of the bowels'' that could, if unresolved, require the help of a professional therapist, says Dr. Sterne.
If he starts withholding, back off. It's a clear sign that a child is not ready to use the toilet if he begins to withhold stools, says Dr. Sterne.
''If that happens, back off,'' he says. ''Say, ' You don't want to use the potty? Okay. If you want to wear your diaper, wear your diaper. I can see you're uncomfortable about letting go.' ''
Withholding can also occur because of fear. ''Some children are afraid of falling into the toilet,'' says Dr. Sterne. ''Others may get scared if you flush the toilet while they're still sitting on it. You may need to give your child more time to get used to the whole idea.''
