Toileting issues can cause anxiety and embarrassment for a child, and worry and guilt for a parent. If you are encountering issues with your child’s use of the toilet, you are not alone. There are steps you can take to address the issue and, most importantly, your child will very likely resolve their issue in time. As a mother of five grown children, I experienced toileting challenges in potty training and bed-wetting, so I can relate directly to the concerns a parent feels. As a pediatrician, I regularly consult parents on three common toileting issues.
Issue one: Complete refusal of the toilet
There is no right way to potty train a child. Every child is different. As a general rule, though, most children are potty trained by two and a half to three years of age. If your child reaches three and a half and completely refuses to use the toilet to either urinate or have a bowel movement, I recommend trying a particular technique that I have seen be successful numerous times – drop the diapers!
What I mean by “drop the diapers” is to literally remove the diapers from the equation. This technique takes tremendous patience and persistence. A parent must set aside two to three days and stay home. They need to encourage their child to use the toilet every time they feel the urge to urinate or have a bowel movement. If they refuse, stay calm and try again next time. The first day is likely to be a bit messy and sometimes the messes persist through day two. Don’t give up! Often by the third day, the child tires of the messes and cleanups and relents to using the toilet.
Issue two: Using the toilet only to urinate
It is not uncommon for a child to be scared and refuse to have a bowel movement on a toilet, particularly on a strange toilet. This behavior is often called stool withholding. It is very important to address this issue early. Ignoring it or believing it will just go away on its own could lead to physical and emotional issues for your child down the road; and these issues can be more difficult to treat.
In most cases, these children are willing to have a bowel movement in a pull-up. If that is the case, there is a technique I frequently recommend to parents. When the child feels the urge to have a bowel movement, have the child sit on the toilet with a pull-up on at the same time. For this to work, the child must have their feet placed firmly on either a stool or the ground and a hole must be cut in the rear of the pull-up through which the stool can pass. This approach allows the child to retain the sense of security they feel with the pull-up while, at the same time, experiencing the safety and satisfaction of going on the toilet. Often very quickly, the toilet becomes much less scary.
If this technique does not work for you, know that withholding stool is usually behavioral and completely treatable. At this stage, it’s important to consult with your pediatrician to develop a treatment plan specific to your child.
Issue three: Bed-wetting
Approximately five million children over the age of six in the United States wet the bed, according to the American Academy of Pediatrics. Two of my sons had this issue. From personal and professional experience, I can confirm that a parent cannot train their child out of bed-wetting. Frustration and anger are natural feelings for parents, but I highly encourage them to recognize that expressing those feelings can only make the problem worse. A parent’s expression of anger only adds to the shame and embarrassment the child likely feels already.
The technique I most commonly recommend for parents who bring this issue to me for the first time is to recognize that they really have no control and commit to waiting it out. In addition, they need to acknowledge that their child would benefit greatly from their proactive support. A good way to position the issue with them is to simply explain that it’s not uncommon for kids to wet the bed and that it means part of their body is taking a little longer to grow up.
Most children mature out of bed-wetting. If your child reaches the age of eight and is still wetting the bed, it would be wise to consult with a pediatrician to determine if a treatment plan is necessary. There also are medications that can be used that help the body make less urine during the night or even relax the bladder.
Toileting issues are not uncommon. They definitely test parents’ patience, but there are techniques to address the issues, as well as support of a pediatrician when appropriate. Good luck!
