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Toilet Training Challenges and Solutions

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Are you having troubles with toilet training your child? Don't worry——that's completely normal. Below, Pampers parenting experts identify some of the most common challenges your child might face and tell you how to handle them.

Find your child's stumbling block below and get the solution!

 Accidents

 Bedwetting

 Boys Refusing to Stand

 Dribbling

 Going in Hidden Places

 Setbacks

 Smearing

 Special Concerns

 Staying Dry at Night

 Traveling and Public Bathrooms

 Withholding


Accidents

 

Most children have accidents after being toilet trained. When your child has an accident, clean it up calmly and have him help. This gives the message that toilet training is his area of responsibility. Make it clear to him that helping is not a punishment.

Accidents most often occur in times of stress (e.g., the arrival of a new baby), when a child is ill or in a new environment (e.g., Grandma's house), or when constipation is emerging. Tell your child that these things happen and that other kids have similar problems. Always take along an extra set of clothes when a child under 5 is outside the house, just in case; a quick change minimizes the embarrassment.


Bedwetting

 

Return of bedwetting. If your child has been consistently dry for three to six months or more (see Staying Dry at Night) and then starts to wet the bed again, the cause may be psychological or may indicate disease. Consult your child's health care provider unless the stress is obvious and resolves in a week or two.

Prolonged bedwetting. A number of children continue bedwetting after age 6. At this age, about 10 percent of children consistently wet their beds, and at age 12, as these kids enter adolescence, about 3 percent still have this problem. For these children, bedwetting is usually related to the maturation process of the brain and bladder connection. Talk to your health care provider if your child is still wetting the bed at age 6 or older.

Here are some strategies and treatments that may help, provided your child is motivated and willing to work at it:

    • Bedwetting alarms are battery powered devices that are attached to a child's pajamas. If a sensor detects any wetness in the pants, an alarm goes off. The devices help a child establish a pattern of nighttime responsiveness to bladder signals. They work best for children at least 6 or 7 years old. After three to four months of consistent use, about 75 percent of children conquer bedwetting, although some relapse may occur. However, these alarms aren't a good choice for deep sleepers——children who don't stir when a normal alarm goes off or who don't respond to a parent's attempt to wake them.
    • Prescription medications are effective in selected circumstances. DDAVP is a synthetic form of the hormone that causes the body to retain water through reducing urine production. The drug is expensive and its success rate varies widely. It may be handy for occasions when bedwetting is a particular problem, such as a sleepover or a week at camp. An older medication, Tofranil (imipiramine), is actually an antidepressant but acts in this context by lightening sleep and lessening bladder contractions. Both of these medications have minor risks and side effects. Discuss these options with your child's health care provider, keeping in mind that they may not be right for your child.
    • Hypnosis may be another tool to consider. Some studies claim a high success rate for hypnosis in stopping bedwetting. Although kids are very good hypnosis subjects in general, make sure you choose a professional who has specific training in working with children.
 

Boys Refusing to Stand

 

Sometimes little boys will refuse to stand to urinate, having initially learned to sit for this task. Instead of making a fuss, let your son go as he wishes until he's ready to stand up. He'll eventually figure this out.


Dribblers

 

Children who consistently urinate in very small amounts or are "always wet" may have some irregularities in the structure or working of the urinary tract. Little boys should have a strong, arched stream; if not, they need an evaluation. If dribbling comes on suddenly, it could be an indicator of an infection.


Going in Hidden Places

 

If you find urine, wet pants, or stool in strange places— (behind curtains, in play chests, or under the bed, for example—) your child may be feeling too much pressure to please you or worrying too much about accidents. In this situation, reassurance and guidance are much better than scolding. Give her a verbal plan on how to handle an accident: "When those pants get wet, put them in the laundry room and get some dry ones to put on from your drawer." Stay away from personal pronouns and confrontive language in your statement. (Asking "Did you put the poopies behind the curtain?" isn't helpful or necessary. You know who did it, unless you have a houseful of poopy hiders.) Your face will show your disappointment; your words should merely provide directions for a better way to handle the problem. Keep in mind that most of us would like to hide our problems behind the curtain or under the bed if we could.


Setbacks

 

Don't worry about lapses in using the potty. Instead, view them as temporary, expected events. Setbacks tend to occur when your child feels too much pressure from training or in other areas of his life.

When faced with a setback, stay calm, and try to remain positive about toilet training. You might want to put the potty away for a few weeks or months and then try again. Remember, this is your child's task, not yours, even though the process is likely to be frustrating for you.

In general, make toilet training as positive, natural, and unthreatening as possible, so your child feels confident that she's doing it on her own. Often what seems like laziness is immaturity or resistance to pressure. If there's a sudden change in her toileting behavior, look for other areas of stress——those wet pants may be trying to tell you something. If you feel you need help with training, call your health care professional.

If a child has been fully trained for 6 months or more and then goes back to wetting, this may indicate a bladder infection or general stresses in his life. Frequent urination, pain with urination (dysuria), dribbling in small amounts, inability to hold urine (urgency), changes in the appearance or smell of the urine, and unexplained fever can all be signs of a bladder infection. Consult your child's health care provider if your child has any of these symptoms.


Smearing

 

Most children find their bowel movements and their bottoms fascinating. Exploring how BMs feel and smell——in other words, playing in the poop——is normal for the under-18-month crowd. However, pay attention when an older child purposely uses bowel movements for finger painting. This usually is a strong expression of anger about something, not necessarily related to toileting. Work with your child's health care provider to figure out what's going on.


Special Concerns

 

Little girls and very rarely little boys insert foreign objects into their vagina or anus. Crayons, peanuts, and jelly beans are some of the favorites. These objects create irritation and often a very bad-smelling, pus-like discharge as well as a regression in training. Look down there and call your child's health care provider if you notice anything.


Staying Dry at Night

 

Even when your child is consistently dry all day, it may take her several more months or years to master night training, so don't throw away her diapers just yet. About 40 percent of 3-year-olds are bedwetters, for example. If your child refuses to wear diapers, try training pants or put a plastic sheet under the cloth ones on her bed to minimize wetness and damage. At this age, her body is still too immature to reliably wake her up in the middle of the night to go to the bathroom.

Aside from taking your child to the toilet before going to sleep, here are a few other ways to promote dry nights:

 

    • Once your child can stay dry during the day, ask him to hold back a little urine during the day to gain better control over his bladder. Ask him to see how long he can go between trips to the bathroom.
    • With your child's permission, wake her during the night and take her to the bathroom.
    • Put an alarm clock by your child's bed, setting it to wake him at 2 a.m. for a bathroom trip. This tactic requires his cooperation and the ability to awaken with an alarm. Some deep sleepers will stay asleep during a fire alarm.
    • Play a radio softly in her room or keep a light on to lighten her sleep.
    • Keep a nighttime potty by the bed to make it easier for your child to go during the night. Put a plastic sheet underneath to protect the floor from puddles.
    • After age 4 or 5 have your child help change her own pajamas and sheets, not as a punishment, but as part of the process of shifting control to her.
    • Start a sticker chart of dry mornings and reward your child when she has three or more dry mornings.
    • Ban all teasing, negative remarks, and even comments about the problem. Siblings can be cruel, and their comments will make matters worse.
 

Travel and Public Bathrooms

 

Once your child is wearing training pants or underwear all day, you'll need to plan ahead for outings. Before you leave home, try to get her to sit on the toilet. She doesn't need to produce anything, just to try.

Either carry the potty with you or locate the bathrooms as soon as you arrive at your destination. It's unrealistic to expect a young child to wait when he feels the urge to go. Never send a small child into a public bathroom alone. Go with him for help and protection. Model good hygiene by using toilet seat covers or toilet tissue to cover the seat and by washing your hands thoroughly afterward.

If you'll be traveling overnight, carry a plastic sheet for the bed; pack another one as a floor cover if you're using a portable potty. The stress of the adventure can make even a solidly trained traveler accident-prone. Be sure to carry a readily accessible change of clothes when on any outing, even a day trip.

If your child refuses to go in a strange place and is acting painfully overextended, put her in a warm bath and let her know it's okay to pee in the water, as she inevitably will. Once that happens, she'll likely realize that it's okay to go away from home and the problem is unlikely to recur.


Withholding

 

If a child feels too pressured to toilet train or if the process is too stressful, he may begin to withhold urine and/or stool. This can lead to constipation and other complications.

Here are some guidelines for dealing with this problem:

1. Hold off on toilet training for a while. Back off for now and come back to this issue in one to three months, asking your child if she's ready to try at that time. Withholding is a power play that a child will win. So don't engage in combat.

2. If your child is suffering from constipation, deal with that now. The longer the bowel gets stretched out and the worse the pain gets, the harder it is to turn this around. Constipation is both a cause and a result of stool withholding. Children who have experienced painful passage of large, hard, dry stools will attempt to avoid that discomfort in the future. This makes the problem worse, of course, and may result in overflow diarrhea that can't be controlled. Smelly pants, sore bottoms, and distress for all ensue.

Avoid enemas unless they're specifically recommended by your child's health care provider. It's better to deal with constipation in ways that do not create feelings of loss of control.

Treat your child's constipation aggressively with stool softeners, gentle laxatives, and lots of extra fiber and fruit. Eating a high-fiber diet and cutting back on dairy products can help soften the stool. Avoid large amounts of apple juice or bananas, which can lead to hard stools. Since children can resist being forced to eat nutritious foods——and since they often learn best by example——eating a high-fiber diet yourself will encourage your child to eat well, too.

If the problem isn't solved in a week, call your health care provider.

 

 
 
 
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Member comments

how to get three year old daughter to stop peeing all over my house
if anyone could come up with suggestion for how to get three year old daughter to stop peeing all ov..

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