In the majority of cases, when a child has bowel movement issues, it's due to retention. Many toddlers don't like how it feels to use the toilet when they defecate. It's unnatural after several years of using a diaper. The feces fall into the air and seem lost, or it takes too long. Boys, in particular, often do not like sitting still and waiting. They'd rather be on the go, which usually makes them have to go.
Once a child starts retaining his feces, for any reason, constipation begins to occur. This exacerbates the problem. The child feels pain and distress while defecating and doesn't want to go. If this continues, he may need to see a doctor and take laxatives. By this point, the problem has been created and it's hard to overcome. Parents have to be diligent to prevent recurring constipation so he can overcome his fears.
Children that don't want to defecate can be given a diet that is high in fiber and fluids. Consuming plenty of fruit, vegetables and water is the key to getting things moving. Prune juice or prune puree can also help a child that is constipated or has a history of constipation. This will stimulate defecation. Watch the child vigilantly over the next hour. Put her on the toilet whenever you see signs that she needs to go, such as squatting or grunting, or every 15 minutes. Sing a potty training song or rhyme to remind her of her job and create a cue. Praise her when she goes on the toilet.
Not all children hold their bowel movements when toilet training. Some children run to the toilet every five minutes and try to defecate, others may be dealing with a bout of diarrhea. If your child is frequently using the toilet, consider it part of the toilet training experience and ride it out. He'll soon tire of being on the toilet and will settle into a routine. If he has diarrhea, do the best you can. Stay near the toilet and put him on it frequently. If you have just started toilet training, you may want to use diapers until he feels better. Keep him hydrated and call a doctor if the diarrhea continues for more than a week. Diarrhea can be caused by a food sensitivity, parasites or bacteria. If the diarrhea is severe, causes pain or is bloody, see a doctor right away.
Occasional accidents happen, even after kids have successfully completed toilet training. Consistent accidents or the regular refusal to use the toilet after successful potty training may indicate relapse. Relapse can also happen during potty training -- some toddlers may start training and, seemingly suddenly, take a turn for the worse a few weeks or months in. Most commonly, regress occurs in kids about 3 or 4 years old.
Why It Happens
The concept of control is central to many relapses. Speaking for Huggies, child development expert Dr. Catherine Neilsen-Hewitt says that some young children relapse when they feel they're losing control of their world, which can happen when they start attending preschool, experience major travels, move houses or have a new sibling, for example. Painful bowel movements or sudden fear of the toilet -- perhaps causes by something like a startlingly loud flush -- may cause relapse as well. General stress and pressure can also cause potty training regress, so avoid coming down too hard on your child when she has an accident.
Just as reasons for relapse vary, many methods may help you get your child out of her slump. Try transferring a sense of control back to your child by letting her know that using the potty is her decision. Remind her of the consequences of her decision, such as having to go back to diapers or training pants instead of big girl pants. Keep a visual log of your child's progress to encourage her. For instance, a running count of days since the last accident -- perhaps with a reward marking a certain number of days -- serves as a positive, morale-boosting reminder. If regress happens during training, try easing the pressure. Talk to your tyke about the potty regularly, making her as comfortable with the concept as you can, but wait until she feels ready to dive back in to training on her own accord.
Neilsen-Hewitt estimates that 15 percent of kids are not potty trained by the age of 3, and 4 percent aren't trained by age 4. She notes that toilet training is not linked to intellect in any capacity. Consistent accidents after age 5 may indicate a smaller-than-average bladder, which may require consultation from a pediatrician.
Cultures in India, China and Africa support toilet-training practices that begin within the first 12, and sometimes as early as the first six, months of life. Because babies are typically carried close during these early months, parents in these cultures learn to recognize and subsequently respond to their infant’s elimination cues. While training children to manage their toileting at such a young age requires parental supervision, it comes with the advantage of avoiding the use of diapers and the complications that can come with them, such as diaper rash or chafing.
Training Between 12 to 18 Months
European and U.S. families in the early 20th century preferred toilet-training children between 12 to 18 months. Training in this age window can have its complications. For example, that's also the age range in which your child learns to walk, he might not want to sit patiently on a potty seat as he trains or might have learned to prefer diapers. If your child falls into this category, you can still use this time to reinforce good bathroom behaviors when he is receptive, such as flushing the toilet or singing toileting-related songs.
Training Between 18 to 24 Months
The National Association for the Education of Young Children, a leading U.S. resource for early childhood development and education, along with the American Academy of Pediatrics, suggests you begin trying toilet-training when your child demonstrates an interest through developmental cues that typically emerge between 18 and 24 months of age. Signs of this interest can include curiosity about the toilet, using words like “pee-pee” in relation to the act indicating awareness, showing a preference for clean diapers, and the ability to pull bottoms up and down. When these signs emerge, NAEYC recommends you develop a plan for training that involves patience and consistency as you work to build your child’s toilet confidence.
Older Toddler and Preschooler Training
NAEYC also reinforces the idea that while some children are fully trained by 2 years of age, others take longer to master elimination control. Some studies have shown, however, that those children trained well into their third year exhibited higher frequency of accidents. A 2009 study published in the "Pediatric Journal of Urology," for example, found that those children who began toilet training after 32 months of age suffered a higher rate of a type of incontinence.
Set the example for your child by demonstrating how to use the toilet. Let your child watch you or your spouse -- depending on your child’s gender -- whenever you go to the bathroom. Ask cousins or siblings if your child can observe them using the toilet to reinforce that the big toilet is for people of all ages.
Get a toddler-sized potty seat to place on each toilet in the house. Place a step stool in front of the toilet so his feet can rest firmly while he is sitting on the potty. Set books about going potty on the counter next to the toilet or in a basket on the floor to help pass the time while sitting.
Give your tot the opportunity to try out his new potty seat. Let him sit on it fully clothed, undressed or in a diaper. Read through some of his special potty books that are in the bathroom. Tell him what a big boy he is by sitting on the big toilet.
Dump the contents of your child’s poopy diaper into the big toilet each time he has an accident. Say, “See, this is where your poop goes. Maybe next time you can go poop in the big toilet all by yourself.” Let your child flush the toilet and say, “Bye-bye!” to the contents. Show him how to wash his hands every time use uses the bathroom.
Celebrate and reward your child for each attempt and success at using the big toilet. Create a sticker chart, offer small prizes and take trips to the zoo or park. Offer positive reinforcement and verbal praise to encourage your tot to keep trying.
Things You Will Need
- Potty seat
- Step stool
Do not scold your child for having an accident or not wanting to use the big toilet. Encourage him to try again later when he is ready.
The Actual Toilet
For a child with sensory issues, sitting on the edge of a big gaping hole may be daunting. Try using a seat that attaches to the regular toilet, or a child-sized seat. Feeling safe will help your child get comfortable with using a toilet. If you're adapting the regular toilet, get a footstool to help your kid get himself onto it. Be patient and try a variety of toilet options until you find one that your sensitive child can tolerate.
Wet and Dry
Some children with sensory issues have trouble with the sensation of wet versus dry. The sensation of feeling wet when using a toilet can be a problem for these kids. Let them practice with water in the bathtub. Start with a dry tub and a big bowl of water and a cup. Let your child pour water over her skin to desensitize herself to the feeling.
Tight, close-fitting underwear might feel too similar to a diaper for a child with sensory issues. Try loose-fitting shorts or letting your child go bare bottom at home during potty training. Having a completely different feeling might make it easier for your child to remember to use the toilet when she isn't wearing a diaper. Try setting a special pair or two of shorts aside as "potty pants."
If your child is anxious about using the toilet for sensory reasons, the actual act of eliminating may become more difficult and uncomfortable. Make sure he has plenty of fiber in his diet to help combat that problem. If your child has auditory issues, putting some toilet paper in the toilet before he sits will absorb the sound of urine splashing. If the noise of flushing is part of the problem, let your child practice when he's not actually using the toilet so he can get used to it.
Toilet Training Readiness Signs
According to the Zero to Three website, many toddlers begin expressing an interest in using the toilet around 18 months while others aren't ready until age 3. Toilet training readiness depends on a number of factors, including the ability to stay dry for at least two hours, a desire to use the toilet and a way to communicate the need to go. Parents magazine adviser Linda Acredolo, PhD, believes some toddlers are even ready to begin training at 12 months old. She suggests that signing gives toddlers the ability to communicate the need to go before they can speak the words.
Benefits of Using Signs to Toilet Train
When you teach your toddler signs to communicate with you, she becomes more in control of her own toilet training. If she has to go, she can let you know, reducing potential frustrations stemming from miscommunications between parent and child. Children who learn to sign before they can talk could become toilet trained sooner because the communication barriers are down. And, the earlier your child is diaper-free, the more money you'll save on diapers.
Helpful Signs for Toilet Training
Dr. Acredolo recommends teaching your toddler several simple signs to use while potty training, including the signs for potty, more, all done, wash and good job. There are many published books, web sites and videos designed to teach babies and toddlers age-appropriate signs. Introduce signs to your tot in engaging, fun ways while repeating them often at the appropriate times. Praise and encourage your child when she repeats the signs back to you.
Parenting techniques regarding discipline, learning and general child-rearing often stir up controversy and baby signing for toilet training is no exception. Some believe that children benefit greatly from being able to communicate with signs. Others feel that products and videos touting the benefits of toilet training using baby signing are just out to make a buck off of parents while providing them with questionable help. Parents should educate themselves and employ the potty training method that suits their toddler best, whether it involves sign language or not.