Going potty with toilet-training stress

Toddler on a toilet seat showing the feet and used disposable diaperQ: I have a problem with potty training that has left me completely stressed out. I have tried many other channels for help but, sadly, there does not seem to be anyone who can give me guidance on this.

My daughter is 31 months old and we have been potty training her for three months. She has a 17-month-old brother. She has never asked to go to the toilet. She will go, reluctantly, if I bring her, but not once has she actually told me she needs to go. She wets herself at least once or twice a day if I miss asking her if she needs to go.

I have tried stickers, rewards, books and talking to her, and I have never been cross or annoyed with her when she wets herself. I believe in talking and asking and explaining, but this is now really getting to me. We have to have her potty-trained for playschool in September.

I will do anything to sort this out. I am very hands-on, and explore all options, but this is one problem that I am lost on. Please advise or let me know where I can get some help.

A: The age at which children are ready to be toilet trained varies greatly, and many children are not fully ready to learn when their parents start the process.

While some children might be ready to learn at two years of age, many children are not ready to learn until they are at least three. Sometimes children appear to learn at an early age – and indeed you often hear parents boasting that their two-year-old was trained in one week – but many of these children have not mastered the process and are much more prone to later setbacks, accidents and even ongoing toileting problems.

There can be big pressure to get children toilet trained by certain dates – for example, the start of preschool – or to complete the process at certain times, for example, during a two-week break over the summer when the parent is off work.

However, pressure rarely helps the toilet-training process and frequently it can be counterproductive. For example, if you get into a battle with your child about toileting, this can lead to them avoiding using the toilet or starting to hold in their poos, which can lead to constipation. Below are some ideas for helping your daughter:

Take a pause in the toilet-training process
If you feel it is not working, it is a good idea to pause the training. If you find yourself getting frustrated, it can be a good idea to take a break and to make a plan to return to it later.

You still have plenty of time before preschool starts in September, so you could easily take a break for a few weeks and return to using pull-ups for a while and take all the emotion and pressure out of the process. Then you can return afresh to toilet training at a future date, when your daughter might be more ready and you have more information about what she needs to learn.

Take time to notice what stage your daughter is at in her learning
It is very important to observe your daughter closely so you can understand what stage she is at in gaining self control and learning to use the toilet. For example, while some children can readily control when they do a wee, they may not yet notice the signals when their bladder is full and thus are very likely to wet themselves.

You also have to remember managing bowels is a separate process to managing one’s bladder, and is usually something children learn subsequently. Whereas a child can consciously choose to do a wee, when doing a poo a child has to learn to relax and let go. That is why the emotional atmosphere of toilet training is so crucial.

Tailor your toilet training to your daughter
When you do restart toilet training, the key is to tailor your approach to the stage she is at. A good principle is to give her a small reward for something she does already with the prospect of a larger reward for something new she is learning.

For example, you might start by praising her or giving her a small star if she tells you when she has done a wee in her pull-ups and then extra praise and a large star when she does a wee in the toilet. Or you might use a small star when she just sits on the toilet for five minutes and a special one when she actually does a wee.

Try to make sitting on the toilet a very attractive experience in the first instance: perhaps read books together or play music when she agrees to sit. It also helps to get her agreement about the whole process by using some good child-centred books on toileting and doing up a nice chart in advance with her.

Getting further help
With gentle patience, all children will learn to use the toilet, though it might be a bit later than you might have expected. In my experience there are advantages to waiting until children are fully ready before you teach them, because at the older age they are more likely to learn to fully master the process in one go and it is much more likely to be a positive experience.

While preschools might ask that children are fully toilet trained, in some cases they will negotiate exceptions for children still learning – and even allow them to wear a pull-up for the three or four hours they are there.

If you need any further help, contact your local public health nurse at your local health centre or consult with the preschool teacher. Public health nurses frequently organise drop-in mornings when you can visit and consult them about these issues.

Dr. John Sharry, Irish Times Newspaper, 2015. John writes in The Irish Times Health+Family every Tuesday.