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Potty Training Problems

Despite everyone's best intentions, your student in Toilet Training 101 may notfollow the curriculum you've set forth. Some possible glitches include the following:

Potty training problem is a developmental and physiological issue, not one involving laziness, lack of intelligence, disobedience, or contest of wills. It's important that your child—and you—not feel like a failure over toilet training.

Make sure the problem isn't your own time pressure, perhaps manifested bynonstop nudging about "getting rid of those diapers." You need not worry thathe's going to enter first grade in diapers, no matter what the in-laws or neighborssay. However, if you have been working with your child for a few months andyou're not getting anywhere or he's reached his third birthday with no control insight, talk this over with his physician.

There are a number of possible causes for bathroom backsliding. Has there been a significant change in his life? A move to a new house or even a newroom can rock his boat enough to disrupt the plumbing control. Even more chal-lenging is the arrival of a new baby, who may suddenly become the center of at-tention. He may have come to the conclusion that doing what the baby does is agood way to recapture adult interest. Take some time with him—perhaps at bed-time or during an outing to get a special treat—to sound him out. Is he worriedabout something or someone? You may be surprised by his answer, and the timeyou spend with him might solve the problem.

Another possibility is that he is becoming so engrossed in play (especiallywith new toys or neighborhood cohorts) that he ignores nature's call until thelast second—and then it's too late to get to the toilet. You may need to reinstitutesome reminders about using the bathroom throughout the course of the day.

A possibility that is less likely but should not be overlooked is a bladder in-fection. Because their urine travels a shorter distance from the bladder to theoutside world, this type of infection is more common in little girls. Clues thatmight suggest this problem include vague complaints of discomfort in the lowerabdomen, an unusual and unpleasant odor arising from the urine, unexplainedfever, or the appearance of urine in the underwear. The classic adult symptomssuch as burning, stinging, and the need to void frequently are not commonly ex-pressed by children.

If you can't figure out why your toilet-trained child sud-denly isn't making the grade, consider having the urine checked at the doctor'soffice.

Sometimes soiling his pants is a sign that he is constipated, with liquid stoolleaking around a solid plug that is stuck in his rectum.

To break the mounting tension, you will want to help the next few stools exitas painlessly as possible. A little lubricating jelly gently applied to his anal areanvo or three times during the day and perhaps some anti-inflammatory oint-ment prescribed by his doctor (if there is local irritation that needs to be calmeddown) will make the passage of stool less risky for him. You will have to sell himon the idea, however, before he tries again.

In order to "prime the pump" and start the bowels moving, you might con-sider letting him use diapers again for a few days, especially if he's a new convertto using the potty. The diaper may seem a safer place to let the poop come out,but let him know that he'll be able to use the potty again soon.

'We know he's ready to use the toilet—in fact, he's done it a few times—but he re-fuses to cooperate, and we know he's not constipated:' Make sure there aren't anyunexpected reasons for his resistance. You might take him step-by-step throughthe motions by playacting with a stuffed animal who "needs to learn to go potty"and see if he'll talk to you about what the animal is thinking. Perhaps he is wor-ried about falling into the big toilet and being flushed away. Or maybe he saw acommercial or cartoon in which some creature came out of the toilet. Whateverit is, don't laugh at him, but calmly separate worry from reality.

If there are indications that "all systems are go" but he won't, and the prob-lem appears to be flat-out balking, you may want to give him a friendly nudge inthe right direction. When he comes to you wanting to have his diaper changed,for example, take your sweet time before you attend to this chore, and when youdo, make it cool and businesslike. On the other hand, if his diaper has been dryafter a few hours, make a pleasant fuss about it and exclaim how grown-up itwould be to use the potty and not need diapers anymore. It may help to offer apleasant incentive (some stickers, new underwear, or an outing he would enjoy,for example) in exchange for a designated period of daytime potty cooperation.