Q&A: Toilet training my three-year-old is driving me potty
Our three-year-old boy is potty trained but only for 'wee'. He still insists on wearing a nappy when he wants to go for a 'poo'. He is adamant that he does not want to use the potty or toilet. He has normal bowel motions and does not appear constipated. I started toilet training him shortly after our baby daughter was born. I don't want to put any pressure on him but am getting frustrated at this point. Any suggestions you have would be really helpful.
Your child obviously has bowel control and is very close to being completely potty-trained. However, he is uncomfortable sitting on the potty and doing his 'poo'.
This is a common concern I come across and in my experience it is more prevalent in boys than girls. There are a number of reasons why children develop potty/toilet resistance for bowel movements.
Fear
There are many reasons a child may dread using the toilet. They may have had a previously bad experience or they're just afraid of the flushing sound or the noise of the bowel movement dropping into the toilet. They may also not actually like sitting on the toilet or potty.
Fear of using the toilet can be overcome through practice and a little reassurance.
Discomfort
As toilet-training coincides with terrible twos and children asserting their independence, there are often changes in their eating habits. It is not uncommon for a child to experience constipation or other changes in their bowel movements stemming from a change in their diet.
Sometimes all it takes is one bad experience to create the fear of a repeat next time they use the toilet. When toilet training, make sure you give your child plenty of fluids, fruit and veg.
Delay
Related to both discomfort and fear, many children who have had negative bowel movement experiences will attempt to delay or avoid using the toilet in the hope of preventing a repeat of the experience.
Sometimes, with strong- willed children, it may have nothing to do with technique but may be the child knowing that they can control this situation.
Here are some additional factors which may cause potty/toilet resistance:
Being pushed too early or fast, before he was ready.
Severe punishment for not using the potty or being forced to sit on the potty.
Haphazard training, especially among different caregivers.
He may have had a painful bowel movement from being constipated. If this is the case, treat his constipation and wait until he is having regular, soft bowel movements before you begin training again.
He may just be stubborn and is involved in a power-struggle with parents and is using his control to decide where he is going to have a bowel movement.
All children love attention, and some enjoy the negative attention they get from not using the potty.
Although rare, there may be medical conditions which delay bowel training. Talk to your GP, public health nurse or practice nurse if there appears to be ongoing problems.
What to do
Talk to your child about pooing in the potty but not when he needs to go; maybe during a quiet time in the afternoon, for example.
Ask him why he doesn't like to poo in the potty/toilet. Tell him that everybody does it. Explain what constipation is and why it may happen.
Take your son and show him there are only a few nappies left so he learns to poo in the potty (keep the chat light, remind him you are there to help him). If after a day or two it turns out he is not ready then don't make a big deal and say you found a nappy.
Stay calm, even if you are finding it difficult, as your child will pick up on this. Never punish accidents.
Ensure he is having a well-balanced diet with plenty of fluids, fruit and veg. If your son is afraid of the toilet you may have to start by taking him into the bathroom, put the seat cover down, put him on your lap and read a book.
When he is on the potty or toilet ensure there is plenty of support for his feet and bottom because sitting correctly on the loo properly supports the muscles in his abdomen to help with pushing. A foot stool is very helpful here.
Get your child to lean forward as much as possible while sitting on the potty. This will help to open up and relax the pelvic floor muscles which must happen every time you pass a bowel movement. A toilet seat fitted to the toilet can give an anxious child added security.
new routine
Like many children, your son has gotten into the habit of a poor routine -- when he needs to poo he goes in his underpants or you give him a nappy and the cycle keeps going around.
You need to wean him away from the habit of pooing in his underpants or soiling his nappy by establishing a new bowel-movement routine that involves the potty or toilet. Rather than becoming annoyed at him for pooing in his underpants, invite him to use the potty in a positive way.
Some children are frightened by the flushing sound of the toilet so avoid flushing the toilet while your child is sitting on it. However other children are fascinated by the sound. They like to see the water flushing away.
This can be used as a reward for using the toilet successfully. A few drops of food colouring in the cistern will change the colour of the water. Changing the colour at each flush may encourage your child to flush the toilet.
Adapt a matter of fact approach to toileting routine. Strive to reduce blame and promote a team approach. Ideally your son should spend five to 10 minutes after each meal on the toilet.
Say something like 'it's time to sit on the toilet.' Having comics or books to read, or toys to play with, helps make the session more interesting. I often suggest toilet toys, these are toys only played with in the bathroom.
Offer your child rewards or incentives to stay on the toilet. If your child refuses to sit on the loo or potty, give them praise for remaining in the bathroom.
Younger children may prefer instant rewards, ie stars. You could use a silver star for sitting on the toilet and a gold star for a poo in the toilet. Do not reward for clean pants as this may encourage your child to hold onto his poo and as a result become constipated.
Watch your child carefully when they show signs of withdrawing, take them off to the toilet even though they refuse to sit on it. Do not force them onto the toilet or potty.
Make the toilet room pleasant, comfortable and safe place. While your son is still insisting on using his nappy for poo, continue to bring him to the bathroom.
Next, sit him on the potty or toilet to have his bowel movement, even if he continues to wear his nappy. Then work on getting his nappy off by opening it and eventually taking it off.
Continuity and persistence are essential. The prompted toilet routine should follow your son on outings etc.
Even though progress may be slow and erratic at the beginning, your son will develop an understanding that you are in control and will not give in.
- Grainne Ryan
