Friday 23 February 2018

David Coleman: Toilet training - my three-year-old daughter refuses to give up on nappies

Boy in bathroom
Boy in bathroom

I have a little girl who has just turned three. She has been out of a nappy during the day (apart from snooze time) for about six months. However, she refuses to poo in the toilet for me or for the creche (she asks for a nappy).

For some reason she has no problem using the toilet to poo at a childminder, who she goes to two days a week. She tells me that she is scared to go in the toilet. I have tried the potty, promise of new toys, told her big girls use the toilet but with no success.

She did go once in the toilet, but when she started she got distressed and I had to lift her off. I just don't understand why she has no problem with the childminder but does have a problem using the toilet for me or at creche (which she loves). Have you any advice because at three years of age she's really testing the quality of her nappies!

David replies:

Small children can easily develop fears of using the toilet. Sometimes all it takes is for them to have a poo that causes them a bit of pain (perhaps because it is particularly hard or big) when they happen to be sitting on the loo.

Some children get unbalanced when they sit on the toilet and so they can be afraid they will slip into the bowl. Some children get an unexpected splash on to an exposed part of their bum as the poo plops in and the small shock they might get can then escalate to a worry that something is wrong with the pooing itself.

I am not sure, however, that your daughter actually has a fear of using the toilet. I know she says that she is frightened, but her use of the toilet at the childminder's house would suggest otherwise.

Normally I would say that even if a child's fears appear irrational we should take them at face value and respond to them. In this situation, however, I don't think it is anxiety that needs to be addressed.

The fact that she poos okay at the childminder's house is a good thing. It means that she doesn't have any physical problem with her bowels and is not constipated and can learn to poo in all toilets.

If your daughter uses a nappy to poo then she is not "out of nappies" and it may be that the whole of toilet training happened a bit too soon for her before she was physically and psychologically ready.

Trying to toilet train children too soon is a common problem. Lots of parents are keen to rush their children out of nappies to save money, time and hassle. Changing the nappies of infants is nurturing and rewarding. In contrast, changing the nappies of wriggling, argumentative toddlers and pre-schoolers is a chore!

However, there are key developmental signs of readiness that we must wait for, before we train our toddlers. For example, before training your daughter you needed to know that:

- She can pull her pants up and down.

- She can follow simple instructions.

- She has words for poo and wee.

- She has dry periods of three to four hours.

- She has regular and predictable bowel movements.

- She is obvious when going to the toilet in her nappy.

- She indicates discomfort after dirtying her nappy.

- She shows an interest in others' toileting.

- She shows an interest in independence.

In an ideal world your daughter will show all of these signs. However, in certain situations we are forced to pre-empt their readiness because circumstances dictate that they must be trained.

Typically, starting in certain rooms within creches or starting in some pre-schools require children to be trained in advance because the carers/teachers don't have the capacity to be changing nappies as well as all the other tasks.

Rushing children into toilet training usually ends up with frustrations, delays, tears and anxieties about using the toilet. I don't know the timing here but the fact that she struggles at home and in the creche, I wonder if it is related to having some pressure to be trained in order to attend the creche?

You may have felt pressure and anxiety about having to train her in order to attend the creche. She could easily have picked up on this anxiety and associated it with using the toilet both at home and in the creche, leading to a problem.

In contrast, however, there may have been no pressure to 'perform' in her childminder's and so she hasn't had the same psychological block.

So, my suggestion for helping her to get comfortable with the toilet again is to take all the pressure off her and to let it be okay to use a nappy for the time being. Go back to basics in terms of re-evaluating her readiness to train. Check, especially, is she showing real signs of wanting to be independent.

By asking for a nappy to poo I think she is trying to tell you that she isn't as grown up as you might think and wants to be minded still. I think that if you let her be small for a few more months that she will take it upon herself to tell you that she no longer needs or wants a nappy.

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