Saturday 24 March 2018

How can my three-year-old's toileting get back on track?

Illustration: Maisie Mc Niece
Illustration: Maisie Mc Niece
David Coleman

David Coleman

Advice from our parenting expert on how to get toilet training back on track and on how to reconnect with an 11-year-old daughter following the death of her mother.

Question: My three-year-old daughter was potty trained before Christmas. Then my husband and I went away for five days and while we were away she got very sick with a throat infection and required antibiotics. A week later she developed thrush in her throat as a result of the antibiotic and didn't eat for a full week. She has completely regressed with regards to doing her poos and is now soiling herself regularly. Could she still be traumatised from being so sick and both of us being away when she needed us? How can we get her toileting back on track?

David replies: Yes, it is entirely possible that your daughter found the sicknesses very distressing and the fact that you weren't there during the initial throat infection may have added to her distress.

A significant disruption, like that, to her equilibrium, may have been enough to disturb the delicate balance of her newly acquired toileting skills.

It could certainly have been enough to cause her to regress temporarily, even if you had been present for the whole time she was sick.

It sounds like she probably wasn't able to eat properly for the two weeks, as I am sure it was quite unpleasant trying to swallow with a sore throat during the initial infection, never mind being unable to eat while she had thrush.

I could imagine that the lack of eating, in addition to the infections, may have disrupted her rhythms, probably changing her pattern or routine for toileting, maybe even leading to constipation.

Most of us tend to do our poos at a fairly consistent time of the day. Some of us are early morning toilet goers, some of us will go within hours of eating and some of us may only go every couple of days. But whatever the nature of our personal pattern, it tends to be quite stable.

However, if we get interrupted by things like sickness, or sometimes travel, or different foods it can throw off those rhythms, causing things like constipation or diarrhoea.

Unfortunately for your daughter, she didn't even have an opportunity to establish a consistent pattern for using the toilet before she was disrupted by the throat infection.

Her soiling may be partially due to this physical interruption to her system and it may be partially an emotional response to needing a lot of minding and attention while she was sick.

I think you may find that it is really helpful for her to talk about the sicknesses and how much she might have missed you and her dad. Talk about how hard it might have been for her to feel so unwell and not to have you there to mind her.

Talk about how it may have been really upsetting for her (and for her tummy and her intestines) to not be able to eat properly and to feel so sick.

Even though she is only three, she will probably get a strong sense that you really understand that it was a difficult time. She will also, hopefully, realise that you do get how disruptive it was.

Then in addition to this emotional understanding you can focus on re-establishing a toilet training programme for her.

Start by trying to recall what her typical pooing rhythm was. When she was still in her nappy, when used she go to the loo?

Use this pattern to try to work out the best times to sit her on the toilet (like concentrating on the mornings, evenings or after food).

Make sure she is comfy, keep her company by being with her in the bathroom, and after five or so minutes of sitting on the loo, let her up. Reward her for sitting on the loo, being ready to poo.

Continue to establish this habit of sitting, ready to poo, and then if a poo comes in the toilet you can add an extra reward and some verbal praise or acknowledgment.

Hopefully the habit of regularly sitting on the loo, with the emotional distress of the sickness behind her, will allow her to start pooing in the toilet again.

If incidents of soiling still occur, treat them, calmly and matter-of-factly, as accidents and stick with the toileting programme.

You can be comforted by the fact that she was able to successfully train the first time around and so, with her emotional world more settled again, it should be straightforward the second time around too.

I worry about my daughter since her mum died and am daunted by having to do 'the talk' with her

Question: I'm a single father of one girl aged 11, and she is approaching the age when she needs to be told about the birds and the bees and all that a girl will go through at this time. Her mum died two years ago, and it has just been really difficult for both of us to come to terms with that. Everything seems pressured and I find the task of parenting really hard. Over the last year she has become more distant towards me and the idea of talking about this with her is daunting. Does this information need to come from me or can I get my sister to do it?

David replies: Discussing the facts of life with your daughter may actually be a secondary issue for you. The need to talk with her about sex and sexuality seems to have highlighted your sense of disconnection with her. That distance between you may be the priority issue to try to deal with.

It must, indeed, be very difficult trying to cope with your own bereavement and also helping her to deal with her bereavement. No wonder you are finding the task of parenting very hard.

How much social and emotional support do you have? Having a shoulder to cry on can be really important when times are tough. It is not that we necessarily need other people to help, or to do things for us, but it is nice to know that others understand and care about the situation we are in.

So, if you have good support from family or friends, do seek their opinion about how you can effectively reach your daughter, emotionally, to try to reduce the distance between you. Maybe your sister might be able to help with the connections too.

If you don't have good support, or if that support hasn't helped, then you may also want to consider getting some professional advice and guidance about parenting your daughter, understanding her and her needs, and strategies to strengthen the relationship between you.

Coming back to the specific issue you are having now, about discussing the facts of life, no the information doesn't have to come from you.

The ideal situation, though, would be for you to feel comfortable to talk with your daughter about all aspects of her development including about sex and all that stuff.

So, even if your sister is the one who has an initial conversation, you still need to let your daughter know that you are open to discussing all of the same issues.

In fact, there is quite a high likelihood that at age 11, your daughter already has a lot of information. Her friends and/or the internet may have given her a particular perspective on sex and relationships.

The job of a parent, however, is always to make sure that the information your child may have already received is accurate and that it fits with your own value system and beliefs about sex.

In your situation, the biggest factor blocking you from talking to her directly seems to be your sense of a distance in your relationship with your daughter, rather than an outright reluctance to talk about sex, sexuality and sexual development and relationships.

However, needing to talk about sex and sexuality might be the perfect opportunity to rebuild or strengthen your bond with your daughter. A heart-to-heart about sex might lead to heart-to-hearts about other things too.

Even if it is daunting or embarrassing, it is a good thing for her to know that you understand about how her body is changing, about periods, about sex, about boys and relationships. This leaves the door open for communication about these crucial issues at any stage in the future.

But, like I mentioned, you may find that if you can talk about these things with her, you can also talk about other important things with her; things like the impact of the death of her mother and the nature of the circumstances that you both find yourselves in now.

Talking about sex, sexuality and relationships might be the catalyst for re-strengthening your relationship with your daughter. Daunting though it may be, it could be a perfect opportunity to reconnect with her.

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