Obstacles to Toilet Training

September 06, 2008

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Obstacles to Toilet Training

by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.

With very few exceptions, almost every child eventually masters using the toilet. If you're lucky with your children, toilet training (or, as I prefer, toilet learning) can be a walk in the park. It certainly was for our daughter. She watched, she played around with the potty, and one day she just started using it. My sense from many years spent talking with parents is that this happens a fair amount of the time.

On the other hand, all too often the road to toilet mastery is steep and rocky. The problem might start with a parent who is overly demanding or impatient, or with a child who is unusually strong willed or apprehensive (or with a combination of child and parent characteristics). Whatever the cause, when children and parents find themselves locked in a no-win battle over the potty, both can become exhausted. A stressful toilet-training experience can lead to long-term problems with constipation, encopresis (defecating in one's pants), or bed-wetting. And when parents turn to harsh forms of discipline to try to compel their children to use the toilet, psychological problems can be the unintended result.

Despite the fact that it's a universal experience, the process of toilet training is controversial. Most experts favor a child-oriented approach, waiting until the child is ready to take an active role. Others advocate starting much earlier, using routines, rewards, and punishments to train the child to use the potty. The truth is, neither approach guarantees that the process will be easy or free of all problems. Whichever way you choose, it helps to be aware of the obstacles you might face along the way:

Expect setbacks. Setbacks are a normal part of children's growth and development, not only in toilet training, but in every area. When learning to talk, for instance, it's common for a child to use a new word for several days, then seem to forget it for weeks or months, before picking it up again. With toilet training, a child who has recently become comfortable with the potty often starts wetting or soiling again for a while. Even after three or more months, setbacks can and do happen.

Sorting out the setbacks. How can you know whether to be concerned or not? If a child who has been toilet trained for six months or less begins to have accidents, there is a good chance that this is just a routine setback. However, the more time that's gone by, the greater the possibility that the wetting or soiling is a sign of a new problem, such as a bladder infection. Also, most setbacks last only two to three months. The longer the problem lasts, the more likely it is that more than just the usual ebb and flow of development is at play.

Usual causes. The classic cause for toileting setbacks is, of course, the birth of a younger sibling. Most siblings are spaced two to four years apart, so the new baby is very likely to arrive just as the older child is working to get his bowels and bladder under control. As a toddler, demanding to go back into diapers is an easy--and understandable--way to express his wish to still be "the baby." Also, if Mom or Dad has to change his diaper, that guarantees a certain amount of one-on-one attention. Finally, if he feels very angry at his parents for daring to love another baby but lacks the words to express his feelings, he can always "say it with feces."

Other possible causes. Any source of stress can derail a recently learned developmental skill. It might be moving to a new neighborhood or just changing bedrooms. Stress that the parents are feeling--perhaps tension in their marriage or just a difficult situation at work--often shows up as a child's toileting setback. Parents often try to protect their young children by hiding such stress, but young children have a great ability to read the emotional state of their parents. Again, if a setback lasts longer than a couple of months or occurs more than five or six months after a child has been toilet trained, it's a good idea to talk with a doctor to make sure there isn't a medical cause.

Click here to join the discussion on Toilet Training.


RELATED INFORMATION

			When Is Your Child Ready for Toilet Training?
			When YOU Are Ready for Toilet Training
			When Your Child Is NOT Ready for Toilet Training
			Toilet Training

Created July 03, 2001
Reviewed September 18, 2004

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