Alyson Schafer - Parent Expert

Needs to Use The Toilet After Tuck-ins

The Situation

I recently received an email from a distraught mother who complained that every night after tuck-in time their 3.5yr old daughter would call out "mooooomy, I have to go peeeeeeeee" even though she was put on the potty right before tuck-in every night.  

The Way I See It.

I suspect that this 3.5 yr old has discovered a behaviour that mom can't ignore.  If she say "I'm thirsty or I'm hungry, mom might be able to disregard the complaint. But what kind of parent wouldn't respond to a toilet-training-tot when they cry out they need to pee?  After all, we don't want to be inconsistent. We don't want to take a step back in training. We don't want them to be wet all night. So we go and put them on the potty again.  No doubt their is a small conversation, an additional tuck in kiss, maybe even a song.  Its really a very social experience for the child. 

( note: This late night bonus socializing is the "usefulness" of this behaviour that sustains the nightly behaviour that we need to address in finding our solution: undue attention-seeking.)

The Immediate Solution

Loss the "pay off" or social benefit of these extra night-time potty visits mom is making by teach the child self-sufficiency. 

During the day, take time for training (T.T.F.T.).  Show your child how to pull their own pants up and down, and practice wiping themselves. Use might find wet wipes are easier for kids than dry toilet paper.  They can wipe first and then you can be the "checker" until you are satisfied they have the manual dexterity to get the job done properly.   

Once they have this skill, you can either put night lights in the hall and explain that they don't need to call you to go to the washroom; "You are so capable! You can go to the toilet and tuck right back in all by yourself!".  

You may also also opt to simply leave a potty in their room with some wet wipes and hand sanitizer ( again after some TTFT). 

Some children find this new limit exciting and what to test it out, however, after a night or two, most children prefer to void before bed and since they no longer have a successful stalling / attention tactic, they just get on with going to bed.   

The Long Term Strategy

As with all the behaviour guidance tips, you're not going to have long term success unless we solve the unmet goal of feeling encouraged. Every child needs to feel secure about their worth and place of belonging in their social group (the family or classroom).  That means parents need to bring on the encouragement and connecting time with our children during those times when they are not demanding our undue attention.  

Still Pooping Pants at 8 Yrs Old

Do you have an older child who still "holds"?   It is a common problem with children in the younger grades.  They check out medically as being okay, yet when they need to move their bowels, they still won't go use the toilet. 

You plead with them to go sit on the toilet, you discover soiled underwear hidden in their bedroom, you find yourself monitoring their washroom habits to see if they are "producing" anything. You're afraid they'll soil their pants in public if you don't help them train properly.  Right?  Actually --- wrong.  Let's look at what is happening:

Why Older Children Hold Their Bowels

Its our fear that our children can't manage that gets us overly involved and as we begin to micromanage them we usurps the child of their proper role and responsibility for toileting themselves. We rob them of this power. This set ups a power struggle.  The child resists the parental urgings and manipulations.  They are saying "its my body, its my decision, and you can't make me".   They "hold" to win the power struggle.   

What To Do?

The power struggle needs to dissolve.  You need to hand over this responsibility back to the child
and trust him to manage it, accidents and all.  I suggest you teach them how to wash soiled underwear and how to do a load of laundry. At 8yrs, with a a step stool, its as easy as a toaster. Once they have learned how to do that, your life is not impacted by their bowel habits, and
I suggest you tell them so, and let them know respectfully that you trust them to be independent and that won't be mentioning toileting to them again. Ever.

The child will decide in their own time how long they want to hold, how much of
a hassle it is to clean up after, and non of that will be worth if it doesn't set you off!

So, we end the power struggle, empower him, and stop being invested in
try to change the child's behaviours.  They won't change until you get un-invested. If the power struggle still exists, they will feel defeated by you if they change, so they are in essence, "stuck" in
this behaviour. 

You can free them to change by stop being involved in their business.

Constipated Child Won't Push Her Poop

Today I was emailing with a mom who had a 5 1/2 year old that would hold her bowels until she was in pain. Her solution was to have her sit on the toilet and for about 20 minutes. They would sit together and read a book at the end of the time if no bowel movement had come yet mom would urge her daughter to "push" and "try". She emailed because she felt that maybe her daughter was doing all this because of all the individual attention she was getting and was worried that her daughter didn't have regular "urges" to push and go without being told to push consciously.   Here is my reply:

Have you spoken to the doctor? I would want to rule out megacolon which can result from prolonged constipation. The urges can fad with continual holding. If she is healthy- and you are keeping her diet and water on track - I would suggest you let her know with great confidence, that you trust she will figure out her body and learn to listen to it's little signals and that you will no longer be with her in the bathroom "your body is your job - and I am sure you'll do fine with this". If she uses the toilet on her own you can be encouraging by saying "you are really learning to manage your body all on your own!". If she holds again so long she is in pain - you can still be encouraging and say "its okay - your learning to manage to body on your own and it takes some time to learn - don't be upset - what do you think you might try differently?" These statements let her know that SHE has the responsibility of looking after herself, and that you are supportive, encouraging but not dominating or taking charge of the problem and enforcing your idea of solutions. With time she will come to see the merits of moving her bowels as well as she will no longer be gaining any benefits from holding: namely receiving your un- due attention and feeling she is winning a power struggle.

Potty Training Books Coming Out My Ears

Yesterday on the way home from my little jaunt to Montreal to promote my book, I finished the last of the stack of potty training books I am reviewing as my job as a Chapter's Indigo Trusted Advisor.

I am reminded once again why parents pull their hair out over parenting.  These books where all written by people with credentials and while they all espoused the "child-centred" approach, if you actual read the details of what they thought that looked liked - WOW - confusion reigns!

All too often they would say - don't bribe or pressure, but a sticker chart is always a good idea! NO!!!!!

Other books said be respectful and don't pressure, let the child lead - but set a timer and make them sit each day at the same time for a set time. WHAT?

In the end - the one that did impress me was Dr Brazelton's book: Potty Training: The Brazelton Way.  He did an excellent job of explaining to parents potty training from the child's perspective and he emphasizes that a child wants to progress and mature, that with encouragement and confidence they will.  But he digs deep into that concept in a way that I think parents need to really "get" this "child lead" approach. Then he explains in lots of deatils and steps exactly how to do this.

I still want to read more potty training books - but at the moment this one is my top recommendation.

Constipation While Potty Training - A Power Struggle?

I wanted to post as much information on potty training as I can because I know this is such a big issue for parents. We all appreciate connecting with other parents going through the same issues. It's nice to know we are not alone. Here is the full e-mail conversation I had with one mom about her daughter holding her bowel movements until she felt pain.

Here is the in-bound email:

Alyson,

I'm actually writing because I have a question regarding my daughter who will be four in May. I have a second baby on the way, due in April, and a couple months back seemed to finally lick a couple of issues that I was anxious to clear up before the baby came. First, we finally got our daughter to willingly agree to getting rid of her soother back in November. Then in early December, she decided she didn't want to wear pull-ups to bed anymore and promptly began doing number-two in the toilet during the day instead of holding it in all day and waiting till early morning or late at night to go in her pull-up.

In the past, she has had some issues on and off with avoiding number 2, pushing it back in, and a couple of times going for days without having a bowel movement. I think it really turned into a cycle - the longer she went without going, it got more uncomfortable, to the point where when it actually did happen, it hurt so much that it only confirmed her fears. Why she would suddenly begin to resist a bowel movement out of the blue after weeks of no issues remains a mystery to me.

Anyway, about a week ago, we had been going for 6 weeks with no pull-ups at all and no issues with going to the bathroom. When suddenly one day, we could tell she was resisting a bowel movement and instead, went in her bed that night. For the next 6 nights, she went in her bed and on the 7th night we put a pull-up on her at bedtime. We're on about day 10 now and I have resorted to giving her a child's dose of ex-lax (which eventually does work - but at night only).

I'm afraid this has become a power struggle with us. She knows we want her to go on the toilet, and not in her bed. When she spends a whole day wiggling and whining to the point where she is clearly in pain and refuses to eat or sit up in a chair, it's pretty frustrating! We've had some bad-parenting moments when we've given threats, or promised rewards, we've also tried to just ignore it. I've tried to be angry and firm, or friendly and easy going. Nothing is working and we have no idea what to do! I hate to see her in pain, and have tried to explain what happens to your body when you don't let the poop out! Nothing works!

Just so you know, her diet is very good. She eats all vegetables, even broccoli and salad, meat, fruits, grains, whole grain cereal every day, milk, drinks water with meals, occasional watered down juice, etc... I can't imagine it's anything in her diet that's doing this... and our paediatrician has recommended a laxative jelly which softens stool but doesn't seem to break the pattern.

I thought we had it licked when she started going in the toilet, but I guess not! Friends have said this could be because there's a baby on the way, but she seems to excited about the baby, I can't imagine that being the case.

Can you help?

Thank you so much in advance!

Here is my reply:

Hi A,

As for your daughter - she is about the fourth 4 year old that I have helped out that holds their stool until pain. I had one little guy go once every 4 days or so, and he too would stop eating, sitting and he even would vomit from this... Amazing will over the body eh?

I suggest you continue regularly with a stool softener (nothing as hard as ex-lax though - milder - like prune juice or the one your doctor prescribed if she'll take it willingly without a fight).

That will keep the hardness of the stool passage from being a factor while we figure out the psychological aspect. Keep with it unless she gets the runs, but for now, nice soft stools are good.

I think you are correct that there is a power struggle happening. It wasn't power in the beginning, but it became one somehow - perhaps with the parental involvement in solving all the accidents that erupted.

We don't need to figure out the past, we only need to look at the present and the usefulness of the behaviour now. How does this behaviour serve her? In power, it re-asserts the message "You can't make me" and "I'll do it my way, when I want - I am the boss of me".

To use the toilet has now been established as what you want and so she feels like if she does use the toilet she will be "losing" the fight to you.

So - basically - back to square one: to end a power struggle we have to change our internal state. We need to decide that we are not concerned what choice our child makes, have faith that she is a typical little girl who sometime before the age of seven, will decide for herself the benefits of not sitting in her own feces and faith that she will come to prefer the toilet to a diaper in her own time and way.

She seems to not want to be potty trained at the moment. For _whatever_ reasons, she has taken a step back in the process, and you have to be okay with that.

Stop training

• Go back to pull-ups and changing poppy pants but NO talking about pooing or peeing.
• Don't ask her if she would like to go.
• Don't suggest she "try" in case it makes her tummy feel better, etc...

No talking / discussion / reminding / nothing ... It is a non-issue.

Put potty training in the "parking lot" for a year.

The idea behind this is that whenever parents really stop taking an interest, the child no longer feels you are "trying" to "make" them. They don't feel manipulated into behaving the way you want them to so the power struggle ends.

The baby's arrival could play a part, but usually it is after the baby is born when mom is busy changing the babies diapers that the older child mimics being "needy" and "helpless" like the baby, since the baby seems to be given such importance for his "inabilities" - the older child gives it a try too. Freud thought they "regress" - not true. They are experimenting with ways to be important. I hope this helps.

Her reply:

Hi again Alyson,

So I think it's been a week since I wrote you, and we have really put your advice into practice. Almost immediately, our daughter got back to going in the toilet and a few nights ago asked not to wear pull ups at night anymore because she goes poop in the toilet!

I don't know if it will stay this way, but our approach will remain the same!

I can't thank you enough for your advice!!

Kids' Books On Potty Training

During a final parenting class a while ago we were discussing potty training and I recommended a couple of great books to share with your kids when they show an interest in using the toilet or potty.

The first is the wonderfully frank and yet sensitive book by Fred Rogers called Going To The Potty (buy at amazon.com or buy at amazon.ca). This is an older book, but still terrific. It is a big hard cover book that is filled with large photos and simple plain-speaking information and instructions that make it all very concrete. We miss you Mr Rogers!

The second was not so instructional, but a favourite for my kids called The Princess and the Potty (buy at amazon.com or buy at amazon.ca, which tells the story of a princess who would not use the royal potty, so all the servants bring her potties of varying styles but none are to her liking. Then one day they bring her a pair of fancy pantaloons so she wears those instead! 

If you have a favourite potty book, let us know about it in the comment section below.

Potty Training - When to Start and When to Stop

Parents want to know when to start potty training.  Here is my answer:

• Begin "training" when your child is verbal and start by helping them learn the language they'll need like "pee" "poo" "bum"  "potty" "toilet" etc...
• Somewhere in the middle of their second year, you can buy a potty and get some fun children's books about potty training.
• Let them see you using the toilet (if you are like me you have never had a minute alone in the washroom anyways!) and let them "play"/"imitate" you by either sitting on their potty or the toilet (with their pants still on is typical) or putting their dolls on.  This is still about "play" and not "trying" to use the toilet.
• Show them how to dress and undress so they can pull their pants down and up on their own.  Show them how to wash and dry their hands at the sink.  These areas should be kid friendly with step stools and easy to reach soap and towels.
• Look for 2-3 hour periods of dryness and predictable bowel movements each day. 

Body maturation and awareness comes in three stages: "I peed", "I am peeing", and "I have to pee". While they share "I peed" and "I am peeing", you can smile and say encouraging comments like "hey, you are really getting to know your body!"

Only when they get to the "I need to pee" stage, which means they now are able to hold their bladder and have a chance to actually plan to get to the potty is it time to invite them to try to use the toilet or potty. This, in my opinion, is when active potty training takes place (somewhere around between 2 1/2 and 3 years) and it means having you child wear fast to pull down track pants or leggings - no zippers, belts, buckles, overall please. 

Now you can invite them to try to do that pee (which they now know they are holding) on a potty!  It's an invitation to try - not a life sentence of sitting until something happens!  They can sit and try, and when they want to get up so be it!  They can try anytime they like.  The next time they announce "I have to pee" say "do you wanna try the potty?" and if they say yes - say "Let's go", and then move quickly to the potty and get them on there fast.  They can't hold for long at this stage.   If they don't make it to the toilet, say "That's okay, you're learning!" and stay positive.

When to stop training - you are being too forceful or are taking over the lead:

• If they say NO.  No means NO and you have to respect that.  If they don't want to use a toilet they may be ready physically, but not psychologically. 
• If they are holding or constipated - what ever you might be doing - back off!
• If they have so many accidents and never even make an attempt to hold or get to the toilet.
• If they don't go when they are on the potty but then go immediately after being re-dressed.
• If they hide to go.

Hope that gives you a good start!