Archive for the ‘Potty Training’ Category:
Help for a Preschooler Afraid of the Potty
Hi Dr. Heather,
I am in desperate need of help. I have an almost-4-year-old son who is afraid of public restrooms. At 2 1/2 years old, his preschool teacher thought he may have a speech delay so we did early intervention with Easter Seals through the State run program. Turns out he just wasn’t ready to talk. (Now we can’t keep him quiet.) We had started potty training him and he was doing so well at home. I thought nothing of it until we went out and he screamed and cried and just didn’t want to use the public restrooms. He said he was afraid of the noise. He also doesn’t like the restrooms with the auto flush feature. We went to the mall almost every afternoon to try to “desensitize” him of his fear. Within a month he was fine. He would go to the restroom at school and in public.
In August of last year, he started at a new school. He was fine the first month and all of a sudden he stopped going to the bathroom at school. He will use the school’s restroom if I’m there, but he won’t go with his teachers or his classmates. This causes him to have accidents during school…especially at nap time. When I take him to school, we use the restroom. When I pick him up, we use the restroom. But he just won’t go with his teachers.
Now he has a fear that the toilet will clog. He cries while sitting on the toilet, asking if it will clog. I know he has anxiety issues but I’m just getting really frustrated and don’t know how to handle this situation.
What do I do? I’m afraid that his school will not let him come back next year if this keeps happening and more importantly, I’m afraid he’ll be like this as an adult.
Any advice would be appreciated!
Thank you,
Kathy
Hi Kathy,
Please don’t worry about his future as an adult. So many of these fears are passing things in childhood. Of course I cannot guarantee he won’t be an anxious adult, but the presence of anxiety in early childhood is extremely common and is almost always normal (and passing). Potty fears are one of the most common, especially with those super-loud (and uncontrollable) automatic flushers. Who ever thought THOSE were a good idea?! Nobody with young children, that’s who.
Now, think back: did anything happen at school to upset him? Did the toilet clog one day and overflow? Talk to his teachers; use your parent detective abilities to see if there is any connection to something upsetting that happened. Then you (and his teachers) can try to slowly reacquaint him with the potty, understanding his fears.
I also wonder about his school. What is the teacher/student ratio? Ideally, one teacher would be assigned to assist and support him with potty trials throughout the day, with no pressure. The pressure will only make it worse. These kinds of problems are really not that unusual in preschools. The teachers hopefully can be asked to support him a bit more. Perhaps a brief return to using Pull-Ups might be considered. Ask him if it would help him at school, especially at naptime. He might feel reassured simply to have the option. He shouldn’t be shamed because of it; it’s just a temporary measure until he feels more confident. Assure him that, soon, he’ll feel better about the potty at school but until then, why not use the PullUps so he doesn’t have to worry about an accident? Lots of 3 and 4-year-olds use PullUps.
But I also hear that you have an underlying concern about your son’s anxiety level, and have had good experience with help in the past. Why not ask his previous therapists if they have any suggestions, including the possibility of an evaluation by a child psychologist, just for you to get some more information and hopefully settle your own anxieties about him? Because your son can sense YOUR anxiety too — and you don’t want him to internalize that you’re fearful about him. If you have a concern, promptly get it checked out, so that you can either get him some help (and feel relieved that he should feel better soon), or feel relieved that everything is OK.
Finally, have you checked out my other posts on “Fears”? Go to “Categories” to the right and below this post, then click on “Fears”. There will be several posts that come up — you can keep clicking “older entries” to see even more.
Good luck and let me know if you need more ideas.
Aloha,
Dr. Heather
The BabyShrink
More on Potty Training: When Your Preschooler Poops in Her Sleep
Dear Dr. Heather,
I have a question for you regarding my daughter, who turned 3 in October. She has been potty trained (pee at least) since August. Here is the problem….she poops in her sleep. She also poops on the potty if she has to go while she is awake. But mostly, she is pooping in her pull-up during naptime. She also has pooped twice at nighttime. I don’t know if she is holding it to do it while she has a pull-up on, or if she is sleeping so soundly that she doesn’t realize she is doing it. Since she also poops on the potty, I don’t know what to think. Is it possible to influence the time of day she poops? She will be starting preschool soon and I am concerned that she will poop in her underwear at school during naptime. When she does poop in her pull-up, she apologizes profusely. I used to say that she needs to poop in the potty, not in her pull-up, but I don’t want to turn her into a neurotic kid, so I just clean her up and say nothing. Any suggestions?
Thanks for your help.
Marcia
Hi Marcia,
It sounds like you are being sensitive to your daughter regarding her poopy-timing. I’m glad you’re not pressuring her about the issue. And the fact that she apologizes profusely shows you that she knows what she is supposed to do, but isn’t there yet. You’re right; lecturing her about it won’t help. And I wouldn’t suggest doing anything to somehow manipulate her potty schedule; this would likely be felt as intrusive by her.
It also seems that it wouldn’t concern you as much if it weren’t for the preschool issue. Many preschools have rules that state the child must be “toilet independent” before starting school. The pressure to be “completely” potty trained before starting preschool MAKES ME CRAZY! It’s really unrealistic for many kids, and parents feel compelled to get their kids trained before they’re ready. This can cause problems later on.
That said, many schools WILL work with you, if you approach them directly. Believe me, this isn’t the first time they’ve dealt with this! They can support your daughter on her way to being fully potty trained. If her school won’t work with you on this — look elsewhere. You want a place that understands the developmental issues of preschoolers.
In the meantime, continue to praise her efforts, and be neutrally supportive when she has an accident. I wouldn’t dwell on it much with her; it sounds as if she KNOWS what is expected, and that’s what matters. It sounds like she’s well on her way to having full control over her potty needs, and I’ll bet that soon, she’ll be making good progress.
Good luck and let us know how it goes!
Aloha,
Dr. Heather
The BabyShrink
Poop-Withholding After a Trauma
Trauma such as illness or injury can cause regression in the developmental achievements of young children. In other words, your child may develop any nature of difficulties that may not be “diagnosable” per se, but rather a short-lived reaction to something traumatic. Reader Alison’s son broke his leg, and since then has become a poop-withholder. Here’s her dilemma:
Dear Dr. Heather,
My son broke his leg when he was about 18 months old and had to wear a cast for a month. Prior to this event, his poops were regular. After a week of having the cast on, he didn’t poop and when he did, it was uncomfortable for him. This started an irregular pooping schedule for him and he has remained constipated since then.
He will now be two next week. The pediatrician suggested a suppository and Miralax. We did a suppository thinking it would get things moving since he seemed soo uncomfortable. We have tried laxative drops that he likes, but seem to give him cramping and diahrrea. When we don’t give him anything, the consistency of his poop always seems soft, not hard. But he will do the poopy dance, and then have to push really hard and cries when he has to poop. The process of waiting for him to poop can eat up an entire day! He will go on his own after 2-3 days, if he has not gone by the 4th day, we have done a glycerin suppository since he seems soo uncomfortable and they help right away, but he hates it and I feel awful doing it. We push high fiber, etc..nothing dietary seems to help. I feel like it’s all emotional. He will run around and around, and we will try to stop him and hold him and encourage him until he will push and go. We tried poopy prizes, nothing seems to encourage him. It is not about potty training, although we have offered for him to go on his potty. He went twice on the potty but it seemed to freak him out.
He is a sweet boy and I don’t want him to be emotionally bruised from this experience. Should we take the same advice you gave to the 3 year old and ignore him when he does the poopy dance? Do we not offer poopy prizes? How many days do we wait before doing a suppository? Please help! We feel awful and don’t know what to do!!
Thank you,
Alison in Berkeley
Hi Alison,
Poor guy! I assume his doctor says there is nothing wrong, medically. Have you tried the Miralax? If not, it’s worth a shot. If you use, it, I wouldn’t point it out to him. I think anything that smacks of parental control over his poops is bound to backfire (so to speak!). So if you use it, sneak it in. Or just tell him it’s “vitamins” that you put in his drink.
On the behavioral side, you’re right, it’s not about “potty training” per se, but it IS about his sense of control and mastery of his own body. And that comes before potty training. He is still quite young for potty training anyway. Many preschoolers don’t “get it” until 3 1/2 or even older, and that’s OK.
The event of breaking his leg very possibly set him back, emotionally. It’s common for physical illness or injuries to cause temporary regressions. Perhaps the experience of being so incapacitated by the cast really scared him, or he got some kind of wacky idea in his head that somehow his poops CAUSED his injury. You really can’t know. Toddlers get all kinds of weird ideas in their minds, things that don’t make sense to us, rationally. But they can be very powerful ideas to the little ones.
This is what I would suggest: Within the bounds of what is medically acceptable, completely BACK OFF the poopy talk and encouragement. First of all, tell him that it’s HIS body, HIS tushie (or butt, or whatever your family calls it), HIS poop, and NOT MOMS OR DADS (or his doctors, for that matter). When HE is ready to make his poop, that’s fine. Be matter-of-fact and reassuring. You might also reckon back to his injury to reassure him that his body works perfectly well again. “Remember when you got your owie on your leg? That’s all better now. Your leg works fine again. And your poops can come out now anytime you are ready. But Mommy and Daddy will not make them come out anymore.” Then, DROP IT. Really try hard to focus on anything BUT the pooping situation. Don’t offer poopy-prizes or focus on his poop schedule at all. LET HIM HANDLE IT. If he asks for help, by all means, help him in whatever way he seems to want. But remember that this is a developmental hurdle that ultimately, only he can surpass.
This may all really be about a struggle to regain independence over his body. The leg injury was likely such a blow to his toddler’s very important sense of mastery over his body. Now, he needs to struggle to get it back. Leaving it up to him is an important part of that process, since it is all about self-control, body mastery and independence.
I know you worry about his frequency of pooping, but believe me, helping him to regain this sense of self-control will be hugely important in the long-run. Again, check with the pediatrician to make sure what I’m suggesting is OK, and allow your son to hold it or struggle with it as long as you can. It will require some deep breathing on your part, in order to NOT interfere, but this is an important developmental process for you, too: learning to let go, as your son is now old enough to start to take over this function for himself. (And I hope you can enjoy a little sense of relief as you can let this worry lift from your shoulders as you begin to focus on other, more fun things with your son.)
It may be days, weeks, or even months as he takes steps forwards (AND backwards) toward progress. Don’t let that get you down; it’s normal. Big developmental gains don’t happen all at once. Just keep your ultimate goal in mind and likely the power of his own normal developmental process will ultimately win out.
Not a fancy solution, I know. But one that respects his internal struggle, and the ultimate goal that he needs to achieve in order to surpass this internal dilemma of his. It’s also good practice for Mom and Dad to see that he can ultimately be in charge of his developing body (and mind).
You can also read about another toddler’s poop-withholding in this BabyShrink post.
Thanks for your question and let us know how it goes!
Aloha,
Dr. Heather
The BabyShrink
