By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. I have a 3-year-old grandson who is pretty much potty trained. The problem is he likes to sit on the potty and play with his penis. When I tell him he should finish his business he tells me he is not finished. I have to distract him to get him off the potty. Will he outgrow this or what?

A. Children this age who are just getting out of diapers are always fascinated to discover what’s been hidden underneath them. Already their genitals are sensitive and physically responsive, and the fact that these have been so inaccessible heightens toddlers’ interest.

At these ages children are scientists and explorers, working hard to conquer the exciting new worlds opening up to them. So it is both common and natural to turn their curious investigations to their own bodies as well.

Three-year-olds are bound to inspect themselves with their eyes and hands as they work to understand themselves and how they’re put together. They’ll also be using their eyes to look with astonishment at parents’ and siblings’ private parts as they struggle to understand differences and figure out whether their own bodies are OK just they way they are.

When boys discover that girls don’t have penises they often think that they must have fallen off and worry that theirs will do the same!

Rarely, a child will become preoccupied with the sensations provoked by this kind of self-exploration so much that this begins to take over and drain the child’s energy and interest for other activities.

When a young child’s masturbation takes on a compulsive quality, persists even with efforts to distract and engage in other activities that ought to be appealing, and goes on for long enough most days to significantly cut into a child’s time from engaging in play and interactions with friends and family, there is cause for concern.

This may occur when a child has been sexually molested, although it sometimes arises in the absence of this kind of trauma. Sexual molestation often produces other changes in a child’s behavior too.

For example, the child may engage in more adult-like sexual behaviors rather than simply just touching his genitals. He may become irritable and angry, or frightened and withdrawn, and he may appear fearful whenever he undresses, use the toilet, or takes a bath, or must separate from a trusted caregiver.

Other causes for persistent, compulsive masturbation remain unclear, although some researchers have suggested that for some children this may be an attempt to make up for a lack of other kinds of stimulation (play, social interaction) or a lack of normal physical stimulation – hugging and cuddling, or for some abnormality in the way touch sensations are experienced and processed. Sometimes referred to as “infantile gratification disorder,” this remains a controversial and poorly understood area of child behavior.

As is often the case, the answer to the question about how much to worry about one behavior in a young child can be found by looking closely at whether other behaviors are thrown off. The child’s pediatrician should be able to help his parents sort through this kind of information.

A 3-year-old is just beginning to learn about other people, what they think, how they react, and the social conventions and expectations that must guide his behavior. Children who touch their genitalia in public can be gently told that their private parts are private. Usually their motivation to please, fit in and win over the important people in their world is even more powerful than the gratification of fondling their own genitals.

Any strong reaction or attempt to change this behavior runs the risk of setting it up as a more deeply engrained habit that is more likely to take on a life of its own. As long as the genital touching is restricted to a private place like the bathroom, the best approach is to try to relax, let it be, and trust that this, and the bowel movements, will eventually pass.

There’s no need to stop the touching or to comment on it. You could try distracting him with conversation or with a book to read or something else to fiddle with while sitting on the potty, but only because this might interfere less with focusing on moving his bowels.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.