toilet training

A TODDLER BACKTRACKS ON TOILET TRAINING

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
A TODDLER BACKTRACKS ON TOILET TRAINING
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Our 3-and-1/2-year-old girl finally used the toilet for pooping, after several months of comfortably urinating by herself.

It happened after a weekend away with a 4-year-old who she watched, and was evidently encouraged to try it at home. She pooped again the next day. We showed her a lot of praise and joy at her accomplishment.

She had previously showed little interest in giving up her diapers to go poop, and admitted she was scared of making a poop in the toilet.

Then she stopped, and we are back where we were. She runs and gets her own diaper when it’s time. Sometimes she will “try,” which means sitting on the toilet for a few minutes, then getting up to find a diaper.

She has said things like, “I really like making poo in the potty!” and “Maybe later I will make poo in the potty,” but never really pushes herself to do it again.

We are just a little confused that she started, then stopped. We don’t want to push her, but we do feel like she likes the ease of grabbing a diaper, going, then having dad and mom quickly take it off and clean her up. We (and she) know she is capable, but she has a routine which works for her and she obviously doesn’t feel like pushing herself.

Should we nudge her along? Go “cold turkey” with all diapers gone from the house? Not say a thing about it?

A. No wonder you are confused. Your daughter does demonstrate many of the signs of readiness.

She can feel her readiness to “poo” coming on, she can tell you, and can hold on long enough to get herself to where she needs to go, or get herself a diaper. She even showed you that she could “poo” in the toilet.

But she isn’t fully ready, since she hasn’t mastered her fears, and perhaps doesn’t fully feel that this achievement is her own.

Perhaps all the praise when she imitated her 4-year-old friend was a little too much – too much excitement, and perhaps too much of your sense of victory interfering with her sense that this was her own.

Do you know what she is afraid of? Some children are afraid of the noise that a flushing toilet makes. Or that they’ll fall in. And many are quite troubled by the fact that once their b.m.’s are flushed down the toilet they disappear for ever. What happens to them? Where do they go? Where does she think they go? These are important questions for young children since they think of their b.m.’s as a part of their own bodies, as a precious product of themselves.

Pushing her isn’t likely to help. She seems quite motivated to imitate and be like older children and is bound to tire of diapers, which distinguish her from them.

Once a child who is developing healthily in all respects has had a chance to fully explore her questions, conquer her fears and feel that pooping in the toilet is her own achievement, rather than one that has been taken away from her, she’ll be fully ready to show herself that she can be successful.

Should she give up her diaper? I wouldn’t recommend it. Instead, tell her that it is up to her to decide when and where she will use it. You will be ready to help her when she asks for it. Let her know that you know that when she’s ready to “poo” in the toilet, she will, and that there’s no need for her to reassure you about “later” or “really liking it.”

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.

IN TOILET TRAINING, A PREMIUM ON PATIENCE

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NEW YORK TIMES COLUMN: FAMILIES TODAY:
IN TOILET TRAINING, A PREMIUM ON PATIENCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Problems in toilet training nearly always arise because of an imbalance in the parent-child relationship. Children usually show signs of readiness between age 2 and 3. When parents can’t wait until then, and impose toilet training as their idea, the child will feel the pressure as an invasion.

All parents, of course, want their child to grow up and cross this threshold. Preschools often insist that a child be “trained” before he comes to school.

Other parents may offer advice and condescending comfort when their children are already trained. Grandparents may imply that toilet training is a measure of effective parenting and of a child’s overall competence. Some families may see the child’s entire second year as preparation for success in this area.

A toddler for whom independence is a passionate issue anyway will have his own struggles. He may stand in front of a potty, screaming with indecision. Or, he may crawl into a corner to hide as he performs a bowel movement, watching his parents out of the corner of his eye.

It’s a rare parent who won’t feel that such a child needs help to get his priorities straight.

When a parent steps in to sort out the guilt and confusion, the child’s yearning for autonomy becomes a power struggle between them. Then the scene is set for failure.

In bedwetting, as in many of the problems encountered with toilet training, a child’s need to become independent at his own speed is at stake. When a child’s need for control is neglected, he may see himself as a failure: immature, guilty and hopeless. The effect of this damaged self-image on his future will be greater than the symptoms themselves.

Given that toilet training is a developmental process that the child will ultimately master at his own speed, why do parents feel they must control it? My experience has led me to the conclusion that it’s very hard for parents to be objective about toilet training.

The child becomes a pawn – to be “trained.” It may take us another generation before we can see toilet training as the child’s own learning process – to be achieved by him in accord with the maturation of his own bladder and central nervous system.

When Problems Exist:

A.) Discuss the problem openly with your child. Apologize and admit you’ve been too involved.

B.) Remember your own struggles, and your eventual successes, so that you can let the child see that there is hope ahead.

C.) State clearly that toilet training is up to the child. “We’ll stay out of it. You’re just great, and you’ll do it when you’re ready.”

D.) Let the child know that many children are late in gaining control, for good reasons. Then, let him alone. Don’t mention it again.

E.) Keep the child in diapers or protective clothing, not as a punishment, but to take away the fuss and anxiety.

F.) Don’t have a child under age 5 tested unless the pediatrician sees signs of a physical problem. A urinalysis can be done harmlessly, but invasive tests and procedures – enemas, catheters, X-rays and so on – should be reserved for children who clearly need them.

G.) Make clear to the child that when he achieves control, it will be his own success and not yours.

(This article is adapted from “Touchpoints: Birth to Three,” by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.)

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.

Prior to Dr. Brazelton’s passing in 2018, he was the founder and director of the Brazelton Touchpoints Project, 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 now the director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.