Potty training, Round 2
What causes a potty-trained child to revert to former ways and refuse to use the toilet? Experts chime in with their thoughts and offer advice for getting rid of diapers for good.
Any number of behavioral and/or physiological factors can cause a child to regress from successful potty training. It’s up to parents to identify potential factors and address them accordingly.
Why would a potty-trained child refuse to use the toilet?
“More conflicts over toilet training occur because parents are afraid to allow children to use the toilet on their own timetables,” says Kelly Perez, executive director of the Natalie G. Heineman Smart Love Preschool. “Parents are often told children should be trained by a certain age, and this can result in parents pressuring children, which can leave children feeling bad or inadequate if they don’t give up their diapers.”
Life changes
According to Perez, regression is not usually associated with a particular age or time frame but rather with specific situations. “It is common after a new sibling is born, with stress or pressure in the child’s life or when the child is not receiving enough one-on-one attention."
Emotional causes
“Rule out the unlikely, but possible, chance that the child has experienced a trauma or a major scare,” says child and family psychotherapist Dr. Fran Walfish, author of The Self-Aware Parent. “This type of emotional shakeup can cause a regression.”
Training too soon
“Introducing potty training too early risks your child’s constriction and resistance,” warns Dr. Walfish. “Many young children fear falling into the toilet. Many boys fear their penis will fall off and be lost down the toilet forever.”
The probable cause
“The most common reason a potty-trained child suddenly refuses to use the toilet is that the child experienced ‘force,’ or too much pressure, by his parents,” says Dr. Walfish. The toddler phase of child development is critically important and rich with milestones the child must achieve — toilet training, self-feeding, putting oneself to sleep, self soothing, speech and language development, frustration tolerance and delayed gratification.
“On some primitive level, the child knows that he is master of his own body,” explains Dr. Walfish. “If Mommy or Daddy presses too hard on toileting expectations, you risk your child bearing down hard on the other side and creating an intense power struggle.”
Could it be constipation?
The power struggle can certainly take psychological issues to a physiological level.
The poop strike
“Often, what parents observe and label as 'constipation' is really a case of your child 'withholding' bowels,” continues Dr. Walfish. “Extended ongoing constipation can lead to days of withholding and trips to the pediatrician and child gastroenterologist who prescribe laxatives, stool softeners and even invasive enemas.”
Ingrid Kellaghan, parenting expert and founder of Cambridge Nanny Group agrees. “While the cause of potty training resistance is usually behavioral, there is a physical component that should not be overlooked,” says Kellaghan. “If your child hasn’t gone in several days, the culprit may be constipation.”
Address constipation
Kellaghan encourages parents to observe the child’s behavior for signs, including discomfort or pain. “Bowel patterns vary from child to child, but if stools are hard and compact with three to four days between bowel movements, your little one may be experiencing constipation.”
- Contact your pediatrician. The doctor may prescribe a mild laxative, enema or other stool-loosening medication.
- Encourage your child to be well-hydrated and incorporate high-fiber foods into the diet.
- Encourage your child to be physically active. Regular exercise helps relieve constipation.
Get back on track
Approach the situation with a positive state of mind. “Be loving, supportive and non-judgmental,” says Dr. Walfish. “At the same time, provide some boundaries and motivate your child back into eliminating into the toilet by having her participate in her own cleanup.”
Have your child remove her soiled underwear, clean herself with wipes (or even bathe, if necessary) and put on clean, fresh underpants. “Encourage and praise self-reliance,” says Dr. Walfish. “Let your child see that accidents and cleanups require much more work than sitting on the toilet.”
Bottom line: “The best way to address regression is to remove all the pressure and try to best understand developmentally where the child is coming from,” says Perez. “When children feel heard and understood and are able to turn to a loving a warm relationship with their parents in times of regression, regression becomes phase-specific and not entrenched.”
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