Since the release of my Gentle Potty Training Book I’ve been asked many questions about specific ‘training’ problems. Hence I’ve decided to write a Q&A covering the most common pee/wee problems.
NOTE: FOR AMERICAN/CANADIAN READERS: Nappy = Diaper!
Before I begin this Pee Q&A I wanted to quickly cover the most common causes of problems I encounter:
- Starting before the child is truly ready physically and emotionally. The absolute key to the calmest, easiest potty training is to begin when the child is emotionally and physically ready. Science tells us that physical readiness tends to occur in quite a small time-frame between 24 and 30 months. This means that the child’s body is mature enough to potty train. Emotional readiness however is a different matter entirely. While some may be physiologically ready to start, they may be months away emotionally. For the easiest training you want a blend of both physical and emotional readiness. To quote from my book “some will train much earlier and some much later. A gentle approach to potty training is based on the understanding that while there might be scientific norms, children are all individuals”.
- Delaying the start for too long. Some children train themselves, they will reach, 3, 3.5 or even 4 years of age and suddenly announce “I don’t want to wear nappies anymore!” and you’ll never look back. Some don’t though. Waiting for this miracle to occur and being blind-sided to the subtle, or not so subtle cues your child is giving you regards being ready to start can result in as much trauma as starting too soon. Preschoolers can be very stubborn and resistant to change, for some – learning to use the potty or toilet, coping with accidents and giving up on the ease of nappies is not an appealing prospect, for these children – the longer you leave it, the harder it can become. To me – being child-led means following their emotional and physical cues, not necessarily waiting it out. The two may coincide, but they may not.
- Not having enough confidence or realistic expectations as a parent. Ultimately – as with all parenting, potty training comes down to you. Unless you ‘wait it out’, the decision to start potty training tends to lay in your hands, even though it is child-led, because you are carefully following their cues (remember child-led is not necessarily waiting for them to announce they want to do it!). A little like deciding to start baby led weaning because your baby has been grabbing food from your plate for the last week and is just about to turn 6 months old. They’re showing you that they’re ready and you make the decision to start. If you go into the process full of fear, trepidation and doubt then in all likelihood you’re going to jinx the whole process. Why? Because your child looks to you ALL the time. They need to see that you have total faith in them, that you really believe they can do it. Even when they don’t. Potty training is a learning process for both of you. It can take weeks and even months. While most will see positive change within a week, by no means will everyone. Accidents happen and those accidents are going to be many. Accidents are important to children as they teach them 1. how it feels to pee without a nappy, 2. how long they can leave it until they go to the potty and 3. what happens when they don’t make it on time. You may think they’re not learning when they have an accident – you may see it as a sign the ‘training’ isn’t working. You’re wrong. Your child is learning so much from every accident. If you were teaching your child to ride a bike, you would expect them to fall off many, many times. You wouldn’t see the falling off as a negative though, you would trust your child (providing you were sure they were ready when you started) and encourage them through the accidents. You would talk about what they had learned when they fell off (do you need to hold on tighter? steer a bit lighter? Turn the corner quicker? Pedal slower?) and you’d encourage them to get back on the saddle. If they hadn’t mastered the art of riding a bike in a week you wouldn’t say “I’m just going to put the bike away for 6 months”. You would focus on the times when they’d ridden it successfully for a few minutes at a time and trust that they would get there. Potty training is the same. Accidents happen – lots of them and they will for some time. When they happen your child is going to look at you to see how to react. If you’re stressed, upset, anxious and despairing – or fostering a fixed mindset – that’s what they’re going to pick up on. It may be draining to spend a week or two cleaning up puddles of wee and it may feel like you’ll be doing it forever, but actually it’s a tiny snippet of time.
- Inconsistency. We tend to send children so many mixed messages around potty training. If we are totally led by them and start because they tell us they don’t want to wear nappies anymore we need to trust them and go with it. Not put them back in nappies or pull-ups after a few days because they’ve had too many accidents. If you’ve decided now is the time to start because your child is at an age where you know their body is mature enough and they are showing emotional signs of readiness you must stick with your decision. Again, putting them back in nappies when the accidents become too stressful, or to save hassle when you leave the house, or they go to nursery is super confusing. On the one hand you’re saying “I totally believe you can do this” and on the other you’re saying “but actually I don’t really trust you”. You need to send one consistent message, one that says “I believe in you!”. Using the baby led weaning example again; the inconsistent nappy free – nappy – nappy free – nappy approach to training is like starting off weaning because you’re certain your baby is ready, but then stopping again when they gag, throw most of the food on the floor and smear it around their face. Do you think they are ready or not? Were you not prepared for the mess enough? Do you feel they have ‘failed’ to wean because they only eat 10% of what you offer them with the remaining 90% on the floor? Would you go back to milk only for a few months? Or would you keep going, trusting that they are learning and will get it soon (soon being weeks, or perhaps even months before the floor is clean again!). Consistency is also incredibly important when it comes to daycare, many potty training issues occur as a result of inconsistency between daycare and home. Removing that inconsistency is paramount.
- Too much prompting. In the book I talk about too much prompting quite a lot, restricting it to once an hour at the most. Ideally though, you’ll prompt far, far less. Children need to learn what their bodies are telling them to do. They need to learn the signs of an impending pee – and how long they can leave until it’s too late. If you constantly prompt you take away that learning opportunity and the child often stops listening, not just to you, but to their body too. Here, accidents again are an important learning opportunity. In fact, I would argue strongly accidents are more important than peeing in the potty – certainly in the first few weeks. You’re trying to be child led, so be child led. Do everything you can to bite your tongue and let them learn when they need to go by restricting prompting as much as possible.
- Too little emotional preparation. While there is a mountain of physical preparation to do for potty training, the emotional prep is the most important. The book covers this in detail – but you’re looking at demystifying the toileting process, removing any fear or anxiety your child has beforehand (that includes working through memories of previous pain) and normalising it as much as possible. You also need to make a plan, together with your child, regarding the start and have a clear idea of what’s going to happen, how and when. In my experience, this area is often scrimped on, with less than positive results.
- Rushing to normality too soon. In the book I talk about needing a minimum of two days at home, preferably bare bottomed, to get potty training off to the best start. Yes, this is inconvenient, yes it’s hard work, no – not all children need to do this, but generally speaking – rushing back to normality (toddler groups, trips to the shops, full clothing etc) too soon can really set things back. Potty training is a big step in your child’s life. It deserves some time devoted to it.
- An uneven balance of autonomy. At some point in potty training your toddler is going to say “no”. No to using the potty or toilet, no to another day without nappies and no to another day of you talking about it. In all of my work I talk about a dance of control – times when the parent takes it and times when they hand over the reins to the child. This is one of the times when I believe the adult should steer. Why? Doesn’t overriding the child saying “no” mean you’re not being child-led? Yes, but only if you take it at face-value. If you presume that the child has made a logical, rational decision using sophisticated thought process such as hypothetical thought, and that they are saying “I’ve weighed all of this up. I don’t think I can do it. It’s stressing me out too much, I don’t believe I’m ready yet, let’s stop”, then in the nicest possible way you are giving them too much credit. We know that children aren’t capable of these sorts of thought processes until they are much older (which is why I’m firmly against the use of discipline that presumes a high level of concrete thinking in young children – such as the naughty step). In reality what the child is probably saying when they say “no” is “I want to focus on playing”, “I don’t like that you’re stressed”, “I got upset when you got angry yesterday”, “I got scared when you flushed my poo away”, “I got sad when I wee’d on my socks”. Young children live in the moment, we live in the past, present and future. When they say “no” it is often very, very different to when we say “no”. Would I carry on potty training when my child said “no”, or cried when I got the potty out? Yes, absolutely I would. I believe that’s a time when it’s best for my adult brain to take the lead, knowing what I know. What makes this gentle is that I would stay 100% compassionate and totally on my child’s side. I would share my confidence, not my doubt.
Pee Problem Q&A
Q: “In the first few days part what exactly do you say/do when they have an accident?”
A: Accidents are an important part of potty training. I welcome them! They teach the child so much. Don’t see them as failures. First, remind yourself of this. Your state of mind is so important. Your child will pick up on how you feel, as well as what you say. You need to be the rock of confidence during the whole process. I would help your child to know that you have zero anger or stress because of their accident, this is conveyed more in tone of voice than the words you say though. I would focus very much on the learning opportunity here “oops, you didn’t make it on time, can you see your pee on the floor? That’s what we’re trying to get into the potty” or “did you feel that the pee was about to come out? that’s your body saying ‘quick – time to go potty!'”. I would also ask if they would like to help you to clean it up too (with no pressure if they don’t).
Q: My son is 2.5. He was using the potty for about a week then he decided to stop altogether. Is this normal? Is there anything I can do to encourage him or do I just have to wait until he’s interested again? I offer him to wear underwear and he says no. He will sit on the potty before bath but no pee anymore.
A: Yes, it’s really normal. Usually this happens for a few common reasons: 1. the excitement has worn off, he’s realised that actually there’s more work involved than he expected and it wasn’t as fun as he imagined. 2. He became stressed by accidents (or more specifically somebody’s reaction to an accident) and wants to avoid it again, 3. You over-prompted him. Over-prompting often results in children withholding. 4. Inconsistency between home and somewhere else, or inconsistency in keeping him in pants and swapping to nappies (e.g: when you’re away from home). What I don’t know here is WHY you started. I’m presuming that you did because you felt he was physically and emotionally ready. If you had some success in the week he was out of nappies (and by some success I don’t mean no accidents – I would expect more accidents than in the potty) and you’re sure you started at the right time, then I would take the lead here and take some of the control back from him. For instance, I would offer him “pants or no pants (bare bummed/commando) today?”, but wouldn’t offer a nappy. Depending on his level of understanding/verbal ability I would also have a chat with him about growth mindset (not using that terminology obviously) and how proud you have been of him over the last week for trying to so hard, re-iterate accidents are OK, they are learning and they all happen, tell him you had them too. Usually what’s needed here is some emotional work – for yourself as well as your son!
Q: My daughter is almost 4 years old and she is still not interested in the potty. Physically she is ready, however nappy gives her a great deal of sense of security. How do you deal with it at this age?
A: Generally speaking there are four approaches to potty training: 1. Elimination communication (using the potty from birth with conditioned cues), 2. Early training, heaping on the rewards and with an aim to complete in a few days (think Gina Ford), 3. Training at the point of a meeting of physiological and emotional readiness (usually occuring 24-30 months, but can – and does- happen earlier or later by several months) – this is my approach, or 4. Wait it out. Wait until the child decides they no longer wants nappies and does it all on their own accord. Number four is what you’ve (consciously or subconsciously) been doing with your daughter. Usually ‘wait it out’ works really well. On average, most children will potty train themselves around 3.5yrs with this approach and most of the time it is an easy and painless process. The biggest downside of this approach however is that some children become emotionally reliant on nappies and can be incredibly stubborn when it comes to parting with them. It’s not unheard of to find five or six year olds still in nappies. Not such an issue if you home-educate, but not particularly desirable if you go the mainstream school route. At four, your daughter is categorically ready physically – IF there are no medical conditions affecting her ability. Similarly certain special educational needs – e.g Autism/Aspergers and Sensory Processing Disorder. I think my first point of call would be to meet with your family doctor to rule any of these out – or to get specialist advice if any apply. If there are no intervening needs, then you’re looking at working with your daughter on an emotional level, lots of preparation: conversations, books, videos and so on. What is the underlying reason behind her wanting to stay in her nappy? Is there anxiety? Does she feel she doesn’t have enough control over other areas of her life? Has she recently had a new sibling or are you expecting (and babies who wear nappies get more attention in your house!). After this stage then you’re looking at motivation. For me, 99.9% of potty training should be reward free. If the child is emotionally and physically ready, then rewards are not only unnecessary, but can be counter-productive. For your daughter however, the late start may require some extrinsic motivation – or a dangled carrot to encourage her to start. I would also consider the impact of consequences on her wearing a nappy – the natural consequence, is that if you’re busy and can’t change her, then she has to sit in a dirty nappy. She may not like that (although many children this age aren’t bothered!), logically, then the solution here is for her to take some autonomy towards cleaning herself up. “If you really want to wear nappies, that’s OK, but as you’re older now I think you’re ready to clean up after yourself when you’ve used your nappy and that would really help me out”. Switch to pull-ups and get her a little ‘cleaning up kit’ consisting of wipes and nappy bags and ask her to take down the nappy and wipe and then pop the nappy in the nappy bag and put a new one on herself – as much as possible independently. Fostering her independence this way is great preparation for when she does start to use the potty (or toilet as more often happens at this age) and also, her increased involvement and taking charge of her own toileting needs means it quickly becomes a bit of an unwanted chore for her, which can inspire potty/toilet using a bit quicker than solely ‘waiting it out’.
Q: How do you get a child to sit and wait for longer than 30 seconds on a potty?
A: To answer this I’m going to back-track a little. First, why is the child on the potty for so long with nothing happening? Have they chosen to sit on it themselves? If they have then you tend to find there is action pretty quickly. If you’re prompting then it’s quite possible that they don’t really need to go. So – pulling back the prompting a bit can really help. You could have a little basket of books or toys next to the potty. I don’t usually recommend this as it can take away focus from the what the child is doing, but for some children it has the opposite impact and helps them to focus. A little like a fidget toy helps a child with ADHD. Bubbles are a great toy here, because they help the sphincters (particularly anal) to open, those actually make toileting easier.
Q: Is there anything you can do to prevent the leave-it-to-the-last-second and run approach (which sometimes causes accidents because it’s too far) especially at nursery?
A: Not really. I’m 41 and I still do this sometimes! The world is a fascinating and fun place for young children. Going to the toilet is something that takes them away from this engagement with the world. It’s understandable they leave it until the very last minute. Actually, the accidents that happen here are really important, because – in time – they teach the child how long they can leave it for before they go. The difference between myself and your child is that – at 41 – I’ve learned what my “point of no return is” and I’m very reliable at predicting it. I know when I can read one more page, or watch to the advert break and NOT wet myself, because of all the practice I had when I was a kid. This is something that will absolutely come in time. Until then, use those accidents as a learning opportunity “Oh no, you were so engrossed in your puzzle, could you feel your body telling you that your wee was urgent?” “next time, do you think you could recognise that feeling and know that you can’t wait anymore?”
Q: How do you deal with a regression? My son had mastered potty training and then his baby sister was born very early and this really knocked him. 4 months on he’s still doing poos and wees in his pants. I’ve tried the method that help us to start with and trying to remain positive but nothing it working. Please help!
A: First – reset your expectations. Children have accidents for months and YEARS after potty training. There is a bit of an incorrect assumption in our society that once they’re done – that’s it, no more accidents, actually – that rarely happens. The learning carries on for months and years after the initial ‘training’ period and with that learning comes mistakes. Regression after a new baby is common, it can and does knock a toddler/preschooler for six, their world is changed over night and it literally pulls the rug from under their feet. I’m sure you know this. Ultimately the key here is to be compassionate and empathic towards how your son is feeling. He’s busy dealing with feelings of anger, grief, sadness, confusion etc.. it’s no wonder his attention has shifted away from potty training. Sometimes wetting and soiling happen deliberately, in this instance it’s almost always a cry for attention (actually it is in most cases) – what does your son need? Simply, you. The accidents draw your attention solely to him for a few minutes. Any attention is better than no attention. The answer to this is to build in one-to-one time with him away from the baby – preferably not with the baby in the same building. Feed and run and take him to the park for half an hour a day leaving your baby with your partner/parents/friend. Make sure you do his bedtime each day, give him a bath and read him a story while your baby is elsewhere in the house. In terms of how to react when the accidents happen – you’re doing fine here. Stay calm, stay compassionate and stay consistent – don’t under any circumstances threaten putting him back in nappies. This will pass!
Q: I have a 5 year old who is still not waking for a wee at night, he’s in pull ups but went dry in the day at 2.5years. Is there anything I can do or is night time control hormonally led?
A: Night-time toilet training is pretty different to training in the daytime. There are several physiological development stages that have to happen first (not just vasopressin secretion – the hormone that controls nocturnal urinary output). Usually night-time dryness happens 6-12 months after daytime dryness, but it can take much longer. Most children will be dry at night at either three or four years of age, however that doesn’t mean they won’t have accidents, bed-wetting is common and normal until at least seven years of age. While 90% of five year olds are out of nappies at night, that does mean that 10% are still totally reliant on them. One in ten really is not a small number. At this point, your son is clearly in the ten percent and I wouldn’t be rushing to change this. This is one potty-training instance when I do firmly believe in ‘wait it out’.
Q: I have been potty training my 3 year old slowly for several months with great success at home . He’s completely accident free at home & out and about but will not use the potty or toilet at Nursery or preschool. We’ve had to revert to pull ups in daycare. If he wears a pull up at home, he treats it like pants but at Nursery he uses it as a nappy! Nursery have tried putting him on potty every 30 mins (I think this annoyed him!) and we’ve taken his own potty in to no avail. It’s frustrating as we know he’s independent at home.
A: I have one word for you – consistency. When you’re potty training over different settings (whether that’s home and daycare, or two different parental homes), it is VITAL that all settings about potty training in the same way. The accidents are happening at nursery and preschool, therefore I don’t think it’s a stretch to say that nursery and preschool are the problem. First off, I really advise you ditch the pull-ups, they’re confusing your son and undermine your belief in him which can dent his confidence (do you trust him in pants, or not?). Next, you really need to have some proper conversations with the nursery/preschool staff. If he has a key worker then even better. They are prompting him way too much – over-prompting is one of the biggest causes of pee accidents (and withholding). Over-prompting is irritating and overrides your son’s listening to his body. He’s clearly switched off and their prompting is causing him to not only not listen to them, but also not listen to his body. At a maximum they should prompt hourly, but preferably less. A big problem that occurs with nursery/daycare is access to the toilets/potties. Does he have to go and get a member of staff to take him? Are they always readily available? Or are they sometimes pre-occupied and expect him to wait? Most kids this age leave going until the last minute, so waiting is not an option. Are the staff approachable enough? To introverted kids, having to find a staff member to take them to the loo is a problem in itself. Ideally he will be able to take himself, however that brings new problems – is it easy to get there? Is it scary in any way? Does he know exactly where everything is? Can he reach it all? These are the questions I’d ask these settings. I would also agree on an approach that is completely consistent with what you’re doing at home, e.g: if you don’t praise/give stickers at home – they shouldn’t do either.
Q: Why is my son is dry with no pants but after 3 months potty training I still can’t get him in pants?
A: I always advise spending a couple of days bare-bottomed, but then trying to get into pants ASAP. For children who are potty training bare-bottomed only, it can be really hard to get them into pants. Close fitting pants (particularly briefs) can give the sensation of wearing a nappy, so it’s not uncommon for kids who have been bare-bottomed trained for quite some time to regress and have lots of accidents when they are put into them. The answers here are either 1. stick it out until they learn and remember accidents are all good – they are learning opportunities!, 2. switch to a style of pants that are less nappy like (hipster trunks for instance) or 3. embrace commando life. I don’t know if your son is just flat-out refusing to wear pants, or if he’s having accidents when he wears them. If it’s the former than those same three points apply. One of my sons was commando under trousers for about 6 months before we could get him into pants. No big deal!
Q: We started about a week and a half ago, after reading your wonderful book! My little boy is almost 2. He’s happy to use the potty or toilet if he’s already started to go, but he gets upset/cross if we encourage him to go before the last minute/during dash.
A: Your son is getting frustrated with you, because he wants more control over the process. On the one hand you’re encouraging him to listen to his body’s cues and go when he needs to go and on the other you’re encouraging him to go before he feels he’s ready. Now – you and I know that he needs to head to the potty before the last minute dash, but he doesn’t yet. He currently thinks he’s going at the right time – when he REALLY feels he needs to go. In time, he will learn that actually he needs to go a little sooner than waiting for that last minute. He’ll learn the subtleties of listening for that gently ringing bell, rather than waiting for the blaring siren. That is something he has to learn for himself though. It sounds like he’s doing really well and as the weeks and months pass you’ll find he’ll take himself off a little (and I mean a little!) sooner each time. Over-prompting can really backfire though, so try to bite your tongue if you can and show your son a little more trust and faith.
In summary, the answer to most potty training problems, especially pee related, can be summed up by focusing on three words. Three words that parents need to have bucket loads of during the process, however long it takes.
Confidence, Consistency, Compassion
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