Karen Deerwester, author of The Potty Training Answer Book, recently took the time to answer LoveToKnow Baby's questions about potty training problems.
What can you do if your child has fears associated with pooping in the toilet?
Sometimes a child will have all the other potty training skills but still ask for a diaper or a pull-up to poop. The diaper or pull-up allows your child to relax, that emotional security is essential when pooping. Your child can be "emotionally ready" to pee in a potty or even to stay dry through the night but still need more time to feel "emotionally ready" to poop in a toilet.
If so, be sure to empty the poop from the diaper into the toilet and let your child participate in the rest of the potty routine - wiping, flushing, hand washing. Reassure your child with a positive message that "one day she'll be ready to poop in the toilet like mommy and daddy" and to let you know when she wants to try.
If your child is not asking for a diaper or pull-up, use the ABC response to help your child feel safe "letting go" on the toilet.
- Acknowledge the situation. Start with a general description like "I see you don't like pooping on the toilet". Wait to hear if your child can say what you can do to help him feel better.
- Balance your support by listening for the deeper emotional fears and offering gentle solutions. If your child is feeling like a part of her body is falling off or being taken away to a mysterious place, she needs time to comprehend the process. Here's where flushing the poop from a diaper or the potty chair helps her gradually accept the new potty reality. A balanced response allows you to respect your child's emotions while still taking baby-steps forward.
- Conquer the fear by telling your child that you can figure this out together. Sit with her, make a game of listening for the poop to fall into the water, use your other "potty games" - like telling stories.
Of course, the reason for the problem might be a physical difficulty with pooping while sitting on the toilet. Be sure your child can plant feet firmly on the ground - otherwise, she may be having difficulty pushing the poop out.
What can you do if your child is "withholding" poop?
Like the child in the last question, some children get "stuck" -they know they don't want to poop in the pull-up but they are still frightened by the alternatives. Unfortunately, getting emotionally "stuck" can lead to getting physically "stuck".
Potty training is not fun or easy when your child is constipated. If you've done all the proactive strategies of a healthy high fiber diet with lots of fluids, have physically active playtimes, and you notice your child is not pooping regularly, check with your pediatrician. Do not give your child over-the-counter laxatives or medicines without the approval of your pediatrician.
Trust that in a positive potty environment with no medical conditions, your child's body will work as it should. Young children should not depend on laxatives and stool softeners. Use the ABC response to help your child get "unstuck".
Pooping is 100% your child's domain. You cannot force him. He might even decide your "gentle encouragement" is excessive. Therefore:
- Acknowledge that he controls when he poops. He must own his potty experience. Withholding situations can be very emotional for parent and child. Acknowledge your own feelings of frustration and helplessness with your pediatrician or with a non-suppository recommending potty training buddy.
- Balance your response by relinquishing your control over your child's pooping as you help him find appropriate ways to exert control in his world. Show your child all the ways he has constructive control by giving him more choices: what he wears, what books he reads, what characters are on the bathroom towels. Make your response as invisible as possible. Keep potty experiences positive while you try to create more relaxing conditions: add poop-friendly foods, simplify your child's daily schedule, make potty trips easy and unthreatening, and conclude each day with a quiet snuggle time when you re-establish an unconditional connection with your child.
- Conquer the problem. Express your faith in your child's ability to do what's healthy for his body. Explain that you don't want him to hold in the poop because it can make him sick and it hurts his body. With positive potty conditions and your relaxed support, your child can enjoy his body again.
Are potty fears normal?
Fears are a normal part of childhood. Fears might be small isolated moments when your child is face to face with something unfamiliar. A simple explanation, a helpful suggestion, or a hand to hold might be all your child needs to move forward. Sometimes all your child needs is a familiar context - "Hey, this toilet looks different than ours. Look at all the ways it's the same as the one in our bathroom". Rationale support can help in situations where the fears are specific and clear.
Other times, fears are deep and developmental. The potty training years coincide with a time of sweeping emotional growth. The deepest fear may not be the toilet at all - it may be the more developmental struggle with separation. Separation struggles recur all through childhood as your child grows slowly and steadily into a person - sleeping, crawling, walking, pottying, school, peers, etc.
Young children often cannot express new complex emotions verbally and rationally. Your child cannot calmly say "I'm afraid if I fall in that big toilet, I'll slip into the drain and never see you again". Or, as one three year old told her mother after weeks of distress, "I want to wear my diaper to bed because I don't want to get old and die."
Before you can calm your child's fears, you must grow comfortable with your own. Children must face some fears in order to grow emotionally. If you aren't intimidated by your child's fears, your child has a better chance of conquering them.
Should you always eliminate the source of your child's potty fears?
If there's a simple solution to a fear-inspiring situation, by all means take it. But you cannot and should not eliminate all sources of fear. The fear may have little to do with the particular situation and everything to do with your child's sense of power and control. Better to teach your child he can handle the situation - he is strong, smart and capable. Of course, telling him so doesn't make it so. You must give him the tools to face these age-appropriate problems.
When rational explanation fails, you can create routines that pump up your child's power reserves. Routines and rituals transform the unknown into something safe and predictable. Your child is no longer a small person in an out-of-control situation. Your child is the master of his world.
In potty training, the problem with eliminating the fear without building your child's sense of competence is that your child becomes potty proficient with a narrow range of skills. He learns to potty on one toilet, at home, with one routine. Addressing fears as they arise will teach your child potty flexibility and all important adaptability. It's big world out there, and it's full of potties.
How should you respond to potty fears in general?
Responding to your child's potty fears is as easy as A, B, C.
- Acknowledge. Never dismiss a fear as trivial or nonsense. Your child's fear may not be rational to you as an adult but it always adheres to the standards of child-logic. You may not know where it originates. It may contradict good sense. But it is "real" to your child. Respect what your child feels with a compassionate adult perspective.
- Balance your response between comfort and power. Your child has an adult partner by her side, someone who can sincerely reassure her that she is safe and capable. It's a fine balance: too much "safe" and you slip into overprotective mode robbing your child of her skill-building; too much "capable" and you rob your child of the emotional growth that parallels the behavioral growth.
- Conquer together or alone. Every fear is an opportunity. Solutions will be personal but there must be some sort of resolution. When possible, let your child decide what to do. Present your child with a few options - sometimes she just needs help knowing what to do next. Then she can conquer the fear "alone". Sometimes, she's willing to act but needs your hand or the physical reassurance that she is not alone. Other times, you will have to act "alone" but with her watching as you act as a brave and resourceful role model.