Toilet Training Woes and Bedwetting

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Perhaps no other area of child rearing has greater potential for innocently destroying a healthy parent-child relationship than toilet training improperly. Parents who gauge their success in parenting by how quickly their children are toilet trained are apt to develop destructive anger or resentment in their children. Children who are willing but biologically unable to control their bowels or urine on their parents' timetables frequently suffer great feelings of guilt and inadequacy.

Remember that it is an exceedingly rare thing to see normal teenagers still in diapers. Since this is the case, let go of any preconceived timetables for you child's toilet training. Parents with the best attitude toward body functions are those who wait for their child to ask for help using the toilet instead of their diapers and avoid pressuring, contests of will, and shaming. I am very suspicious of parents who brag to me that their very young child is completely toilet trained. I fear that their child will experience a regression of her toilet training or will demonstrate a fear, anxiety, or other disturbance in another area of her development (e.g. becoming extremely negative about eating). Regression or fear/anxiety is probable in very early-trained kids because their parents almost certainly pressured them into it.

Bowel training is usually much easier and earlier accomplished than urine training. Still, very few children have the biological ability to do this before the age of 18 months. Two-and-a-half-

to three-year-olds can be bowel trained quickly. In fact, this is the age when they often begin training themselves anyway. You can begin by predicting the time of your child's defecation and watching for grunting or straining. If you "catch" a bowel movement correctly, you can help your child learn to associate her body feeling of bowel movement with sitting on a toilet the way Mommy and Daddy do. After a while, she will learn to squeeze her anal sphincter muscle until she is fully enthroned on her little potty seat. She will do this partly because of the adoration she receives when she does. Don't overdo the praise, though, or you may find yourself with a child who uses her bowel training to experiment with her newfound independence and ability to displease others.

You may have a child who, after she is bowel trained, begins once again to pass her bowel movements into her underwear (soiling). Soiling may be caused by severe constipation due to a medical problem (rare), a low fiber diet, dehydration, or (most commonly) avoiding bowel movements because they feel painful or as a way to resist toilet training. Have your child evaluated by her health care provider. In most cases, there is no cause for worry. Make sure not to punish your child for these accidents, force her to sit on the potty, or spend excessive amounts of time talking about toilet training. The problem will go away by itself.

Urine training requires more physical maturity than bowel training. Your child may be ready to begin this lesson if she is around her third birthday, is successfully bowel trained, is aware of the feeling of wetness, and can hold her urine for at least a couple of hours. If she awakens from her nap dry, she may be ready. Again, don't stress over this process. You will find yourself in the pleasant position of not having to exert much effort in urine training if you leave the timing up to your child and instead offer her plenty of opportunity to watch the toilet habits of older children and adults. Young preschoolers love to copy others, and if you provide them with a little potty "just like the big one" you will likely have an easy time of your child's urine training.

Night wetting is a problem that is incredibly common in toddlers and preschoolers. Preventing any emotional problems related to bedwetting should be your highest priority. Keep your child in night diapers until she has had at least a couple of weeks awakening to a dry diaper. This accomplishes two things: 1) it avoids the inevitable unpleasant reaction from the parent who comes upon a wet bed and envisions extra work in washing and remaking the bed; and 2) it normalizes the reality that children cannot control their bladder functions any more than you can control how often you toss and turn while you are asleep.

Bedwetting can happen for physical or emotional reasons. Many children under age five wet the bed some nights because of the small capacities of their bladders. Ifyou notice that your child's bedwetting does not lessen in frequency over several months, or your child has achieved nighttime dryness and returned to bedwetting, you may want to have her checked out by your health care provider. Such an exam will help reassure you that your child doesn't have a bladder infection or other anatomical problem that will make it impossible to achieve a consistent dryness through the night.

Once you have ruled out a physical cause, the other likely reason for bedwetting is emotional. A child who experiences upsetting events, or is progressing through a challenging stage of her development often demonstrates her stress through bedwetting. Once again, the best solution (with as little attention or fanfare as possible) is to have her wear night diapers. If your child asks you for additional help, you may want to offer her one of the inexpensive night bladder alarms that will wake her at the first sign of wetness. Only use this device for the older preschooler who expresses her own motivation to learn "to wake up in time." Bed-wetting may be an escape valve for her daily stresses, or a minor sign of rebellion for all the restrictions society necessarily places upon preschoolers. Rest assured your child will soon enough find another way to "act out" her frustrations. Remind yourself that her bedwetting is an unconscious symptom of her distress.

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