Toddler's frame of mind could hinder potty training


January 08, 1995|By BEVERLY MILLS

Q: My 3 1/2 -year-old will not have a bowel movement in the potty. He goes and hides to have a B.M. Otherwise, he was completely potty trained six months ago. What do we do?

D. A., Hyattsville

A: This issue is complicated, so we'll cover it in two parts. Today's column deals with defining the problem. Next week we'll talk about solutions.

The most common reason children refuse to go in the potty is that they are caught up in a power struggle with one or both parents. Fear, constipation and a new baby in the house are other likely suspects.

Between the ages of 3 and 4, children are at a stage of testing their parents to see who is in control, says Dr. Barbara Howard, a developmental pediatrician at Duke University Medical Center in Durham, N.C.

"If you're not setting adequate limits in other areas of the child's life, then when it comes to poop, they'll say, 'You can't make me,' and you can't," says Dr. Howard.

Lots of children in these situations end up withholding their stools and getting constipated. Then the situation can get even worse with painful bowel movements and severe blockages. Several mothers say their children's doctors had to prescribe stool softeners, mineral oil and sometimes even stronger laxatives.

While you're working on the problem, try to prevent constipation by including lots of fruit and fiber in the child's diet.

Sometimes the underlying cause is fear, and these children are most likely to be worried about falling in, being sucked down the toilet or they have experienced painful bowel movements.

Then there are children who are proud of their stools, and view them as a valuable product that they don't want to see flushed away, says Dr. Howard, who was the consulting physician for the Duke Family Series video "It's Potty Time."

"It also looks like a body part, and some children associate losing their stools with losing a body part," Dr. Howard says. "You need to explain this doesn't happen."

The other tack Dr. Howard takes is to explain to children that their poops really want to go and be where all their friends are.

"They think of poop as being alive with feelings," Dr. Howard says. "So you tell them their poops want to come out, and they want to go to what I call the 'poop party' under the house."

When the cause is a power struggle, Dr. Howard tells parents to put potty training on hold for several weeks and examine the other aspects of the child's life.

"The main solution is that parents have got to establish better control," she says. "What happens when the child throws food? What happens when the child gets out of bed at night?"

Once parents set firm and reasonable limits in other areas, Dr. Howard says, the potty training issue often solves itself.

While a reporter at the Miami Herald, Beverly Mills developed thi column after the birth of her son, now 5. Ms. Mills and her husband currently live in Raleigh, N.C., and also have a 3-year-old daughter.


Here's a new question from a parent who needs your help. If you have tips, or if you have questions of your own, call our toll-free hot line any time at (800) 827-1092. Or write to Child Life, 2212 The Circle, Raleigh, N.C. 27608.

* Different strokes: "My 3 1/2 -year-old son behaves differently depending on which parent he's with," says Clint Williams of Phoenix, Ariz. "I have fewer problems than his mother. What might account for the inconsistency and what can we do about it?"

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