ASK THE EXPERT:Your parenting questions answered, by DR JOHN SHARRY
Q
My daughter is two years, eight months old and when she was two years, four months, we toilet trained her. She was showing all the signs of being ready and really got the hang of it very quickly. She still has a nap during the day, so I continued to put a nappy on her for her nap and for going to bed at night time. For about the last month to five weeks, she has been continually wetting herself.
She has never had an accident with a bowel movement but wets herself very frequently and will not go to the potty when prompted. She is in playschool three mornings a week and I am told that she does go to the toilet there, but sometimes when I pick her up she is wet.
In March of this year, her brother was born. She seemed to be fine with him when he arrived, but as time went on she got more jealous and really started acting up (tantrums, looking for more attention from me). I think that the problem with the potty is to do with her brother, but I am unsure as to what to do in order to make her want to go to the potty/toilet.
I have tried the star chart and given her a sweet when she goes to the potty. Sometimes it works, sometimes it doesn’t. I did bring her to the doctor and had a sample of her urine analysed but no infections were found, so the problem seems to be behavioural.
When she does wet herself she won’t tell me she is wet, and it is only when I realise she is wet do her clothes get changed. She seems happy to stay in wet clothes. Should I just leave her be, let her go to the potty when she wants to rather than always prompting her – perhaps this is her way of getting more attention from me? I really don’t know how best to handle this.
A
A setback in toilet training can be a tricky problem to deal with and is very common. Toilet training is one of the first times a parent’s agenda comes up against that of a toddler. For lots of reasons, such as independence, getting the child ready for preschool, etc, the parent can be much more motivated to get the toilet training complete, but this can easily come up against the toddler’s own agenda as they are discovering and exercising their own independent will.
Doing a wee or a poo is one of the few things that your daughter can control in her life as a toddler, and this can become an emotive issue and a focal point for conflict.
As a result, toilet training can easily become a battle of wills and a focus for attention in the child’s life. It can easily become a vicious circle. As a parent it is easy to get very frustrated when your child wets, because you know she can go to the toilet and it is such a messy problem to deal with.
However, this negative attention can cause your child to dig their heels in or to cut off from you and not tell you when she wets.
In the absence of any physical reasons, I think you are right that the setback in her toilet training is related to her insecurity about her brother. Though it is not deliberate, wetting might have become her way of getting your attention (albeit negative) and even her way of expressing her upset feelings about the arrival of her brother.
The first thing to do in dealing with the problem is to take a step back. I would suggest you take a break from toilet training for a few weeks. Have the potty in the bathroom and notice when she does use it, but in a more matter-of-fact way and take a break from reminding or pressuring her to go.
When she wets, don’t make a big deal about it and change her without even mentioning the fact she is wet – talking about something else entirely.
During the break from the training, work on building your relationship with her. Make sure to have regular one-to-one time with her (for example, when her brother is sleeping or when your partner is home), such as playtime or a reading before bedtime when you give her attention and enjoy her company.
Address her rivalry with her little brother by showing her how to play with him, gently guiding her how to tickle his tummy and then praising her (“You are such a kind big sister”) making links between them (“Oh look he is smiling at you . . . he loves his big sister”) and always praise the two of them together (“J is my lovely boy and G is my lovely girl”).
When caring for her brother, try to involve her and give her some attention. For example, as you change his nappy make sure you chat with her and praise her if she helps (“Thanks for that nappy, that is a great help”).
During the break from the training, the wetting may begin to stop itself, but you can also restart some training when you think she is ready again and when you have some time to help her, such as when she is on a break from playschool.
The key is to try to build on her successes and what she is doing well already. For example, you can do up a picture reward chart where she gets a star for when she uses the potty for a wee or a poo, but then a special big treat if she manages to keep her pants dry for an afternoon.
Picking a motivating reward can be key, but it does not have to be expensive or complicated. For example, when she sits on the potty she gets to read a favourite book with you or gets five minutes playing with bubbles when she is dry in the afternoon – pick something that will work for her.
Make the period short enough to ensure she succeeds. For example, she can get a reward if she is dry until snack time and then a further reward if she continues until teatime.
If the problems persist, contact your public health nurse, who may be able to help further or make a referral to an appropriate service.
Dr John Sharryis a social worker and psychotherapist and director of Parents Plus charity. His website is solutiontalk.ie.
Readers’ queries are welcome and will be answered through the column, but John regrets that he cannot enter into individual correspondence. Questions should be e-mailed to healthsupplement@irishtimes.com