Navigating Potty Training Problems

Welcome to Toddlers Made Easy where there's no fluff, just practical research based 15 minutes or less parenting strategies to help you calmly manage all those crazy awesome toddler moments. For those of you who don't know me, I'm Dr. Catherine. I'm a pediatrician with more than 33 years of experience. I'm the author of two parenting books, the founder of Healthiest Baby, and the mother of four amazing adult kids. And then there's Smudge My great Big golden Doodle. Today I'm going to answer a few burning questions I received this week about potty training. And the first one is a DM I received from Tony and here's what she asked. One of the biggest issues we're having is how often my 3 year old needs to poop. We've been using the reward method during potty training so every time he goes number two, he gets an M and M. But now he'll get up after the first little plop and say he's done. And then an hour or two later he has to go again. How can we get him to make one normal poop instead of a bunch of small ones? Well, thank you Tony, for sharing your concern about your little guy. There's a few considerations for us to discuss. Let me reassure you though, before we get going that pooping issues during potty training are very common. You are definitely not alone. So it sounds like your little guy is having small, frequent poops. Let me explain why this may happen. I'm going to approach this as if you're sitting with me in the office. Little kids, they tend to be very busy. They have a short attention span and they basically buzz from one activity to the next like a little bumblebee. And they use the potty in the same way. In that many toddlers, they don't sit as long as they need to to fully empty their bowels. And then what happens over time is the stool becomes a little harder and more dry and a little more difficult to pass. And a child may then start resisting pooping or fully emptying as they're worried it's going to hurt. So the question really here is, is your little guy holding back on his bowel movements because he's a little constipated or is it because he wants more MMs? I'm leaning towards that he's slightly constipated because he's a little young to be making a game plan like that. But I'm going to show you some ways that we can help tease out one from the Other. I want to just talk a little bit about constipation first. There's basically two types of constipation, organic and functional. Organic constipation is very uncommon, and it means there's a problem with the bowels that's resulting from an underlying problem like a thyroid disease or other disorders. This is really uncommon. What's more common is functional constipation, and this often occurs when a child's holding back their bowel movements and because they're afraid it might hurt or because they're flaunting their independence during potty training or they have other priorities. So, Tony, the question is whether your toddler's pooping small chunks because he's a little backed up, or is it because he wants more M&Ms? So back to the issue about constipation. My first thought is he's passing his poops in little bits and pieces because it's hard to pass the entire stool. And I'm wondering whether your child's straining at all, having bowel movements, and whether he's complaining about having any pain. One way to tease this out is by looking at your child's stool and then referring to the Bristol stool chart. This is a chart that will show you normal stools versus constipated stools, or at least that's what we're going to use this chart for. So when you look at that chart, Bristol is spelled B, R, I, S, T, O, L. So I would just Google this I and then look at the chart. You're aiming for a type 3 or 4 stool. Your child's stool may be type 5, which means he needs more fiber, but he's not really constipated yet. But please look at your child's stool, then look at the chart and see if you can tease out what your child's stool looks like. So it's unlikely that your little guy is conniving and passing poops and bits and pieces to get more M&Ms. But practically speaking, I'd stop giving the rewards, and that will eliminate it as a possibility. When he poops or pees, I'd just be very relaxed and say something like, you did a really good job of listening to your body. I saw you run to the potty, pull down your pants all by yourself. That's really the only reward your child needs. But I'm guessing you're thinking something like, well, what if he complains about not getting a reward? So instead, what I would do now is for the next few days, not forever, but give him the M and Ms. In his snack or with his dessert. And if he's asking, if he doesn't say anything, I probably then would do nothing. I would just use the verbal rewards like we spoke about. So let's recap. Since it's hard to say whether your child needs more fiber and water or whether he's withholding his poop to get more M and Ms, I'd first refer to the Bristol stool chart and look at your child's poop and analyze whether or not the poops look like a constipated stool. If you're not sure, it does no harm adding more fiber and water to your child's diet. But I'd also eliminate the reward. So we take it out as a possibility. So I drop the reward. It's not needed and it's making it hard to sort out what's going on. I hope that helps you going forward. Please send me a DM and let me know how potty training is going. And next, let's hear from Jillian. She sent me an email that said, hi Dr. Catherine. My three year old just refuses to sit on the potty. I've tried bribing, I've tried telling him I believe in him. I've tried explaining that he's the boss and he can go whenever he wants to, but he says, no, thank you Mommy, I just want a diaper. It's so frustrating and I really want him to get in underwear. I tried using cloth diapers, but he doesn't care if he's soaking wet and he won't go bare bottom either. And I'm just not sure where to go from here. So thank you Jillian for your email. I can just imagine how frustrating and confusing it can be, especially if your friend's kids are potty trained, for instance. And here your child won't even sit on the potty. But let me reassure you, your child will learn and he won't be in diapers for much longer. But here's the thing. While you sound good and ready to ditch those diapers, it sounds like your toddler has a different opinion about the situation. So how can we raise your child's comfort level so he feels more comfortable or even curious about losing the diapers? And although this may not be exactly what you want to hear, the first thing you need to do is take a step back. Your son is saying, mom, I'm not ready. I'm not comfortable with making this change just yet. In order to reset, I'd say something like, right now you feel safer and Better in a diaper. I get it. But one day you'll use the potty to go pee, pee and poo. And I'm here to help you when you feel ready. Do you see how this repositions things so it empowers your child? So for a few weeks or longer if needed, I take the pressure off and say nothing about the potty. I wouldn't put it away. I'd leave it there. And I know it feels like you're taking a step backwards, but honestly, potty training is so easy when your child is interested and motivated. Now, there's a lot of reasons for a child not to be ready. Your child may be resisting you because he doesn't want to be told what to do. It can also be because he has some anxiety. It can be that he's constipated and he's already a little uncomfortable and the potty makes him feel more uncomfortable. But what we're going to do is use this period of time when you back off to help raise your child's comfort level. I'm going to show you some ways how to do this. The first thing I'd allow times of messy play, like allowing your child to play with slime or shaving cream or sand, because potty training involves a lot of sensory issues and this can help ease them. This is a really big point. I'd really encourage independence by letting your child help in the kitchen or other jobs, anything he can do himself. Although it will take more time, I would encourage you to try and let him do it because that that will inspire his desire for independence even more and will help with toilet training. The next point is really easy to do and it has a powerful impact. And that is, I would model going to the bathroom. Don't make a big deal of it. Just say something like, oh, I have that feeling. I need to go pee. Pee. I'm just going to run to the bathroom. You want to come? Then keep the potty out. Put some books and stuffed animals around the potty. You don't have to keep talking past this point. We just want to start raising your child's awareness of that I need to go pee feeling. Now, just imagine how many times your child will hear this before you start training again. He'll be that much further ahead. I'd also use this time to teach your child how to undress himself, so when you're ready to start again, he'll be a pro at it. And I have a nice review of this in our new course, Potty training Made Easy if your child is interested. I'd also read books about using the potty. If he's not interested, don't push it. I love turning everything into an art project and I'm just going to tell you a quick story here which may put this into perspective. But on the day I received my acceptance to medical school, I also received my acceptance to my dream art school. So I had a huge colorful fluorescent envelope in one hand and a nice big heavy, creamy one in the other. Yes, in my day we got our acceptances by the mail, so you know which one I chose in the end. But the funny thing is, I'm finding this podcast is really fulfilling that drive for creativity that I had in my art school days. So back to the art project. Take pictures of your child getting dressed, sitting on the potty if he's willing. If he's not, just do stuffed animals sitting on the potty, take pictures of him washing his hands, and then allow your child to decorate a potty poster. But really, the point of this is, number one, raising his comfort level. But also it gives you an opportunity to talk about potty training and gauge his comfort level. Next, if there are older siblings or potty trained friends who don't mind your child accompanying them in the bathroom, I'd send them all up to the bathroom together when appropriate. I'd also allow your child to play around the house with the bare bottom when he's willing. And lastly, I'd use Play for a time to work through potty training. So if you're playing with your child, you can have the stuffed animals pretending to go pee and poop when you sense less resistance. Start right back from the beginning. In our potty Training Made Easy course, I give you an exact step by step routine of how to begin potty training and also how to prep your child for potty training. You want to start by prepping your child by saying something like hey, something really exciting is going to happen on Thursday. Explain that you're going to start using the potty. Don't focus on the things he's not going to be doing. In other words, that he's not going to be wearing a diaper. Focus on what he is going to be doing. You're going to be sitting on the potty or the toilet to go pee and poop. I'd encourage you to use a gentle approach, which means you invite your child to use the potty with when he or she looks like they need to pee. So you help your child recognize this feeling by talking about it like this when you see your child wiggling or doing the I need to pee dance, then you'd say something like, hey, it looks like your body is telling you it's time to pee. Let's see if we can make it to the potty on time. I'm so excited to share my Potty Training Made Easier brand new potty training course that shows you step by step how to potty train your child so they feel empowered and in control of their own learning, which leads to a smoother and more positive experience. In fact, kids beam with pride when they discover this new level of independence. This approach is a lot easier on both of you as it's not based on coercion, you're not pressuring your child and that means there's going to be fewer tantrums and power struggles. But most importantly, it really protects your child's self esteem. It feels good to use and that helps you feel like the parent you want to be. And there's a link about this course, Potty Training Made Easy in the show notes if you'd like to learn more. So thank you Jillian. I hope that gives you some idea on your next steps, which is to reset things and then try again. In the meantime, thank you for listening today and I hope this was helpful. Be well and I'll speak to you soon.