"My son will be 4 years old soon. He does a great job peeing on the potty and he has gone poop before without any issues. Suddenly, he just doesn't want to use the potty. He wants to keep using his diapers. Should I be concerned about this at his age? I'm getting frustrated and I'm worried that the more I insist he use the potty the worse things get. Sometimes I am downright angry with him because he refuses and just goes and gets a diaper, poops or pees in it and then comes to me for a diaper change. He knows when he needs to go potty and he knows when he's already gone, too. What should I do?"
We don't always like to hear it, but sometimes potty training setbacks and failures have little to do with our toddlers and have a lot to do with our own decisions as parents. In this case, the problem is compound. There are really three possible issues to be addressed here and two of them have little to do with his readiness, skills or abilities. So, let's address these issues one at a time.
If That Doesn't Fix the Problem, Dig Deeper to Find Out Why Doesn't He Want to Use the Potty
Do you remember those first few days after giving birth? Your baby would cry and you were kind of sure he was hungry but maybe he needed a diaper change. Or maybe he needed to sleep. Or maybe he was too stimulated or too hot or too cold or… You kind of had to prod around to find the reason behind the cry. The same is true in this instance. Think of your child’s refusal to go to the bathroom as a cry and you’re going to need to do some detective work and engage in some trial-and-error experimentation to figure out what's wrong. Often your child can’t just come right out and tell you what the reason is.
Consider his development or maturity level: While your child’s problem solving skills are becoming more sophisticated every day, much of the way a child approaches a problem is based on his memory of what worked best in the past. Or, in this case, probably what didn’t work. There can be many things that can cause a child to avoid using the potty. For instance, he may avoid using the potty...
- if he was constipated at some point in the past and the bowel movement was painful.
- if he had spicy food and the bowel movement was painful and burned.
- if he was wiping himself and he got poop on his hands or made a big mess (this bugs some kids to the point that they want you to do all the clean-up).
- if he fell in the toilet at some point in the past (this sometimes also explains why a child will stand and pee but not sit and poop).
- if he’s afraid of the noise of the toilet flush (this is easy enough to remedy -- just flush when he's out of the room and teach him this skill later).
- if the toilet lid fell on his penis (this sometimes also explains why a child will sit to pee and poop even when they've been taught otherwise).
- if he is regularly engaged in activities that he doesn’t want to interrupt then he may delay going potty until he can simply hold it no more. Then he grabs a diaper, hides and has a quickie poop so he can get back to the action.
- if he has left activities to go potty and then, when he returned, the toys or activities were cleaned up, taken by another child or the he took so long it was time for another activity (he may make an association in his mind that pooping takes his fun away).
It's a bit like solving a jigsaw puzzle with all the pieces turned the wrong way, but hang in there because your toddler really needs you to help figure it out. Keep trying different things, asking different questions and don't be afraid to get analytical if necessary. Once you've learned what the problem is, you can start trying different solutions. You might be surprised how simple those solutions can be. Avoiding spicy foods, offering a toilet lid insert or giving assurances that his activity will be there when he gets back may be all that he needs.
Constipation and Avoiding Bowel Movements
Constipation is another story, however, and can take more work to fix and more time, too. Most toddlers have a consistent diet since this age is when they determine that they only want to eat a few favorite foods. Unfortunately those foods can often be refined foods that don’t provide the fiber needed for good bowel movements. These favorite foods can also be heavy on the dairy which is constipating for some children. If your child is having issues with this, you should try to get some regularity going and choose foods that cause regular, comfortable bowel movements like fruits and whole grains.
Regularity isn’t just good for your child’s system, it can help you get him into a routine and if you know when he’s going, you can work to make those times as positive as possible. If dietary changes don't seem to work, make an appointment with your health care provider and ask about using something like a gentle stool softener or laxative (like polyethylene glycol 3350) to help things along. Ask first before you give any over-the-counter medication.
Overcoming a Painful Potty Experience
The most difficult of the above issues is if your child had a fearful or painful experience. It can be difficult to help your toddler overcome fear of pain enough to want to try going on the potty again. If fear is involved, don't try to make this a sink-or-swim situation. Even as an older toddler, he doesn't have the coping skills to calm his own fears or know why he feels the way he does. This is the one case where I would suggest temporarily going back to diapers. It may be the only measure that gives him enough security to try using the potty again. As they say, "Time heals all wounds."
If you determine that a painful experience is keeping him from going and decide to stay in diapers for a bit, then just make sure you keep the lines of communication open. Continue to talk about the processes of going to the bathroom. Let him know that he is responsible for telling you both before and after he's gone to the bathroom in his diaper. Don't talk about going on the toilet or potty or try to get him to go there, but just focus on the bodily functions and on establishing the habit of communicating his needs. Once he's regularly doing that, announce a date to say goodbye to the diapers, remove them all from your home or use the last one and move forward with potty training once again.