Toilet Training and Bedwetting

Toilet Training

Many parents are unsure about when to start toilet teaching or "potty training." Not all kids are ready at the same age, so it's important to watch your child for signs of readiness, such as stopping an activity for a few seconds or clutching his or her diaper.

Most children begin to show these signs between 18 and 24 months, although some may be ready earlier or later than that. And boys often start later and take longer to learn to use the potty than girls.

Instead of using age as a readiness indicator, look for other signs that your child may be ready to start heading for the potty, such as the ability to:

·        follow simple instructions

·        understand words about the toileting process

·        control the muscles responsible for elimination

·        express a need to go verbally

·        keep a diaper dry for 2 hours or more

·        get to the potty, sit on it, and then get off the potty

·        pull down diapers, disposable training pants, or underpants

·        show an interest in using the potty or wearing underpants

About Timing

There are some stressful or difficult times when you may want to put off starting the toilet-teaching process — when traveling, around the birth of a sibling, changing from the crib to the bed, moving to a new house, or when your child is sick (especially if diarrhea is a factor). It may be better to postpone it until your child's environment is stable and secure.

Also, some experts may recommend starting the process during summer because kids wear less clothing, but it is not a good idea to wait if your child is ready

How Long Does It Take?

Of course, teaching a toddler to use the potty isn't an overnight experience. The process often takes between 3 and 6 months, although it may take more or less time for some children.

And although some little ones can learn to both make it through the night without wetting or soiling themselves (or the bed) and use the potty around the same time, it may take an additional months to even years to master staying dry at night.

Potty Types

The two basic potty options are:

1.    a standalone, toddler-size potty chair with a bowl that can be emptied into the toilet

2.    a toddler-size seat that can be placed on top of your toilet seat that will let your child feel more secure and not fear falling in

If you opt for the modified toilet seat, consider getting a stepping stool so that your child can reach the seat comfortably. Stools can also help kids learn to push with their legs when having a bowel movement.

It's usually best for boys to first learn to use the toilet sitting down before learning to pee standing up. For boys who feel awkward — or scared — about standing on a stool to pee in the toilet, a potty chair may be a better option.

Buy a training potty or seat for every bathroom in your house. You may even want to keep a potty in the trunk of your car for emergencies. When traveling long distances, be sure to take a potty seat with you and stop every 1 to 2 hours. Otherwise, it can take more time than your child may have to find a discreet location or restroom

About Training Pants

Experts sometimes disagree about whether to use disposable training pants. Some think that they're just bigger diapers and might make kids think it's OK to use them like diapers, thus slowing the toilet-teaching process.

Others feel that training pants are a helpful step between diapers and underwear. Because kids' nighttime bladder and bowel control often lags behind their daytime control, some parents like using training pants at night. Others prefer that their child use training pants when they’re out and about. Once the training pants remain dry for a few days, kids can make the switch to wearing underwear.

Ask your doctor if your child would benefit from using disposable training pants as a transitional step.

Common Problems

It's common for a previously toilet-taught child to have some trouble using the potty during times of stress. For example, a 2- or 3-year-old dealing with a new sibling may regress (return to a previous level of development).

But if your child was previously potty trained and is having problems, talk with your doctor just to be on the safe side and to rule out things like an infection.

If your child is 3 years or older and is not yet potty trained, talk to the doctor, who can help determine the problem and offer advice to make the process easier

Tips for Toilet Teaching

Even before your child is ready to try the potty, you can prepare your little one by teaching about the process:

·        Use words to express the act of using the toilet ("pee," "poop," and "potty").

·        Ask your child to let you know when a diaper is wet or soiled.

·        Identify behaviors ("Are you going poop?") so that your child can learn to recognize peeing and pooping.

·        Get a potty chair your child can practice sitting on. At first, your child can sit on it clothed. Then, he or she can sit on the chair with a diaper. And when ready, your child can go bare-bottomed.

If you've decided that your child is ready to start learning how to use the potty, these tips may help:

      Set aside some time to devote to the potty-training process.

      Don't make your child sit on the toilet against his or her will.

      Show your child how you sit on the toilet and explain what you're doing (because your child learns by watching you). You can also have your child sit on the potty seat and watch while you — or one of his or her siblings — use the toilet.

      Establish a routine. For example, you may want to begin toilet teaching by having your child sit on the potty after waking with a dry diaper, or 45 minutes to an hour after drinking lots of fluid. You may be able to catch your child peeing. Only put your child on the potty for a few minutes a couple of times a day, and let your child get up if he or she wants to.

      Try catching your child in the act of pooping. Children often give clear cues that they need to use the bathroom — their faces turn red, and they may grunt or squat. And many kids are regular as to the time of day they tend to have a bowel movement.

      Have your child sit on the potty within 15 to 30 minutes after meals to take advantage of the body's natural tendency to have a bowel movement after eating (this is called the gastro-colic reflex).

      Remove a bowel movement (poop) from your child's diaper, put it in the toilet, and tell your child that poop goes in the potty.

      Make sure your child's wardrobe is adaptable to potty training. In other words, avoid overalls and shirts that snap in the crotch. Simple clothes are a must at this stage and kids who are potty training need to be able to undress themselves.

      Some parents like to let their child have some time during the day without a diaper. If he or she urinates without wearing a diaper, your child may be more likely to feel what's happening and express discomfort. (But if you opt to keep your child's bottom bare for a little while, you'll probably need to keep the potty close by, protect your rugs and carpet, and be willing to clean up.)

      When your son is ready to start peeing standing up, have "target practice." Show him how to stand so that he can aim his urine stream into the toilet. Some parents use things like cereal pieces as a sort of bull's-eye for their little guys to try aiming at.

      Offer your child small rewards, such as stickers or time reading with Mommy, every time your child goes in the potty. Keep a chart to track of successes. Once your little one appears to be mastering the use of the toilet, let him or her pick out a few new pairs of big-kid underwear to wear.

      Make sure all of your child's caregivers — including babysitters, grandparents, and childcare workers — follow the same routine and use the same names for body parts and bathroom acts. Let them know how you're handling the issue and ask that they use the same approaches so your child won't become confused.

Above all, be sure to praise all attempts to use the toilet, even if nothing happens. And remember that accidents will happen. It's important not to punish potty-training children or show disappointment when they wet or soil themselves or the bed. Instead, tell your child that it was an accident and offer your support. Reassure your child that he or she is well on the way to using the potty like a big kid.

And if you're torn about when to start the toilet-teaching process altogether, let your child be your guide. Don't feel pressured by others (your parents, in-laws, friends, siblings, coworkers, etc.) to begin. Many parents of past generations started potty training much sooner than many parents do today. And it all depends on the child. Kids will let parents know when they're ready

Bedwetting

Bedwetting is an issue that millions of families face every night. It is extremely common among young kids but can last into the teen years.

Doctors don't know for sure what causes bedwetting or why it stops. But it is often a natural part of development, and kids usually grow out of it. Most of the time bedwetting is not a sign of any deeper medical or emotional issues.

All the same, bedwetting can be very stressful for families. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.

Bedwetting may last for a while, but providing emotional support and reassurance can help your child feel better until it stops.

How Common Is Bedwetting?

Enuresis, the medical name for bedwetting, is a common problem in kids, especially children under the age of 6 years. About 13% of 6-year-olds wet the bed, while about 5% of 10-year-olds do.

Bedwetting often runs in families: kids who wet the bed often have a relative who did, too. If both parents wet the bed when they were young, it's very likely that their child will.

Coping With Bedwetting

Bedwetting usually goes away on its own. But until it does, it can be embarrassing and uncomfortable for your child. So it's important to provide support and positive reinforcement during this process.

Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about other family members who also struggled with it when they were young.

Remind your child to go to the bathroom one final time before bedtime. Try to have your child drink more fluids during the daytime hours and less at night. Fluids given later in the day should not have caffeine. Some parents try waking their kids in the middle of the night to use the bathroom. Many also find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

When your child wakes with wet sheets, don't yell or spank him or her. Have your child help you change the sheets. Explain that this isn't punishment, but it is a part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night

When to Call the Doctor

Bedwetting that begins abruptly or is accompanied by other symptoms can be a sign of another medical condition, so talk with your doctor.

The doctor may check for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes, or severe stress.

Call the doctor if your child:

      suddenly starts wetting the bed after being consistently dry for at least 6 months

      begins to wet his or her pants during the day

      starts misbehaving at school or at home

      complains of a burning sensation or pain when urinating

      has to urinate frequently

      is drinking or eating much more than usual

      has swelling of the feet or ankles

      your child is still wetting the bed at age 7 years

Also let the doctor know if you're feeling frustrated with the situation or could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about the bedwetting.

Remember, the long-term outlook is excellent and in almost all cases dry days are just ahead