Is your 4+ year old still not potty trained? Everyone has an opinion on this topic. You, your mom, your Facebook mommy friends, your pediatrician, your cousin who you only see once in a blue moon….. What if traditional, forced potty training isn’t the best option?

Everyone thinks they know how to best potty-train. You need to just make him go diaper-less for 3 days! Just clean up the messes! You need to make him sit for an hour on the potty until he pees – he will get it! Reinforce with candy! I can only know what is working for my own child. When you have a child with delays, Sensory Processing Disorder, physical disabilities, challenges with potty training are much more common.

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E’s Potty Learning

My son is 4. He had phases of being interested in the potty. During those phases, I found myself getting too focused on completing the task of reverting from my own parenting beliefs. I pushed. And each time – his interest waned.  One of my concerns with him revolved around the sensory aspect. Did he know that he needed to pee? We realized that when it was time, he would know and we wouldn’t need to push.

I talked to his pediatrician about potty-training (if you are concerned, please consult yours!). I expressed my concern that he was not trained (I believe this was at his 3 year). She was in no way concerned, and praised our style of waiting and letting him take the lead. She also said that she has seen more children with GI/urinary concerns who started training too early.

By the time he was ready, E was able to verbalize how he was feeling. He could pull up and down his diaper/pants. He was expressing more and more interest in independence and being a “big boy.”

We have always had a floor potty easily accessible. When the pandemic hit and we were stuck home, we figured it was a great time to take advantage and gently encourage potty learning. He had asked for special undies.  We reminded him that undies are not for peeing in. They don’t work like that. So we needed to work on peeing in the potty and not the diaper before we could get those awesome undies. We read special potty books while he sat on the potty. He absolutely adores this book (I can now recite it by heart…)

We changed pee diapers with zero negativity and praised any time he peed on the potty. It only took a few days when he made the decision that he was ready. It was so easy – all those times before when I started to push were just unnecessary. This occurred about 2 months ago and since then he has had only 3 or 4 accidents. He is loving the increased independence and can now tell us when he needs to go, rather than us reminding him every hour or two to go try.

Here’s some research and medical info:

1. One study found that 60 percent of early trainers (before age 2) experienced daytime wetting. Almost all of those children had issues with constipation¹  
2. Only 40 to 60 percent of children complete toilet training by 36 months²
3. Children on the spectrum or those with SPD potty train later³
4. Did you know that pushing potty training when a child is not truly ready (physically, emotionally, etc.) can lead to
   • Bladder problems, including daytime wetting after being trained and UTI’s⁴
   • Unnecessary stress⁴
   • Constipation and other GI issues⁵

What are signs that your child might be ready?⁶

1. Can dress him or herself
2. Expresses interest in the toilet
3. Has regular, healthy, bowel movements
4. Asks for a clean diaper
5. Asks for underwear

Do you see where there may be a hiccup? E is 4. He has worked with OT to learn to dress himself. It wasn’t until this year that he has been able to put on his diaper/undies, shorts, and socks on independently. The shirt is still something we are working on.

Constipation

If your child is dealing with constipation, potty learning is not going to go well. One reason we knew forced potty training wouldn’t work, is that constipation has been a chronic issue. He had the hard clumpy stool that he had to strain so much for (E calls them “poopy rocks.”) Some kids with constipation go 4+ days without pooping, and it becomes the norm. If E skips just one day, his body goes out of whack and his sensory system becomes much more sensitive (Interoception!). He even had to have an enema at the hospital one time after a spell of vomiting! That was a pretty awful experience… We tried different things, like Mamas Bliss Constipation Ease, which helped in a pinch. What also helps is what E calls “flower chocolates.”

1. Put equal parts coconut oil and chocolate chips in a bowl.
2. Microwave for 30 seconds and stir. Microwave again if necessary, until it becomes a smooth liquid.
3. Pour this mix into chocolate/candy molds and chill.

He is now very regular, but we have decreased dairy to special occasions or very small amounts, monitor diet/water, and this fiber/probiotic supplement. If you use it, be sure to mix into oatmeal, yogurt, or applesauce. It doesn’t dissolve well into liquids.

Is your child dealing with constipation? What has worked for you? Please leave thoughts and comments below!

References

¹Wake Forest Baptist Medical Center. (2014, October 7). Potty training before age two linked to increased risk of later wetting problems. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2014/10/141007091657.htm

²Choby, B., & George, S. (2008, November 01). Toilet Training. Retrieved from https://www.aafp.org/afp/2008/1101/p1059.html

³Healthy Children.Org. (2012, February 8). Toilet Training Children with Special Needs. Retrieved from https://healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-Children-with-Special-Needs.aspx

⁴Children’s Health Team. (2020, April 28). Are You Potty Training Too Soon? Retrieved from https://health.clevelandclinic.org/are-you-potty-training-too-soon/

⁵Salahi, L. (2012, July 18). Is Potty Training for Toddlers Harmful? https://abcnews.go.com/Health/Wellness/early-potty-training-harmful/story?id=16806522

⁶Choby, B., & George, S. (2008, November 01). Toilet Training. Retrieved from https://www.aafp.org/afp/2008/1101/p1059.html

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