‘Let Max know it is OK to have accidents’
Friday, June 2, 2017
Max is nearly four years old but still refuses to open his bowels on the potty. Are we right to suggest he goes back into nappies at nursery? Hilda Miller, nursery SENCO, suggests how to approach this sensitive situation.
Q Max attends pre-school part-time. He is three years and nine months old and is still showing no inclination to toilet train. His mother started to toilet train him when he was two years and 10 months old and he made good progress with sitting on the toilet or potty when he needed a wee but never for a poo. He can do up to 10 small poos a day and never say that he needs the toilet, preferring to go into a corner to hide.
After discussion with his mother, we were sitting him on the potty if we saw this happening but then he'd withhold the poo. Max had constipation as a baby and toddler before starting potty training and took medication for this. His mother is concerned that this may happen again. We have talked about the issue and agreed that it is best that he goes back to wearing nappies for a while at pre-school and at home. He can use the toilet if he wishes to but we're not putting pressure on him to do so and at the moment he isn't choosing to.
Max is often upset and resistant to having his nappy changed, even when it is soiled, and other children are starting to question why he is still wearing nappies.
Children refusing to open their bowels on a potty is quite common. There can be a number of reasons for this. Max suffered from constipation as a baby and as he is having up to 10 small poos per day this could indicate that he may still be suffering with this. If this is the case then Max may find opening his bowels quite painful, so it may be worthwhile seeking medical advice.
It might also be worth talking to Max's mum about his fluid intake as lack of fluids can result in very hard stools and constipation. There are also a lot of foods that can assist with bowel movements so I suggest looking into that and maybe increase Max's vegetable intake.
A lot of children also find defecating difficult as they see their poos as part of themselves so can find it very distressing.
Potty training is a huge psychological change for children and has to be dealt with very sensitively. When Max was originally potty trained he may not have been psychologically or emotionally ready and this can have an adverse effect on how long it can take for him to master this milestone.
If Max is having accidents daily then we need to let him know that this is OK. Never get cross or frustrated, just show Max where he needs to go and encourage him to go for a poo on the toilet or potty.
You can use visual aids to support children through this very difficult time. Always use lots of praise, and I think it's important not to give up.
I would not recommend that you put Max back in nappies at nursery as this is a backward step and he gets distressed when having his nappy changed. I would advise mum to bring in lots of spare clothes and, if Max does have an accident, flush the poo into the toilet and encourage Max to wave goodbye to it.
Max is nearly four-years-old so he is probably feeling very confused and frustrated.
The more pressure that he is under to poo in the toilet or potty may be hindering his progress so we need to let him know that it is alright to have accidents, that you are there to support him and that he will be able to go for a poo on the potty or toilet when he is ready.
Compiled by Annette Rawstrone.
ERIC, the bowel and bladder charity, has advice on potty training. Visit: www.eric.org.uk
If you have a problem for Hilda please email firstname.lastname@example.org