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Potty Training Disorders

by Sharon Perkins

Most children do eventually become potty-trained, although you might despair of your child ever getting to that point. Physical or emotional issues can arise during potty-training that complicate the process. If you're struggling with potty-training your child, knowing some of the problems you might face can help you figure out how to treat or avoid them.

Toilet Phobias

Toilets can be scary objects for little ones. They're loud and they make parts of people -- yes, urine and stool are a part of your child, in his eyes -- disappear, never to be seen again. A bad experience on the toilet, such as pain from a hard or large stool, parental scolding or punishment threats, can also set up a toilet phobia. A power struggle with parents can also cause point-blank refusal to try to use the toilet. Take steps to gradually reduce fear of using the toilet. For example, first have him empty his diaper into the potty. Then have him produce a bowel movement in the bathroom with his diaper on. Progress to having a bowel movement with a "magic diaper," which has a hole cut in it and lastly, to having bowel movements on the potty. Don't flush until he leaves the room.

Holding Stools

Some kids attempt to avoid the whole potty training scene simply by refusing to go at all. Holding back stools makes them more difficult to pass, which creates a vicious cycle of stool holding, pain when defecating and more stool holding. Laxatives can help break the cycle of stool holding, which, in its most extreme form, can lead to an intestinal blockage or manual removal of the stool, which is every bit as unpleasant as it sounds. Stools softeners alone often don't work for stool holder, pediatrician Barton D. Schmitt warns in the 2004 issue of "Contemporary Pediatrics." Your child might need a daily laxative to trigger the urge to defecate, Schmitt suggests. Talk to your child's pediatrician before using any type of over-the-counter laxative for your child.

Daytime Dribbling or Incontinence

Some children have difficulty completely emptying their bladder, which results in leakage during the day. Problems with the muscles of the bladder or simply impatience when urinating can cause incomplete emptying and daytime dribbling. Urinary tract infections can also cause urinary incontinence or dribbling. Urinary tract infections occur more frequently in little girls, because bacterial contamination from stool is more common due to the proximity of the rectum and urethra. Most kids don't wipe well until they're nearly 4 years old, or around 45 months of age, psychologist Gwen Dewar explains on her website, Parenting Science.

Bed-wetting

Overnight bladder control develops more slowly than daytime control, for many children; many children don't achieve nighttime control for six to 12 months after they master potty training during the day, according to Dewar. A smaller-than-normal bladder, poor muscle control, urinary tract infection or the inability to recognize signs that the bladder needs emptying can all contribute to bed-wetting. The American Academy of Pediatrics doesn't consider bed-wetting abnormal until your child reaches the age of 5.

About the Author

A registered nurse with more than 25 years of experience in oncology, labor/delivery, neonatal intensive care, infertility and ophthalmology, Sharon Perkins has also coauthored and edited numerous health books for the Wiley "Dummies" series. Perkins also has extensive experience working in home health with medically fragile pediatric patients.

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