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3 year old won't use potty

Dr. Laura,
What do you do with a 3 1/2 year old in preschool who won't use the potty chair for a BM? She will hide to go in her diaper. She goes #1 in the potty chair just fine. We have never scolded her, only gentle reminders that #2 goes in the potty chair too. We have also told her about activities that she will be able to do next summer if she does get potty trained, like simming lessons. We try not to put too much pressure on her only that next time try to go in the potty in the chair. She simply refuses saying, "no I just go in my diaper." Maybe we didn't spend enough time with her when she was little, I don't know. Thank you.
Jenny

Dear Jenny,

I had to laugh when I read your comment "Maybe we didn't spend enough time with her when she was little, I don't know. "  

It's actually very common for a 3.5 year old not to want to use the potty chair for BMs.  If we can figure out the reason, we can address it.  Here are the most common reasons (and of course they don't include not having spent enough time with her!)

1. She's afraid she'll fall in.  We can cross this one off since it is usually a reaction to the toilet, not the potty, and you are using the potty, right?

2. She's had some bad experience at preschool.  This raises the question:  What happens when she has to go #2 at preschool?   Do they change her diapers? If they ridicule her, it is possible that she is having a power struggle with them and therefore doesn't want to stop using her diaper.  Worth checking out. 

Also, if they don't have a small potty and the alternative is the toilet, then she might well be nervous about sitting on the big toilet if at home she only sits on the potty.  I have repeatedly heard that kids at preschool get frightened when they see some kid "fall in" the toilet at school.  Again, worth checking out.  (Unless she does use the toilet at home and you know she is fine with it.)

3. Her body is accustomed to the position of squatting to move her bowels.  This is the most common reason.  On the toilet, many kids just can't get the leverage they need to push, because their feet dangle, which tightens rectal muscles and makes defecation difficult.  But even on the potty, little ones aren't in their usual position to defecate, because instead of squatting, they are sitting back.  This takes some retraining of their bodies. 

So if she is indeed using the potty at home, I would try getting one of the most simple potties, that she can squat over.  Baby Bjorn makes some very small ones -- I think one is called the Smart Potty. You want one low enough to the ground that her knees are higher than her bottom, and of course her feet flat on the floor, so she feels like she is squatting. 

(If she is using the toilet, you might want to consider a stool like this:  http://www.thepottystool.com/index.html.  I know it might seem excessive to buy a special stool, but it gives kids the support and security they need, as well as the leverage.)

4.  She wants privacy.  It's normal for little ones to"hide" when they have a BM.  Where does she usually go in her diaper?   One option is to put the new potty there and tell her she can squat over it with her diaper on.  But then you will have to pursue her there to be sure she actually squats over the potty, so it sort of defeats the purpose of privacy.  A better option, if she goes at a regular time of day, is to make a big deal about the new potty you got her, and how she can have some special alone time with it, and can even keep her diaper on, you can do it, and have privacy,  but she has to squat over her potty in the bathroom.  (With the diaper on, to start. More on that in a moment.)  And with incentives...

5. She needs some incentive.  When you think about it, your daughter has no reason to want to use the potty; this is for your benefit (or at least that is what she assumes.)  She is in this habit, and changing a physical habit is hard, even scary.  You might have to provide some incentive, like a small basket of wrapped small  gifts that she can choose one to open and play with as she squats over the potty.  I don't generally recommend "rewards" beyond parental hugs, but I have heard so many stories of kids having a hard time making this transition, and then "holding" so they get constipated, and it becomes a vicious cycle.  I think making it worth their while to "try" to change this entrenched habit is probably worth it.   

This doesn't really taking buying many small toys, since she opens a toy and successfully uses the potty for her BM, she is allowed to play with the toy for the next two hours, but then it goes back in the basket and she can look forward to playing with it then. Sometimes that is a great motivator to get her back on the potty.

I know one family that used a hand-held video game that was only available to the child during potty time.  Apparently, it was very quick and effective in solving what had become an intransigent problem in which their son adamantly refused to use the potty.

6. She is used to the feeling of her diaper and is frightened to have a BM without it on.  Again, VERY common.  Tell her she can go in her diaper, no problem.  She can wear it while sitting on the potty.  Once she does this, change her in the bathroom and let her help you flush the contents of her diaper, reminding her that "BMs go in the toilet."  (WARNING: Only do this if she is not afraid of the toilet, obviously. And let her be the one to flush.)

Give her a couple of weeks of this to solidify her habit of going into the bathroom to have her bms on the potty, in the bathroom, in her diaper.  Then start loosening the diaper, so it is on/under her still but not as tight.  Just gradually loosen it, day by day, until she is finally having her BM ON the diaper, but it is not even attached to her.  Then it is just a small step to take it off her as she sits down, and lo and behold, she is using the potty!

This may seem like a lot of trouble to go to, and it is.  On the other hand, she's already 3.5 and set in her ways, and you really want her potty trained.  Fighting with her about her body is a fight you won't win.  So far you have shown terrific restraint, and that is great, because you have side-stepped any kind of power struggle.  But maybe it is time to give her some incentive?

 I will tell you a story.  When my son was your daughter's age, he also would pee in the toilet but needed a diaper for BMs.  One day when I was changing him, I said "I'll be glad when you decide to use the toilet for BMs. "  He was shocked, and asked "Why?"  Clearly this had never really sunk in, even though I had been telling him that some day he would use the toilet, and that BMs go in the toilet.  "Because I love you, but I don't love changing poopy diapers" I told him.  He never used his diaper for BMs again!   I think it is ok to express your preference, as long as it isn't a power struggle, and doesn't involve punishment. 

I hope this is helpful.  Please let me know how it goes. Good luck!
Dr. Laura

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Anonymous commented on 14-Mar-2011 04:49 AM
I am having this problem but the opposite my daughter will not willing go pee in the potty on her owe but has no problem with bm and she is 38 months old. My husband stated it could be she want more attention that it's my fault because I don't spend enough time with her. In the mornings i take her to the potty and she screams no potty, no potty. Every morning I ask her, plead please go pee in the potty for mommy 85% of the time it is a no go. My daycare person says it is a no go also she had to drag her to the potty.recently I started using cloth underware from morning to bed time on her so far she wets her self several times a day usless I drag her to the potty and then fully insist she uses it, not a fun chore! Plesse what else can I try to get her to use the potty. Thanks for any helpful advice. feeling like a bad parent in PA.
jenny commented on 07-Apr-2011 01:05 AM
My daugther is 3.5 and still wearing daipers for #1 & #2. She goes pee on the potty at preschool, but refuses at home. She has had a constipation problem since she was 6 months old. I've had her on daily miralax since 6 months. She has held her BM's for
as long as 8 days. I've been to a prediatric gastroenterologist and talked to my pediatrition about this problem repeatedly, but no one has any answers other than it's in her head. My ped even recommended therapy, which I have tried. The therapists says my
daughter may have ADHA and recommended a psychiatrist. My daughter and I have a difficult relationship. She is very strong-willed. I get very frustrated and I'm very worried about her being on laxatives for so long. I'm at my wit's end that she is not potty
trained. I don't know what to do anymore. I feel like a failure as a mother.
Laura Markham commented on 07-Apr-2011 07:56 AM
Unfortunately, when we have power struggles with our children, they often get entrenched over potty-training.



Jenny- This sounds to me like either a power struggle -- you have a difficult relationship with your strong-willed daughter -- or encopresis, or both. Take a look at the whole thread on encopresis here:




http://www.ahaparenting.com/_webapp_3723625/Fecal_Retention,_Encopresis_in_5_Year_Old



And I don't think your three year old needs therapy. I strongly recommend that YOU seek parenting coaching. There is no reason to have a difficult relationship with your daughter. You may muddle through this, but there will be worse crises unless you figure
out how to partner with your strong-willed child! -- Dr. Laura



Anonymous- I suggest you take the pressure off by not making a big deal about the peeing for now. Fights with your daughter about her body are fights you will never win. Instead, try a little play therapy -- take two stuffed animals and have them re-enact the
scenario you describe where the little one screams "No potty!" See what happens with your daughter after this. Also, if it is true that your daughter needs more time with you, then spending that time would make a huge difference in her willingness to cooperate
with you. If you need some support with the play therapy, please contact me for parenting coaching:



https://yps1.worldsecuresystems.com/Parenting-Coaching



Good luck! -- Dr. Laura
Anonymous commented on 27-Dec-2011 11:37 PM
I am trying to potty train my 3 year old. - ughh how hard could these possibly be. Well she will do it for everyone but me or her father. She won't tell us that she has to go. She wears underwear to preschool, but wants diapers at home. I have tried putting
her on the potty everyhour and all the other stuff one reads about but she still makes messes and wants her diaper. I am pulling my hair out trying to figure this one out. Anyhow, this evening she decided to role play going to the bathroom. We were sitting
in the family room and she said, "mommy I need to go potty," I said ok and got up to take her there hoping this was the new welcomed change. Anyhow she said sit down I pretend. And she began to role play walking to the bathroom, opening a fake door, pulling
her pants and diaper down, pretended to sit on the potty and go pee and poo. then proceeded to wipe and pull her pants up, flush and wash and dry her hands. Does anybody know is this a sign that she is ready, or beyond ready and just can't sort out in her
own mind that she should do it for real. Please give me advice, cause I am so so so stressed over this. Leslie

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