Toileting: Questions and Cases

Contents

Anne Armstrong-Coben, MD

November 2007

 

  1. The mother of a 1 year old girl tells you that she has decided to begin toilet training her daughter.  A friend told her this was the right time to start.  What is appropriate advice regarding the age to begin this process? 

     

    Upon further discussion, the mother reveals that the cost of diapers has factored into her considering the initiation toilet training.  Do you have a response for the mother’s concern regarding the cost?

     

  2. The parents of a 2 year old think that their son is ready to begin toilet training.  However, they do not want to push him too soon because they have heard that can lead to future problems.  What would you discuss with/ ask the parents in order to determine if the boy is ready to begin the process of toilet training?  Is their fear of future problems a real one and how would address this?

    3.  

  3. The above family decides that their son is ready to begin the process.  They now want to know- “How do we do it?”

    4.  

  4. The parents of a 3 year old are at the end of their rope.  Their son refuses to defecate in the toilet.  He has been dry for a year but will only stool in a diaper.  What are your questions and your advice?

    5.  

  5. A 5 year old is in for her well child visit.  Her parents are embarrassed to discuss it but reluctantly admit that she is still wetting the bed nearly every night.  All of her siblings were dry at this age and the mother is angry and tired of washing the sheets and mattress.  The father then offers the information that he was never able to sleep over friends’ homes because of the same problem.

 

Primary Toilet Training References:

  1. Turner TL, Matlock KB. Toilet Training. UpToDate Online. November 29, 2006
  2. Michel, RS. Toilet Training. Pediatrics in Review. 1999;103:1359
  3. American Academy of Pediatrics Parent Guide to Toilet Training http://www.aap.org/publiced/BR_ToiletTrain.htm

 

An old but historically significant article that is often cited. 

  1. Brazelton, TB. A child-oriented approach to toilet training. Pediatrics 1962;29:121

 

Primary Enuresis Reference:

Gonzales ET, Tu ND. Approach to the child with nocturnal enuresis. UpToDateOline. October 16, 2006

 

Books for Children:  There are soooo many.  Some classics….

Once Upon a Potty by Alona Frankel

No More Diapers by JG Brooks

Everyone Poops by Taro Gomi and AM Stinchecum

 

Resources for Parents:

The American Academy of Pediatrics Guide to Toilet Training

 

Public libraries often have books and videos about toilet training.