Potty Problems: 4 Solutions to Your Preschooler's Toilet Troubles

It was a happy day when my oldest child was potty trained. For me, it meant no more dealing with the mess of diapers. For him, it signaled big-boy status. But then came the trip to our local mega mart -- and the public bathroom. My normally confident son approached the stall, and then quickly bolted out. Our problem? The bane of little kids everywhere: the dreaded auto-flush toilet. (My son fearfully referred to the red sensor as "the blinking eye" for years.)

You may think that you're past bathroom issues once your child earns that "officially toilet trained" certification. But there are other problems that can pop up, even for a kid who's a potty pro. "Learning to use the bathroom involves a series of stages, but parents can help their child master the process by remaining calm and supportive," says Edward Christophersen, Ph.D., a clinical psychologist at Children's Mercy Hospital, in Kansas City, Missouri.

Check out some of these tips to help your preschooler feel more comfortable.

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These typically happen when a kid hasn't gone to the bathroom in a while and becomes overexcited. She has a full bladder and gets so psyched about something ("A pony at the party!") that she can't control herself and pees in her pants. A child may also have accidents if she's been chronically holding it in, says Steve J. Hodges, M.D., professor of pediatric urology at Wake Forest University Baptist Medical Center, in Winston-Salem, North Carolina. "The bladder is a muscle just like any other," he says. "If she's been doing the potty dance all day, every day, she's constantly contracting her bladder." This makes the muscle thicker and the bladder's capacity smaller. Pretty soon, it'll start contracting with less warning and more force -- and your kid ends up with wet pants.

The solution is to make sure she goes to the bathroom regularly. Kids this age often don't realize they need to go until it's too late. You don't have to escort her to the bathroom every ten minutes, but be aware of the last time she went (and how much she's had to drink). As she gets older, she'll become more in touch with her body's timing.

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Going to the bathroom is a private event, so it's natural for kids to grumble about a bustling, noisy -- and let's face it, sometimes smelly -- public restroom. Your kid will never love going potty there, but you can make things easier by planning ahead and making sure he sees you using public bathrooms, whether it's at church or the mall.

Help him get comfortable with the process by making a couple of visits when he doesn't actually have to go, recommends Lawrence Balter, Ph.D., a psychologist in New York City. If he's fearful of the different loud sounds, point them out casually. Say, "Oh, look. When you press the button, it makes a noise and blows air to dry your hands." The next time you stop in, ask if he'd like to press it.

As for those toilets with a sensor? A surprise flush can scare any kid into refusing to use one ever again. Dr. Balter suggests the same method. "Before he even uses the toilet, have him stand in front of it, then calmly tell him, 'You don't even have to press anything and the toilet will flush down this paper for us.' " And if your child really has to go -- right now? Clever moms carry a few Post-it notes in their purse. Stick one over the "blinking eye," and it won't flush until your kid wants it to, so he can pee in peace.

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Cleaning up is easy for most kids to handle after urinating, but after a bowel movement it's another story. "The majority of 3- and 4-year-olds don't have the strength or dexterity to really do the job right," says Dr. Christophersen. "Kids usually have to be at least 5 to do it properly." But for now, you can help your child get the hang of it.

The best way to do this is to teach the "wipe, look, and drop" method. Be sure to explain how you press firmly to wipe, then look at the tissue, and drop it into the toilet. Remind her that you need to repeat the process until the tissue comes back clean and finish up with a thorough hand-washing. Keep the whole thing simple and matter-of-fact, and skip any extra commentary if it's messy. After you've shown her how to wipe once or twice, turn the task over to her but do a follow-up check of your own. If your child's a neatnik, she may not want to even give it a try, but stay firm. This is a skill that preschoolers need to master.

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Your kid can become constipated because he's choosing not to go, or it could be his diet or lack of fluids that's backing him up. Either way, it can turn into a vicious cycle: If he doesn't go for a while, pooping becomes even harder and more painful -- and that makes him not want to go. "It's important for a child to eat plenty of fiber and go when he gets the urge," says Dr. Hodges. But bathroom breaks aren't high on any child's priority list. He'd probably rather hold it in and keep on playing with his friends.

You can't force him to go to the bathroom, and you definitely don't want to turn the situation into a power struggle that you'll both lose. "The natural urge to poop is usually in the morning or after a meal. Make it a routine to get him to the bathroom then," suggests Dr. Hodges. Offer high-fiber foods like whole-wheat pasta, black beans, and apples. Talk to your doctor about whether giving your child a stool softener like Miralax would be helpful. If his constipation -- or any other potty trouble -- seems to be a chronic problem, your pediatrician may want to make sure there are no other underlying issues.

Originally published in the April 2011 issue of Parents magazine.

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