Toilet Training and Accidents

by T. Berry Brazelton, M.D., author of Toilet Training: The Brazelton Way

Accidents happen. They often occur when a child is under pressure or is making an adjustment to a new demand. But they can occur when a child is having a coughing fit, or when he has to hold out too long. He may even wet when he's giggling. It is common for a child to be so excited about playing that he fails to pay attention to his bladder's signals. He will squirm, wriggle, and maybe even hold himself. Parents will know he's doing the "pee-pee" dance—even if he doesn't. At times like these, all he needs is a gentle reminder: "Do you need to go pee? You can come back and play some more as soon as you're done." In general, though, parents' reactions to accidents should be kept to a minimum. The less attention the better.

The child is likely to take accidental wetting or soiling more seriously than they deserve. Watch his face—Does he look sad or worried? Does his head hang? These are signs that he is taking the accident too seriously. Let him know you understand. You can help him understand why he may have had an accident. "You have just gotten used to being out of diapers. Of course, you're likely to make mistakes. Particularly after you've had a big fight with your older brother, or if mommy is going away. (A parent can mention any unusual pressure on the child.) I get tense too, and then I make mistakes. Don't worry about an accident like this. It's not the end of the world. You can control yourself most of the time. You've worked so hard and I hate to see you discouraged."

If he's really preoccupied about this, there may be something more serious on his mind. Don't probe, but do watch for it. Listen for it. Perhaps you'll hear: "They called me spoiled at school, and teased me about being a baby."

A common reason for accidents is a new baby in the house. After the initial adjustment has been made, and everyone assumes it's over, a recently toilet-trained child may start wetting again. The baby may have just made a new step in development—like crawling or standing. This is such an exciting step for the whole family that their attention may set in motion the older child's sibling rivalry. Wetting again may be a symptom of this new stress he feels.

Rather than being upset with the older child, try to understand it and to share it with him. Let him fall back on diapers or training pants until he is ready to try again. Unconsciously, he may be imitating the baby, but that would be too much to expect him to understand and to face. You might say, "You know, most kids need to go back to diapers for a little while every now and then. Don't worry. It won't be for long. You'll want to grow out of them again soon. I'm not in a hurry and I hope you're not. When I change you, you can be my baby again, too."

If the accidents happen frequently in a child who has been trained for awhile, there might be a medical cause. Parents will then want to consult the child's doctor. For instance, when a child (particularly a girl) starts wetting repeatedly after she's been dry for several months, she should be checked by her doctor for a urinary tract infection.

Excerpted from:

Excerpted from Toilet Training: The Brazelton Way © 2004 by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Perseus.

To order this book click here or call 1-800-253-6476.