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Trouble Potty Training a Three-Year-Old

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: My son is three and a half years old. He has shown some signs of potty training readiness and seems to be interested in trying, but he has had no success. He can sit on the potty for an hour, and it seems that as soon as he gets up, he wets his pants. As many times as he has sat on the potty, he has never gone once. I am wondering if there could be something wrong. Do you think we should see a doctor about this?

A: It does sound as if you may benefit from talking with your child's doctor about toilet training. There are no hard and fast guidelines for when a child should be toilet trained. In general, parents provide the encouragement and guidance, but when a healthy child is ready, he will do it eventually. Your child's doctor should be able to offer suggestions that will be helpful in getting your child over this hump.

Staying dry for periods of time during the day (daytime continence) is usually achieved between 36 and 48 months of age, with nighttime continence coming months to years after that. By meeting with your child's doctor, you can assess your child's signs of readiness for toilet training and identify potential barriers that may be slowing his progress.

There are many reasons why a child may be resistant to toilet training -- stress in the home, illness, hard stools, and parental pressures are common causes. The key for parents who are dealing with a resistant child is to stay positive and to reinforce all signs of progress. Sometimes a child even benefits from taking a break from toilet training. The "time off" can be helpful in decreasing the pressure of the experience for both parent and child. Talk with your pediatrician for the right approach for your son.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

Please note: This "Expert Advice" area of FamilyEducation.com should be used for general information purposes only. Advice given here is not intended to provide a basis for action in particular circumstances without consideration by a competent professional. Before using this Expert Advice area, please review our General and Medical Disclaimers.

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