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Backsliding on Potty Training
Q: My daughter has been potty trained for three months with some accidents. She was doing so well, but the accidents have recently increased significantly. She's pooped in her panties two days in a row. Do you have any suggestions?
A: Relax! Toilet training is a lot of work for both the child and parents. Remember that accidents will happen naturally, so try not to get too frustrated by them. It sounds like your daughter has been doing a great job for three months and there's no reason to believe she won't continue to do so. Just like learning to tie her shoes, toilet training takes lots of practice to make perfect.
Since your daughter is having bowel movement (BM) accidents, she may need friendly reminders. Explain that her body makes poop everyday which needs to go into the toilet. Teach her how to listen to what her body is telling her (for example, the sensation of a full tummy) which suggests she needs to use the toilet. It's also important to keep your daughter on a regular schedule. Having her sit on the toilet shortly after a meal helps. Why? Because eating tends to stimulate the movement of stool through our intestines, giving us the urge to have a BM. She should also sit on the toilet before leaving the house and at bedtime.
Accidents can also occur when a child is too excited or too busy. She may be rushing through the process to get back to playing as soon as possible. To reduce accidents, make each toilet sitting a pleasant experience. For instance, try reading her a story each time. You should also give her responsibility. Make sure that she takes an interest in staying dry. She should help clean and change herself whenever she has an accident.
Avoid punishments and, instead, offer small rewards on days or weeks without accidents. A potty chart with stickers on the wall to document successes gives her more encouragement. Let others know about her routine so it can be maintained away from home, too. Positive reinforcement works wonders and helps build your daughter's self-confidence. Like reaching the other milestones of growing up, your daughter will master toilet training at her own pace. Be patient. If she continues to have a lot of accidents despite your best efforts, touch base with her doctor.
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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.