Dear Is This Normal,

My daughter is 3 years and 3 months old. She does not have accidents anymore but will not use the toilet or potty either. She waits until nap time or bedtime when her pull up goes on to pee or to have a bowel movement. I have tried almost everything (even taking the pull up off at nap time, which just resulted in a big mess). I continue to try and underwear is the only thing I use now during the day and even when we go out. But she continues to hold her urine in until that pull up comes on at night. I’ve even tried putting the pull-up back on but she stays dry until she gets in bed. There was only 1 occasion where she used the toilet to pee and my husband and I made a huge deal and rewarded her but she did not do it again after that. I am lost on what to do and I am desperate for help.

Signed,

Potty Boycott

Dear Boycott,

Oof. My sincerest sympathies to you – potty training is not for the faint of heart! I have always said that if I somehow had to do it all over again, I would gladly take a mulligan on the newborn stage if that meant not having to potty train. And full disclosure, we got through it pretty unscathed, all things considered! But even when it goes well, it’s a rough road to travel. Because kids aren’t born with this innate understanding of how to use a toilet, and it can be scary and stressful for them (and you!). Setbacks are super common, as are regressions. And every child is completely different when it comes to potty training – they def pee to the beat of their own drum. It sounds like your kiddo has an understanding of the basic mechanics, but is dealing with some mental blocks. A toddler holding their pee until they can get to a toilet – totally expected. A toddler holding pee until nap time so they can release sub- or unconsciously? Definitely something that needs to be addressed, not just for the implications for potty training, but also for health reasons. So let’s talk about it.

One of the concerns with a toddler, particularly a female, holding their urine for long stretches of time, is that it can lead to urinary tract infections. The female urethra is much shorter than a male urethra; bacteria in the bladder can multiply if it’s not emptied regularly, and that bacteria can easily (and quickly!) make its way into the urinary tract and cause issues. Same principle behind the front-to-back wipe for girls – we don’t want to introduce bacteria into the urethra that could lead to an infection. My first recommendation would be to have your daughter checked out by her pediatrician, to rule out that she doesn’t already have a UTI. That could definitely be contributing to her unwillingness to pee on the toilet, since it can cause some ‘performance anxiety’ (unable to pee) and discomfort. Kids, especially younger kids, aren’t always able to accurately communicate why they can’t pee or if it hurts when they do, so ao urinalysis to rule out a UTI would be my first step. 

Once you’ve got a clean bill of health, it’s time to tackle breaking through this barrier she’s put up and work with her on peeing in the potty and not a pull-up or diaper. You mentioned that she has peed on the toilet at least once, so she CAN do it. Now it’s just a matter of getting her comfortable with doing it on a regular basis! For this, there is but one answer: Bathroom Bootcamp (and it works any gender!) 

So what is Bathroom Bootcamp? So glad you asked! It is no-holds-barred, all-in potty training. It is 3-4 days blocked off where you don’t leave the house, you stock up on paper towels and Clorox wipes, and you throw away alllllllll of the pull-ups and diapers. It’s you, your little one, some undies, a timer, a toilet, and a lot of water and fiber. 

• To get started, find a block of 3-4 days where you can stay at home at all times – a long holiday weekend works well, or if you’re able, a few days off from work and daycare in the middle of the week. 
• Your kiddo can wear undies or go commando, whatever works best for you guys. But at no point should you put them in a pull-up or diaper, not even at nap times or at night (this is where the messy comes into play!). 
• During bootcamp, you want to make sure to keep them REALLY hydrated – offer water or juice often, and make sure they’re drinking more than the average. 
• Set a timer to go off every 30 minutes. Every time it goes off (and I mean EVERY time), take your kiddo to sit on the potty. They may do it themselves or you may need to pick them up and plop ‘em down – whatever it takes. 
• Set another timer for 15 minutes, that’s how long they should chill on the toilet every time. Your kiddo can have toys or books or a tablet to stay occupied and distracted – having distractions may also help with taking their mind off of peeing and help their body relax a bit. You can also include some water play, either by keeping the sink running or letting them play with some water toys in a bowl of water, which can really help! 
• At the end of the 15 minutes, they will get up (regardless of if they peed or not) and you start over again with the 30 minute timer. Lather, rinse, repeat.

As you can imagine, this is called bootcamp for a reason – it’s going to be long and difficult and one or both of you will probably cry at some point. Your mini may also have accidents, which are fine! Don’t punish them, but do enlist help in cleaning them up while explaining pee goes in the toilet. Nighttime and nap time will also be a struggle, as you’ll likely be changing sheets at least once a day (might I suggest investing in a high-quality waterproof mattress protector and some cheap sheets you can cycle through?). Through it all, it’s important to remain positive and upbeat and not punish or discipline for not peeing in the 15 minute windows or having an accident. If there’s not a physiological reason for the unwillingness to pee in the toilet, that means it’s most likely psychological, and a negative or punishing mentality can make it worse.

It may take a day, it may take all four, but once they’ve peed on the potty the first time, each time thereafter will get easier and easier. I wish you both the best of luck, mama! I know it won’t be easy, but really, has any part of this parenting thing been a cake walk?

May the Pee Be with You,

Is This Normal