Questions about Potty Training
Questions and Answers About Potty Training
Brenner Children’s Hospital Pediatric Urologist Steve Hodges, M.D. has developed a website to help parents better understand the dynamics behind toilet training and to help make the process more successful for both child and parent. The website is www.brennerchildrens.org/HPT/ and gives information on behavioral modification techniques, potty training techniques, medications used to treat incontinence in children and answers to frequently asked questions. The site also gives information on urinary tract infections and answers questions like, “How much should a bladder hold?”
What are the most common reasons a parent might visit your office with his or her child?
“A large number of the cases I see involve parents who are concerned about their child’s toilet habits,” Hodges said. “Nighttime wetting is always of great concern to parents and really shouldn’t be. Once it has been determined that there is not an underlying medical problem, most parents can just relax. Nighttime wetting is out of the child’s control and will resolve itself on its own. Negative reinforcement is not recommended. Many times this is an inherited condition and the child will outgrow it at the same age the parent did. If the wetting is a major concern to the parent or child, there are treatment alternatives that can be very successful.”
Daytime wetting stems from children who put off emptying their bladder throughout the day. “Their bladder muscles get stronger and the child gets little to no warning that they need to void and this results in an accident,” he said. “Some kids can’t relax their bladder neck and as a result don’t empty it all the way. My website contains information that helps parents train their children to empty their bladder completely for better control.”
What kinds of information can a parent find on the website?
The site lists information on medications used to treat continence issues and helps parents decide when medication might be the next step.
“Most parents can try some behavioral modification techniques and be quite successful – avoiding medication altogether,” he said. “And in a very small number of cases, surgical intervention is required. That’s why it’s always important to have the child evaluated before beginning the behavioral modifications listed on this site.”
When should a child be potty trained?
“Children may potty train at different ages, just as children walk or talk at different ages,” Hodges said. “Usually children don't have the ability to potty train until after they turn 3 years old (and most are fully trained by 4yrs), so sometime after a child turns 3 is good time to work on potty training.”
Children whose parents were potty trained at a later age may also toilet train at a later age, usually at the age their parents achieved control.
What are the most common problems associated with potty training?
Bedwetting and holding, Hodges said. “The most common problem in potty training children is that once children learn to hold their urine and/or stools, they neglect to empty when nature calls and put off urinating and/or passing bowel movements to the last possible moment,” he said. “This problem, which we'll call holding, is very frustrating for parents and can cause a number of problems for the child.”
Bedwetting is another very common problem, he added. “Approximately 15% of 6 year olds still wet the bed, and only 15% get better each year after the age of 5. In fact, 1% of 15 year-olds still wet the bed. It is important to note that isolated bedwetting is not a behavioral problem like daytime wetting often is, but a problem with the control of bladder function during sleep for various physiologic reasons. The common treatments include medications that decrease urine production during sleep or alarms that prompt the child to awake each time they wet, which can be successful 70 to 80 percent of the time when used correctly.”
Brenner Children’s Hospital has two pediatric urologists, Anthony Atala, M.D. and Steve Hodges, M.D., who treat both simple and complex pediatric urological conditions, ranging from bedwetting and frequent infections to surgically repairing bladders and kidneys. Pediatric experts in our Center for Regenerative Medicine were the first in the world to grow bladders for children with spina bifida, sparing them from kidney failure. The researchers are currently working to grow 20 different organs and tissues -- technology that has the potential to benefit patients of all ages.
For more information about pediatric urology at Brenner Children’s Hospital, visit our website at www.brennerchildrens.org or call 336-716-1999.