My Child is Toilet Trained, Now What?
When your child first started walking, it was a major milestone, but it wasn't immediately perfect. She had worked for months building strength, pulling up on furniture, trying to balance her weight. Once she accomplished her purpose, she continued to fall and get back up, she started to climb and move in other ways to further her development and control of movement. We also see practicing, building up to and then continued work and progression in the development of language--a child babbles, says simple words, imitates sounds, builds into sentences, all while learning grammar and syntax along the way.
This is the pattern of development, and it is no less true for toileting. Working with your child so they could transition from wearing diapers to using a toilet took preparation and practice. It is an accomplishment and a milestone, but just like all other aspects of development, the work is not yet done. Just as you keep giving your child opportunities to walk to develop movement and reading books and singing songs to help develop vocabulary, you also have to take the next steps in the development of toileting independence.
· Accidents are a normal part of toileting development. There should not be repercussions or anger when it happens, but instead a calm, non-reactive response and direction to your child to change his or her own clothes. Your child can take dirty or wet clothing to the laundry room or directly to the washing machine, then dress himself in dry, clean clothing.
· Many children need frequent reminders about the steps following use of the toilet, such as flushing the toilet and washing their hands. Often, if you ask a child if they have done these things, their automated response will be yes, even when you have seen that they did not. If you instead, tell them to flush the toilet and wash their hands, without it being a question, they will most likely go back to the bathroom and do any steps they forgot, or they will let you know that they did all the steps already.
· Another aspect of toileting is learning to get all of their urine in the toilet, instead of on the seat or floor. You can talk with your child about this and support them in trying different positions to be more successful. You can also suggest they check the toilet and floor to see if it needs to be wiped off and cleaned before leaving the bathroom.
· Children also need guidance and direction in learning how to use toilet paper to wipe themselves. They should be shown and given opportunities to practice all of the following aspects of this step: getting the appropriate amount of toilet paper (counting squares is helpful!), folding and holding the toilet paper, wiping from front to back and adjusting their body to do this, and discarding the paper in the toilet. Give your child opportunities to practice these things at times when he or she has NOT just used the toilet. Let them practice when their body is clean and dry, and they are more willing to do it themselves.
· Another step to independent toileting is not having accidents while sleeping during naps or at night. To support your child in this step, put them to bed in underwear. Pull-ups and disposable diapers are designed to rapidly absorb moisture and pull it away from the skin. Your child therefore cannot feel that he or she is wet. The feeling of wetness is what triggers the brain to recognize the physical cues of the urge to urinate. Prepare your child's bed in layers--a mattress protector, then a sheet, another mattress protector, another sheet. Leave a set of underwear and pajamas out somewhere close to the bed. Prompt your child to use the toilet before bed. Then, wake your child to use the toilet before you go to bed. If your child wets the bed and wakes up, take him or her to the toilet first. Remove the top layer of mattress protector and sheet. Help your child as needed to remove wet clothing and dress in the new dry set. It may be disruptive to you and your child's sleep, but remember this step is temporary and it will pass!