Author’s practical guidance
Toilet training goes backwards for no clear reason
Source named in the book: AAP toilet training guidance
Regression is common and it usually has a dull explanation sitting in plain sight: a new baby, a new room, an illness, a move, a change of daycare.
Say this now
“Accidents happen. Let's get changed.”
Flat voice, quick change, no commentary.
“Does it hurt when you poop?”
Ask directly. They rarely volunteer it, and often say yes.
Do this
- Check for constipation first: hard stools, straining, days with nothing.
- Look at what changed in the last month, including things that seem too small.
- Go back to announcing, not asking: "It's potty time."
- Take the pressure off entirely for two weeks and watch.
- Book the appointment if it is still going after that.
Avoid this
- Punishing accidents or making them sit until something happens.
- Restarting training as a campaign with charts and stakes.
- Assuming the worst first when the ordinary causes have not been checked.
TALK TO YOUR DOCTOR IF
- Blood in the diaper or underwear — call the same day.
- Pain, straining, hard stools, or days without a movement.
- Wetting that comes with fever or pain.
- Regression past a few weeks with no clear cause.
- Daytime wetting after months of being dry.
- Regression with fear, withdrawal or poor sleep.
Why the book suggests this
Regression is common and it usually has a dull explanation sitting in plain sight: a new baby, a new room, an illness, a move, a change of daycare. Most of it resolves in a few weeks with nothing done except the pressure coming off.
The one cause that gets missed most often is constipation. A child who had one painful movement holds on afterwards, which makes the next one worse, and the whole thing looks like defiance from the outside. It is a medical fix, not a behavioral one.
From this collection
Same Words: Their Own Body
45 prepared situations in this family area.