Potty Training Wars: Training with a Chronic Illness

Hi Amalah,

I’ve been reading your column and blog since your firstborn was a baby, and in all honesty, reading about someone else’s kids for so many years helped give me so much more confidence when I finally got pregnant and had my son in 2016. You’ve helped me navigate things like sleep regressions and eating just by having basic principles in mind. Thank you for the work you’ve so faithfully done for so long!

Here’s the problem. My son will be four in two weeks. I have been very limited physically for the past two years with severe endometriosis and fibromyalgia. Because of my pain and fatigue, especially when bending over—it can make me lightheaded and out of breath faster than almost any other activity, and it can trigger my abdominal pain—if I have to pick something up off the floor, I often have to sit and catch my breath for ten minutes to recover—we didn’t try too hard with potty training in 2018. He started getting interested in 2019, and he learned how to pee on the potty, but not necessarily how to notice when he had to go. And he’s never pooped on the potty.

Right now I think he could make it over the hump if I consistently put him in undies and just made him go every 20 minutes (as we’ve done for a few hours here and there), but I can’t always get off the couch every 20 minutes for an entire day, much less weeks at a time. I’m not thrilled about cleaning pee out of a rug or couch cushion, either, not because it can be gross but just because it could wear me out so badly and put me in so much pain that I won’t be able to work that afternoon (I tutor most afternoons and have a couple other mostly-from-home jobs).

He has an incentive for pooping on the potty three days in a row (an Aragorn toy and a Skye Paw Patrol pup), and a small disincentive (he doesn’t get to play with any new happy meal toys until he poops on the potty), but that hasn’t made a difference for a month now. I’ve tried telling him he doesn’t have to poop on the potty yet but he does have to tell me when he’s about to go in his pull-up and go stand in the bathroom when he does it, and he won’t do that either (unless I catch him mid-poop, and then he’ll run in there and finish).

I think it’s mostly that transitions are hard and he doesn’t want to stop what he’s doing, but I’m also wondering if he truly just doesn’t know what we mean by “having to go.” We ask him all the time if it feels like he has any pee ready to come out or any poop waiting to come out and he says no, but then pees or poops not long after. I’m wondering if we just aren’t explaining it right or if he truly doesn’t feel the sensation of urgency.

I’m guessing that naked time would help him notice, but I simply can’t do the cleaning required for that multiple days in a row and still be able to work. (As for weekends, my husband and I both work at church on Sunday mornings, so the only full day we are both home is Saturdays, so it’s hard to build consistency.)

He’s a smart kid, sensitive to his feelings and others’, and he can recite the names of every character in all three Lord of the Rings movies in his adorable little-boy voice. I think it’ll click fast once he gets it.

So, help! How can I help him notice when he has to go in a way that doesn’t end up with me flat on my back for weeks on end?

Sincerely,
Mom of a Hobbit Who Is Too Old For Diapers

Not gonna lie, this is a tough one. I think we’re all well aware of how draining potty training can be on an emotional level — the bottomless well of patience it requires, the frustration over setbacks, the crushing realization that you are losing a battle of wills to a toddler who is determined to continue to crap in their pants — but there is absolutely no denying that there’s a physical component to it as well. The (literally) hauling ass to the bathroom, the clothing assistance, the wiping, the laundry, and the cleaning. OH, SO MUCH CLEANING.

Can your child physically sense his need to go potty?

Obviously I can’t speak to your son’s ability to physically sense his need to go, but at four years old — if he’s otherwise hit all his physical and physiological milestones more or less on track — it’s highly likely that yes, he can. He absolutely can tell when he needs to use the bathroom, but is simply choosing to ignore it in favor of whatever fun thing he’s currently engaged in. Which is a Tale as Old as Toddler Time. (Or in this case, Preschooler Time. But I loves me some alliteration.)

And usually for kids like him, I’d recommend going ahead and letting him learn the consequences of ignoring his body, in the form of soiled clothing he needs to change and/or messes he needs to help clean up. Over and over, until he’s like, “ENOUGH, I get it.” But in this case, that puts you at a high risk of debilitating physical pain. Which we do not want!

Ideas to help get your preschooler over the potty hump

So let’s see what else we can brainstorm here. (Lovely commenters, I am counting on you today as well.)

1. If you haven’t already, get a copy of Toilet Training in Less Than a Day. It’s a classic, and actually the only book on potty training I ever owned! I personally never had a kid who lived up to the title’s promise. I really think for most toddlers, three days is more realistic…but for an older kid like your son, who is more than halfway there already… Yeah, this book might help you figure out how to get him over this last little hump. Either a new phrasing/prompt idea, a regimented schedule, combined with tips on how to minimize the physical toll on you and put more of the work on him, etc.

2. Remember the division of responsibility. My memory on some of the specifics is probably fuzzy, but I remember the above book is big on putting as much responsibility on the child as possible, like dressing/undressing, getting on the potty themselves, changing their own wet clothes and cleaning up accidents. I believe they even included clothing recommendations that both made it easier for the child to go more or less unassisted, but also helped to keep accidents more “contained” within the clothing vs. training naked or in just underwear.

3. Can you possibly get a Sunday morning off, or find someone to cover for your shifts at the church? But while I love that book, I can make zero guarantees that just one Saturday will be enough.  (I feel like a church SHOULD be a pretty understanding employer when it comes to stuff like this.) Then maybe add in a Friday afternoon or a Monday morning to keep at whatever boot camp schedule and expectations you set for him?

4. Alternatively — or perhaps additionally —  is there anyone who can come…help you during the final push? Someone you can outsource specific triggering tasks to? A family member or close friend who’s Been Through It Too? A babysitter or mother’s helper from your church?  Could you treat yourself to a cleaning service when all is said and done? Your letter is like, Exhibit A of why it takes a village.

Speaking from personal experience, we always closed out our boot camp days by bringing in a non-parent — usually a trusted babysitter. Once they realized that the babysitter was ALSO expecting them to use the potty and wasn’t going to let them revert to diapers or pull-ups…that pretty much did it. So don’t feel like potty training needs to be a 100% solo and solitary endeavor.

If I were your IRL friend, I would totally come and help you. I would bring cleaning supplies and wine. So don’t be afraid to ask someone in your village for help here. We get it. We might still not get your child to poop on the potty in a single day, but we do get it.