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Three Year Old Can't Relax on Potty

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Question

Dear Dr. Laura,
My daughter just turned three. She has successfully used the toilet (with a special seat) but has begun holding instead of peeing, so I put her back in diapers. But she keeps requesting panties and we get into a real power struggle if I don't let her wear them. So I say she can wear panties IF she sits on the toilet, but then she is there for an hour without peeing. I tried your trick of putting her feet in warm water and that sometimes works. (And then she is very proud.) But often it doesn't. She doesn't usually have accidents in her panties -- mostly she just holds it, but I don't want her to get a UTI.

Answer

This is not uncommon. When she feels the pee coming when she is on the toilet, she feels out of control. So she gets scared and holds it in. Also, I think she is working so hard to control herself so she doesn't have accidents that relaxing is really hard for her. Lots of kids go through this. With patience, they all do learn to use the potty. I think you have the following choices.

1. Let her wear panties as long as she is willing to sit often throughout the day.
Upsides:
a. No power struggle (as long as she is willing to keep going to bathroom. When she isn't, you do have to set the limit: no potty, no panties.)
b. One step closer to potty training

Downsides:
a. Since she can't release, she could get frustrated. But you don't need to get frustrated. This is a new skill she is learning. It takes awhile.
b. She will have accidents. A drag, but bearable.
c. You still have to enforce diapers at night until she is regularly emptying her bladder, or get a plastic sheet.
d. Holding - This is obviously the most significant downside. But it is temporary. If you keep working with her and putting her back on the potty every 20 minutes, sooner or later she will pee. the more often she pees in the toilet, the more quickly she will relax about it.

2. Force her to wear diapers.
Upsides:
a. No accidents.
b. No time in bathroom.
c. Less anxiety for you.
d. No holding.

Downsides:
a. Power struggles.
b. You are ignoring her messages to you that she is ready to potty train

So given this, I think I would still let her make the decision to wear panties as long as she is wiling to sit on the potty often throughout the day.

It doesn't have to be for an hour. 20 min is plenty. Then come back in 20 minutes. So every 20 minutes, you are back in the bathroom. Keep using the warm water trick. Sometimes running water in the sink helps. Eventually she goes. She just needs your help and patience to learn how.

BTW, if she has any fear at all of relaxing on the big toilet, she might prefer the small plastic potty. You might want to give her a choice. Another way to get beyond this stuck place is to let her go naked outside and pee outside in the portable potty. I bet she would do that, because it is such a different thing -- no baggage about using the bathroom. Or even get her used to peeing outside, then squatting outside to pee, then squatting outside to pee in the portable potty, then squatting inside to use the portable potty. There's no right or wrong here. Whatever gets her one step closer to peeing in a potty is great.

Also, I would talk to her about it while she is on the potty. Tell her that her body washes itself out inside and gets rid of all the dirt and trash and that is what she pees and poops out. When her body feels like going, she needs to go. If she holds it in, it could make her sick because it keeps the garbage inside. (If she asks how the garbage gets in, you could say that it's what her body can't use from what she eats.)

Finally, since she has so much anxiety about this, I would help her giggle about it. Play silly pee games while she is on the toilet, sing silly songs, act like you want to pee but are scared to do so, act like you had an accident or are afraid of having an accident...have her doll do these things. (Do you have one of those dolls that pees? Good idea!) Anything that gets her giggling about pee will loosen up this knot of fear that is keeping her from relaxing and peeing. There are more ideas about this in this letter about helping a toddler through potty fears.

And of course if she does seem like she is about to pee and it makes her so anxious that she wants to get off the potty, don't let her. Tell her that you will hold her tight and keep her safe, that you know she can do it. If she cries, it's fine. She will be very proud once she pees.

Good luck!
Dr. Laura

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