Potty Training 4 & 5 Year Olds

Parent Q&A

Pediatric urologist for 5yo's daily wetting accidents Oct 19, 2017 (1 responses below)
potty training a 4 year old Jun 6, 2017 (3 responses below)
  • Hello, I'm in search of a pediatric urologist with expertise in enuresis.  My 5 year old boy has been having daytime wetting accidents for nearly a year and we feel like we've exhausted the interventions of timed bathroom breaks and clearing out any bowel compaction.  We think there's a plumbing problem that can't be addressed behaviorally.  Can anyone recommend a pediatric urologist or other medical expert for daytime wetting?  Thank you!

    Dr. Baskin at UCSF. Top in the field & a genuinely nice person. 

  • potty training a 4 year old

    (3 replies)

    I have twin girls that have just turned 4. One is making potty training progress (pees on the potty, does not yet poop), but the other is terrified of the potty and absolutely refuses to have anything to do with it. I have encouraged her to sit on the potty with her diaper on to get used to it, but she absolutely refuses to go anywhere near it. I would just let this go if I felt assured she'd come to it on her own in the next year, but I have a feeling that another year, or two, or more (!) could go by and she would continue to have a deep anxiety about it, and refuse to ever even approach it. Help! I am feeling totally hopeless on this issue. She is otherwise very bright, observant, and fairly cheerful girl, although very stubborn. How to I give her positive encouragement without further deepening her anxiety?

    RE: potty training a 4 year old ()

    This is a big challenge for all.  Pelvic health isn't something most of us learned about, and it is key to a sense of well-being and function. I would encourage you to lighten up about it, to lessen the anxiety load for her. Proceed with gentle confidence and let her know this will all work out fine, it's sometimes just takes more time.  See the award-winning ads for Squatty Potty with her and buy one (Costco is a good local source). Buy yourself the book "Below Your Belt, How to be Queen of your Pelvic Region," by Lavender and Ihm -- a pelvic health handbook for girls, published by the Women's Health Foundation. This will be a good resource for her as well, when she is older.  For her age they make a book called "Riding the Potty Train: Better Bathroom Behaviors for Little Girls on the Go!"

    RE: potty training a 4 year old ()

    I'm going to tell you what someone told me when my younger daughter was resisting potty training: No kids go off to college in diapers. I was convinced mine would be the first, but her anxiety lifted - quite abruptly - and when she decided to potty train (she was about 4 as well), she just -- was already potty trained. Boom, one day, no diapers. Kids are weird! 

    RE: potty training a 4 year old ()

    I had a friend with twin girls with the same predicament. One potty trained completelyby 4 and the other stil in pull ups with zero interest and even alot of upset and resistance built up. 

    Eventually my friend ( who ironically is a psychologist) just asked the kid what it would take for the kid to go potty. The kid said "Disneyland". And they struck a deal that they would all go to Disneyland once she was out of pull ups and using the potty consistently for a month. And it worked!

    That said, mom ruled out medical conditions, sensory processing problems and the like begore moving to incentivizing. She speculated the kid was a wee bit anxious but got over it quickly once the incentive was in place. Provided Disneyland reminders strategically around the house as reminders and it worked!

    good luck!

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4 year old potty training woes

June 2007

Not his woe, mine! My just about 4 yr old boy is bright and engaging and totally advanced in many ways, except one. He is fighting potty training like you wouldn't believe. Not just pooping, peeing too. Most of the advice in the archives relates to 4 and 5 year olds who still won't go poo but use the toilet to pee.

Sometimes I can coax him to sit on the potty and he'll sit there for awhile and do nothing. Then I put a diaper on him and he goes pee right away. I let him wear underwear and he pees in them (yes, we take him to sit on the potty regularly when he wears underwear). He wakes up with a dry diaper every night, but refuses to sit on the potty in the morning.

We talk about it regularly and we offer him plenty of opportunities to use the toilet. I am really trying to let him direct the potty training, but I'm really feeling despair around this issue. I feel like I'm failing him some way. People keep saying he'll get it when he's ready, but I'm not convinced.

I'd love some responses from parents of later potty trainers about what worked for them finally and I'd love some reassurance that it will happen soon (hopefully) from somebody who's been there. Or at least before kindergarten! Anon

Hi there, This is what happened with my son. We took him to preschool when he was 4 years old (part time). He was in pull-ups. The other kids there weren't. One day when I was picking him up, I asked the kids he was playing with if they wore big kids undies, and they all replied yes. I didn't say anything to the kids ''like, oh your parents must be proud'' or say anything to my son. I didn't want my son to think I thought any less of him. The very next day, he refused to wear his pull-ups. But I told him he had to wear them until he knew how to use the bathroom. He promised he could do it - and he did. From that day on, he was potty trained. Call it luck - but it worked for me! Good luck. Diana

Oh I so relate to this issue! My older son, who is now almost 8, was absolutely the most stubborn potty trainer. We decided he was ready to train when he was about three (note the language: WE decided) and proceeded to try every entincement known to man to also convince him that he was ready. I'm talking wheedling, begging, bribing, the works. Things finally degenerated to the point that, around his fourth birthday, we made him go to school in his unders, he held himself for THE ENTIRE DAY, and then wet his pants spectacularly on the walk home. Disaster, and totally heart-breaking. The problem was that we were convinced that potty training was somehow the achievement of the parents! And of course this is not the case. Learning to use the toilet is, in a way, the first important thing thing your child is DECIDING to do. My advice is to let them decide. Do what we did: sit your child down, tell them that you love them and trust them and that you know they'll start using the toilet when they're ready. Tell your child that you're not going to bother them about it anymore, and then stick to your words. Our experience was clear: five days after the aforementioned conversation, my son decided to start using the toilet, and he never looked back. Neither did we -- we all learned from it. Just take a deep breath! You'll all be fine. Alexis

Some advice from my sitter...Just drop the topic. If you KNOW that he is completely ready, then give it a month or two of ignoring the subject and then have a visit from the diaper fairy (very similar to Santa Claus, but the diaper fairy arrived with underpants and takes away all but the nighttime diapers). My sister has four children -- she was so excited recently when her third child was potty-trained at 3 1/2. That was the youngest by a year for her. The 3 1/2 year old had been trying really hard since she was two. She just couldn't 'get it.' Her kids are smart, fantastic kids. I just think that genetically (what do I know, though) that they didn't have the muscles to do it. jan

I don't know if this will work for you since your little one doesn't tell you when he's about to poop but here's what I would do. I'd cut out the underwear altogether. I've heard you're not supposed to use them until potty training is very well established. When I stopped putting underwear on my son he didn't pee in his clothes anymore and he asked for a diaper for pooping. I think maybe underwear feel a bit like a diaper to them and they think they can let go while wearing them. The next step for us that worked (a year after he pee pee trained), was weaning him off the diapers for pooping. We got him a toy we knew would be highly coveted (a Buzz Lightyear in his case) and let him play with it only while sitting on the potty (with his diaper) then if he pooped he would get to play awhile longer. After that it was just a matter of getting him used to pooping with one side of the diaper undone, then both, then just setting the diaper in the potty, then laying some toilet paper across the seat. Thanks to Buzz, we are diaper free Yay! Unfortunately he still refuses to wear underwear... win some, lose some

5 year old still resisting potty training

Oct 2006

Has anyone else had an experience with a 5-year-old boy who is partially potty-trained, but still resists using a regular toilet (insists on using only the ''little potty'') and insists on going #2 in his pants? This is an otherwise very bright, sensitive, and creative little boy who is well-liked at preschool. He must go to Kindergarten in July, so time is running out. We took away the pull-ups a month ago. He has generally resisted wearing underwear, but wore it this weekend in exchange for getting a ''big kid'' bed. We have tried all kinds of incentives (candy, toys, outings, etc.) and he still doesn't budge. His close friends are girls, so he doesn't have other little boys to serve as role models. He seems to want to remain a ''baby'' in some other ways too. I would be interested to know how others may have resolved these stubborn cases, and how they managed to keep their own sanity in the mean time. Thanks for any advice or insights you may have. Beth

For some children, pooping on the potty is, for unknown reasons, terrifying. Often times incentives don't work because it is too hard for a child to go from whatever he is comfortable with to using the potty independently. I have worked with a number of kids with this issue, and have found that by breaking down the act into baby steps, it becomes much easier. The baby steps can vary from child to child, but the basic principles remains the same - make it small enough so that the child is successful, reward the success with something small, and refrain from moving to a new step until the current one is second nature (usually a good 2 weeks of consistent success). I suggest the following steps: 1) Have him go into the bathroom while he is pooping. 2) Have him touch the toilet while he is pooping. 3) Have him sit on the toilet (lid down is easier than lid up) in pull-ups or his clothes (whichever works for you). 4) If you did lid down, then move to lid up. 5) If using pull-ups, you can either cut a hole out of the bottom or better yet, pull them off his bottom while leaving them along the front of his thighs. You can also take off the pull-ups and cut a piece that he can have next to his skin - for some kids, the feel is a significant comfort. If wearing clothes, you can pull them just over his bottom, leaving them as high across the front as possible. 6) By now, he should be comfortable with the idea, and may be able to do this with no adaptations.

Remember to give two weeks with each step and reward success. If your child cannot begin to master a step within about one week, then back it up and find an intermediate step. For some kids, a fair amount of creativity is needed (e.g., I knew a kid who needed to be standing, so we had him squat in front of the toilet to help him get used to a crouched position before step 3). I have never known a child who is ready to be toilet trained who has been unsuccessful using this method - the steps just need to be broken down more than one can initially imagine. It takes a while, but be patient. Good luck. Lindy

Yes, we experienced a version of the problem you are having with your son. Like you, our otherwise very bright, creative, sensitive son resisted bowl movements in the toilet. He is 6 now, and for about the past six months things have been better. BUT, this was a long journey, and one that a simple post-reply just can't do justice to. So, if you'd like to talk more, or trade LONG emails (it's just a long story, no way around it), please email me and I can send you my phone number. Can't promise I kept my sanity the whole time, but I can say I've been there, and I would be happy to provide some support and ideas to someone who is there now. I know one of the hardest things for me was that I felt like we were the only family around having this problem. Anyway, let me know if you'd like to email/talk. Monica

I wrote a few months ago about my 5 year old (see 6-year-old will only poop in a pull-up , Post by Linda) I thought I would let you know that it has worked and he is now pretty much potty- trained. Only a slight accident every now and them. If you would like to use our commodes, let me know and I am happy to give/lend them to you. Feel free to contact me if you want to talk about it. I know I felt like I was the only one whose kid wouldn't toilet train. Linda

Potty training tips for a dev. delayed 4 yr old

Nov 2005

Could anyone give me some advise as to how i can potty train my 4 year old. He is developmentally delayed in all areas and is at a 2 1/2 to 3 yr old level.(cognitive) This has been a challange for me because sometimes i feel he's almost got it then he stops letting us know he needs to go and poops in his pullups, and hides when doing it. He can walk around with the poop in his underpants and it doesnt even bother him... I have a 5 month old and the diaper changing on both boys is getting to me. Please help! Anon

Our 6 yr. old dev. delayed boy is still in pull-ups at night. However, for the pooping our dev. pediatrician suggested bringing him into the bathroom everytime he seemed to need to poop, or right after if you don't catch it, and saying ''this is where we poop, in the bathroom'' or something to that effect. It took a lot of diligence, and we did this for quite awhile (continuing to use diapers) until he was finally going on the big toilet with help (I just skipped the little potty, it was too much trouble). At school we sent him in underwear and his special ed. teacher was willing to work on the toileting. My son would wait to poop when he got home anyhow. Good luck. Anon.

If your child is a really visual learner, you might want to try a potty video. These have kids songs (about washing up, etc.). They just show kids entering the bathroom, but it was enough for my son to get the idea. Good luck. anonymous

4-year-old NEVER says when he has to go

Sept 2004

Our son will be 4 next month. We've been steadily, patiently, and calmly working with him to use the potty since January. He's fine with using the toilet at home or anywhere else but he will NEVER say when he has to go. So if we forget to take him or ask, he just goes. It's only AFTER he goes that he'll say ''I have to go to the potty'' or ''I'm wet''. I don't scold him other than saying something like ''some day you'll tell me BEFORE you go so you can go in the toilet.'' I've read the archives, books, talked to other parents, his doctor, teachers, tried rewards (stickers),special undies, going cold turkey on diapers/pullups, only to get mess after mess. Obviously I know he will master this eventually, but would love any reassurance and suggestions. Thanks.
Wet and in Distress

My own son trained at not quite 3 1/2 when one evening he announced, out of the blue, that he wanted to bake a cake, and I told him we only had time for that if we did not spend the evening going to Target for diapers, as I had intended, and that if we didn't buy diapers, he was going to have to wear underpants to preschool the next day. Really! He had to think about it hard, but he made his choice, he got his cake, and he never wore a diaper again (except at night). Before that evening, our every attempt to encourage him had failed. We had a baby on the way and so we simply stopped talking about it, not wanting to add to his stress level nor enter into a power struggle that we would lose, and I was beginning to think he'd go to kindergarten in diapers -- but it really does happen that easily...eventually. You might just go back to diapers and give the whole thing a rest for a while. He'll let you know when he's ready to try again.

Alternatively, if your son WANTS to wear big boy pants but never makes it to the potty, I think the only thing you can do is take him every half hour or so. Set a timer to remind both of you. Or, maybe your son needs to be given explicit permission to go to the toilet himself, without telling or asking anyone first? At nearly 4, he probably doesn't actually NEED any help with the mechanics of the process, and perhaps there's some reason he's shy about announcing when he has to go? Best of luck! Holly

I wasn't successfully potty trained until I was 4 years old! of course I had all the tools I needed - could walk, communicate, knew when I had to go - long before that but it turned out I needed motivation (I was stubborn and not into pleasing anyone but myself). my parents said I couldn't go to preschool until I was out of diapers - it took 2 days. maybe you can find the magic motivation that your son will respond to.

4 yr. old potty-trained everywhere but at home

April 2003

We're out of ideas on how to handle a potty-training impasse, and are hoping someone out there has some new ones...

Our 4 year 2 month old boy uses the potty pretty much all the time everywhere but home. Preschool, out at friends, at grammie and grandads for the weekend, running errands with mom, hanging out with dad at work...no problems. But home from preschool and home during the weekend, and we can be changing him 2 or 3 times a day - wet and poopy. Sometimes he'll use the potty if he's in underwear or bare-bottomed, but more than half the time not, regardless of what he's wearing

I've tried everything from stoic silence, nonchalant chattiness, outright bribery , gentle pleading (and not so gentle pleading) reminding him to ''listen to his body'', asking him at possibly productive moments if he has to go, potty chart stickers and peepee targets, and nothing seems to work. I've really resisted the ''you're a big boy'' because I want to stay away from any hint of shame, but I am getting awfully sick and tired of cleaning up his darling lil poopy four year old butt!

Now we're at a point where if I see he's about to poop, I'll ask him urgently to use the potty, and he shakes his head at me and urges me to ''just go away'' and ''don't talk to me now''. When I'm changing him, he's chatty and relaxed, will sometimes want to see his poops. In fact, he once was laying back, hands clasped behind his head and commented that he ''finds it so relaxing'' to be changed!! It's gotten to the point where he's in pullups all weekend now, and not just at night anymore because I'm so tired of washing stuff. That's fine with him - he says no more diapers, but pullups are fine with him.

At our recent 4 year-old ped appt., the dr. talked with him a litle and I was hoping that might help, but there's been no change.

We had a baby in August, but this has been an ongoing, though I think worsening, problem, so I'm not sure what impact that has had.

Any advice would be greatly appreciated. Thanks!! anon

I have no idea whether this would work but is it possible that having him clean up his mess (without humiliating or shaming him) might help? For example, what if he had to clean himself or take a bath each and every time he pooped anywhere but the potty? It would be an awful weekend or evening for you but maybe he's got it too easy. good luck