Toilet Habits
Getting out of nappies is a significant change in a child’s life. Just like starting to eat ordinary food, learning to walk or losing the first tooth, it’s a natural part of growing up and developing.
There are a lot of indications that it’s possible to introduce the potty or the toilet before the child has learned to walk. For some it’s easy from the start and for others it takes a while longer. Around sixty years ago, most children in our part of the world were out of nappies by the age of one and a half. By comparison, a Swedish study in 2005 showed that only one in two children were dry during the day at the age of three and a half.
Compared to many other cultures and countries, Swedish children stop wearing nappies relatively late. That may have to do with factors such as our efficient nappies and the notion of waiting for the child to take the initiative. It can be difficult to assess when a child is ready to start using the potty or the toilet. It’s an advantage if a parent takes the first step towards allowing the child to become familiar with the potty and practise not wearing a nappy. It’s important never to force the child to sit on the potty or the toilet. Try and achieve an undemanding, positive atmosphere!
Getting out of nappies
To start with, it’s a good idea to let the child be without a nappy when you’re at home during the day. A first step towards stopping with nappies is when the child sees that it gets wet when you pee. A potty is often needed, but don’t count on the pee and poo ending up in there right from the start. There’s nothing strange or unusual about pee on the sofa and poo on the carpet in homes where there are small children. Such events are part of the development towards “being dry”. Different children need different lengths of time. Don’t make your child feel guilty when he or she pees or poos somewhere other than the potty or the toilet.
If the child would rather sit on the toilet than on the potty, a footstool is a good investment. It’ll then be easier for the child to climb on to the toilet him or herself and it might be nice to have support for your feet. When a child is small, an adult needs to be close by to hold the child if and when he or she sits on the toilet.
Try to recognise the signs when the child needs to go. The child may show it in many different ways. For example, the child begins to wriggle, becomes a bit restless or starts pulling faces. If that happens, suggest trying the potty or the toilet. If no pee or poo comes when the child has been sitting there for a while, you can say something like “We can try again in a little while” and it’s a good idea to say what happened using neutral words such as “Look, you’ve done a pee. Great”. That’s better than praise. Using the toilet or the potty should be relaxed and shouldn’t be associated with performance or the child being “good”.
Fixed routines tend to make it easier for the child to remember to use the toilet or the potty to pee and poo. For example, always suggest the potty after a nap or a meal. Using the potty or toilet directly after a meal is particularly suitable because you make use of a congenital reflex to empty your bowels.
Small children need help wiping themselves and they also need help or reminding to wash their hands after using the toilet.
Pooing in the nappy
Some children want a nappy just when they’re about to poo. One advantage of sitting down instead of standing is that it’s normally easier because the rectum changes shape/angle. As long as the child has no problems pooing or is not constipated, it’s nothing to worry about if the child still wants to stand. Some children want to hide behind the sofa, for example, when they’re going to poo. You can then start by allowing the child to carry on pooing in the nappy, though inside the toilet or bathroom. Then move in stages towards the toilet or potty. Sometimes, reluctance to poo leads to or is due to constipation, which you can read more about further down this page.
For most children, it takes a while to stop using nappies. Be patient. Children of preschool age find it difficult to take in impressions that come from several directions at once and unconsciously choose to focus on the most interesting. That means that a fun game takes priority over the potty! Even children who have been completely dry for a long time can begin to wet themselves again at times. It usually stops by itself. The child may need to be reminded a bit more often in order to get there on time. Sometimes, when an older child starts wetting him or herself again, it may be due to an infection or because something has happened at preschool or in the family. Talk to the BVC if you’re worried or have any questions.
It usually takes longer to become dry at night than during the day. When the nappy is usually dry in the morning, you can try letting the child sleep without a nappy.
You can read more about children’s toilet habits here (in Swedish).
When the poo takes time to come out. Could it be constipation?
If your child hasn’t emptied his or her bowels for several days, the child may get a stomach ache and can feel bloated and uncomfortable. It’s called constipation and it’s very common. Constipation in children is often caused by going for a long time without pooing. These problems often begin at some point after the age of 2–3. When the poo comes, it’s often hard and it hurts to poo. Fear of it hurting means that the child holds it in and gets into a vicious circle. If a child is constipated for a long time, poo can start to leak out in his or her underwear.
If your child has become constipated
In the case of slight constipation, your child could benefit from regular routines for visits to the toilet. It can help to give the child more to drink and provide a mixed diet including soluble fibre from fruit. Pears and prunes are examples of fruit that tend to be good for this. However, be a bit more careful with non-soluble fibre such as wholegrain products. They can have the opposite effect, especially if the child doesn’t drink enough. If the child has problems with constipation, it’s best if the child can go for a poo in peace and quiet.
Constipation can be a symptom of various illnesses. For example, it may be a symptom of gluten intolerance. If your child’s constipation doesn’t clear up, you should have him or her examined by your BHV nurse or a doctor.
You can read more about constipation in children here (in Swedish).
