Emma's journal, week 4: toilet training, tantrums and night continence

toilet training
toilet training 

Emma’s son Thomas is 18 months old and has just started toilet training. Read Emma’s firstsecond and third journal entries, or read on to see how Thomas is faring in his fourth week. 

He's got it! Well, not completely, but it feels there has been a huge leap in Thomas's potty understanding this week. He now sits on the potty and within a few seconds he's done his wee and jumped up to demand his sticker! He's also weeing in the potty at his grandparent's house, and for the first time this morning he also pulled off his Pull Ups to tell me he was weeing rather than just keeping quiet and continuing to play. It feels pretty exciting and rewarding for us, and I'm sure Thomas is feeling proud of himself too. 

It feels like this new understanding has come at the same time as a general leap in development - with, sadly, more tantrums. Is this possible, or is it just a coincidence? 

We still have lots to work on with our trips out of the house, and of course nap and bed time. Given Thomas only naps for an hour during the day and is often dry when he wakes this isn't such an issue. However, I have no idea how to tackle night time. One big problem is that Thomas still has milk before bed, so he’s surely going to need a wee at some point in the night. Also, he's in a cot, so I wonder if, knowing he can't get out, he'll just assume he has to wee in bed. Any advice you can give would be great! 

Response by Dr Cathrine Neilsen-Hewett, early childhood education and child development expert:  

How exciting! It’s wonderful to hear how well things have progressed for Thomas this week. Now that Thomas is confident to use toilets outside home, be sure not to leave it too long between outings. The more opportunities Thomas gets to practice this new skill, the more likely it will be here to stay.

Start with familiar surroundings, visiting the homes of family and friends; let Thomas see you using their toilet. Using the toilet at Aunty Jan’s or a neighbour’s house is much less confronting than busy, noisy public restrooms. You’ll also feel more at ease and less conscious of being subjected to the possibility of public power struggles.

Of course there will continue to be times when accidents still happen – and treat them just as that, accidents. Toilet training outside the home is no different to toilet training inside the home. Praise Thomas when he’s successful and ignore or minimize the impact of accidents. 

Toddlers’ development and understanding tantrums

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As toddlers grow and develop they often experience periods of “developmental explosion”, characterised by a sudden leap or burst in the acquisition of new skills. The fact that this increased speech and independence has coincided with Thomas’s increased toileting skills is largely symptomatic of his age. From around 18 months, toddlers make great strides in language development, adding between six to 10 new words to their vocabulary per day. Toddlers’ productive speech typically lags behind their receptive language, meaning they understand more than they can say, which can translate to increased frustration, especially when we don’t understand their attempts at communication.

Tantrums typically emerge around two years as toddlers are forming a sense of self, as evidenced by Thomas’s sense of what he wants. Thomas is at an age where he has a sense of "me" and "his wants", but is still too young to know how to satisfy these wants. Tantrums are more likely to occur when he’s unable to use his words in order to achieve these needs or wants. As Thomas continues to develop in his ability to communicate, his tantrums will decrease.

Understanding night time continence

The best way to manage night time wetting is time! Unlike daytime toileting, which is conscious and deliberate, night time bladder control is more dependent on maturation of children’s nervous systems and bladder, so it’s much more challenging to train a child for night. Essentially children become dry at night when their body matures to a point where their bladder can store the amount of urine they produce overnight or they learn to wake up in response to a full bladder. The time between a child achieving daytime continence and becoming dry at night is quite variable, with some children doing so in a matter of weeks or months, while others take years.

The best indicator that Thomas is moving toward night time continence is an increase in the number of mornings he wakes up dry. Night time wetting is reasonably common and considered to be developmentally normal up to the age of six or seven years of age, with at least one in five continuing to wet at night when they start school.

Given Thomas’s age I wouldn’t be particularly concerned about his night time wetting. You can certainly encourage healthy bladder habits by ensuring he drinks plenty of water throughout the day, tapering off in the evening, and ensuring he has a healthy diet. It’s fine for Thomas to have a drink before bedtime, however it’s generally recommended that children avoid juice or milk at night, as this can stimulate the kidneys and result in increased urine output.

Sleeping in a cot would definitely make it more difficult for Thomas to get to the toilet in time, although at this age I wouldn’t expect him to take himself independently to the toilet without parental assistance anyway. If you’re not ready for him to move out of the cot you can suggest he calls for you if he does wake and needs to go to the toilet. 

All the best for your journey ahead, I know it will be an exciting one!

Regards,

Dr Cathrine

Talk to other parents about toilet training in the Essential Baby forum