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My four-year-old is fearful of sitting on the toilet

Ask the Expert: Now that she is in junior infants this is becoming a bigger issue

There is complete meltdowns if we try to broach the subject of taking the pull-ups away. Photograph: iStock

Question: We have a four-year-old daughter (will be five in December) who has huge anxiety over toileting (ie has never used a potty or a toilet, but rather puts a pull-up on when she needs to do a wee or poo).

Now that she has started junior infants and afterschool, this is becoming a bigger issue. She has perfect control and doesn’t wet herself but holds everything in until she gets home so she can put on a pull-up and do it standing up in the bathroom. The odd time she will do this in afterschool as she has pull-ups in her school bag. I think I pushed her with toileting when she was too young because of pressures from her first preschool and in the process turned her off it completely. Now there is complete meltdowns if we try to broach the subject of taking the pull-ups away. It has just become a complete mental block now.

She will sometimes sit on the toilet for me after she has gone when she is sure nothing will come out. She can’t explain to me what she is actually scared of but is a bit embarrassed about the whole thing and doesn’t really like her peers knowing she uses nappies.

Answer: Toilet training problems are very common and extend much later into childhood than most parents realise. As you rightly judge, the pressure to train children early for preschool is a common cause. Developmentally, there is a great variance as to when children are ready to learn to use the toilet. Some are ready in their second year, most in their third year but many are not fully ready until four years of age.


Pressurising a child to learn before they are ready, can make it a stressful experience and lead them to develop unhelpful “holding” or “avoidance” habits which can have long-term consequences causing constipation, bedwetting and ongoing accidents. As toilet training problems are embarrassing for parents and children, they are usually kept secret and this makes them more stressful. This stress then makes the problem harder to solve. Here are some ideas to help her:

Take all the pressure off

Accept that your daughter is using pull-ups for the moment and remove all the pressure on her to progress quickly. The key is to become relaxed and chilled and to make sure to praise and normalise what she is doing already. So when she goes off to use the toilet with a pull-up you can say, “Oh you are going to do a wee/poo ... good girl”. When she uses a pull-up at afterschool, praise her for this: “Great you went to toilet in afterschool, great that you did not wait ... always good to go when you feel like it”. The most important habit you want to break is her “holding habit” – the long-term goal is for her to go to the toilet when she feels like it and not hold on too long.

Try to understand your daughter’s fears

Your daughter has developed a specific phobia or fear of using the toilet. She is unlikely to be able to explain or verbalise what she is actually fearful about happening. Instead you have to work this out by closely observing her behaviour and tuning into what might be going on in her mind. Some children find it awkward sitting on a toilet seat or have a have a fear that they might fall off. Some remember a painful experience like constipation which causes them to tense on the toilet. Some don’t like seeing their wee and poo come out and prefer to hide it in their nappy. Understanding the specifics of her fears will give you an idea as to how to help her going forward.

Help your daughter feel comfortable

At the moment your daughter only feels comfortable or relaxed enough to “let go” standing up with a pull-up on. Over time, you want to help her to develop the same comfort with a new habit of sitting down on the toilet seat. There are lots of ways of doing this.

For example, you can pick a very comfortable child seat that allows her to sit in a relaxed squat. To relax her you can let her watch a favourite cartoon on a tablet when she is sitting and/or read a book or sing songs together (without any expectation of doing a wee or poo). You could also have a special game that is only played when she sits on the toilet. For example, you can keep a bottle of bubbles in the bathroom cabinet and take turns blowing bubbles when she sits.

Blowing bubbles are a particular good toilet game as the blowing action will cause her to relax and mimics the letting go action of doing a wee or poo. Making the bathroom a place of fun and relaxation is key to making progress.

Break toilet training down into very small steps

Break your daughter’s toilet training down into very small steps starting with steps she is already doing.

For example, these might be:
1) Using a pull-up in the bathroom.
2) Using a pull-up in afterschool bathroom.
3) Sitting on toilet with her pull-up on.
4) Sitting on toilet without a pull-up.
5) Sitting on toilet with pull-up on and doing a wee or poo.
6) Sitting on toilet without a pull-up and doing a wee or poo.

Set up an attractive reward chart to motivate her to slowly move through the steps but reward her for steps she is doing already. For example, she might get a small star for steps one and two and then a big star for steps three and four and a special treat for five and six. Wait patiently, until your daughter is ready to progress between steps. Picking the right attractive rewards will help.

– Dr John Sharry is a social worker, founder of the Parents Plus charity and an adjunct professor at the UCD school of psychology. He is delivering a number of online parenting courses throughout the Autumn. See