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The Pull Up Nation

November 17, 2021
By Mara Mauze, PhD, ABPP

Over the last few months, a theme has been emerging in schools and on child education listservs across the nation, “The Pull-Up Nation.”  When I first started hearing about this, I assumed this meant this year was one to help “pull kids up” academically.  However, it turns out that children across the country are arriving at preschool and kindergarten wearing pull-ups and are not toilet trained.              

On the surface, this trend is surprising as many children and families have been home for the past year and a half to two years.  However, this past period of time has been traumatic for many.  Parents have been working from home while trying to educate their children and maintain some sort of normalcy.  Every decision became weighted in a different way and parents are exhausted.  For many, many families, focusing on toilet training was an easy battle to forego.  However, now many children are entering school behind their peers in this key developmental milestone.

Certainly at The Acorn, we have very young children (2 and 3 years old), many of whom come to us early in the toilet training process.  This is not unusual.  However, if any of you are considering toilet training or are trying to make the process more successful, here are some recommendations:

1. Aim for an extended period of time at home to begin.  Winter break, Thanksgiving vacation, or a long weekend are great times to begin as you have an extended period of time together.  It’s generally a good idea to focus on remaining home as much as possible for easy access to bathrooms and laundry.

2. Plan out a schedule.  When toilet training, it can be helpful to give children scheduled toilet times.  Ideally, have your child try to use the toilet immediately upon waking up in the morning, about 20-30 minutes after breakfast, mid morning, after lunch/before nap, after nap/rest time, mid afternoon, and before bedtime.  Tie toilet attempts to natural changes in the schedule.  “As soon as you try to go potty we can eat lunch,” or “let’s go to the bathroom and then we’ll go play outside."

3. Wear underwear, not pull ups.  While pull ups can be great for school and sleeping, they are designed to help pull dampness away from the body.  Wearing underwear helps children have the sensation of wetness and feeling uncomfortable which helps them learn the body signals of needing to use the bathroom.  If you are concerned about running errands, sitting in car seats or your child sitting on furniture while toilet training, consider wearing underwear underneath a pull up or plastic pants.  It’s important that the child have underwear against their skin to feel the wetness/discomfort to help increase their awareness of those bodily signals.

4. If your child is against underwear, consider going pantless.  If you have a fenced or private backyard, allow your child time to play outside without pants.  Again, this can help them learn those body sensations and signals that they need to use the bathroom.

5. Make toilet attempts fun.  Have a basket of toys, books, or activities in the bathroom.  These are activities children use just when using the toilet.  This makes trying to use the toilet fun and helps them sit for a little longer.

6. Be sure children’s feet are properly supported. It’s very difficult to use a toilet if your feet are dangling in the air.  Add a stool for children to put under the feet.  This helps them feel more secure on the toilet and helps their body be in the proper position for a bowel movement.  Also consider a child sized toilet seat to fit on the adult sized toilet seat. This can make children feel more secure as well.

7. Keep your patience and your sense of humor.  Children will have accidents.  This is an inevitable part of toilet training.  Stay calm. Keep your sense of humor.  This too shall pass.

As always, we are here to help you.  Mara spent many years in private practice helping parents with toileting challenges with their children.  Feel free to use us as a resource.  We are here to help you anyway we can.