Steve Hodges (pediatric urologist) article

[twowhat?]

I know an article written by this pediatric urologist in Slate has been posted here before. Here's another one that offers a bit more info behind the physiology of withholding...I'm going to be asking my pediatrician today to see if we can pursue whether DD2 is actually still constipated despite being on Miralax for more than 2 years and whether that might be contributing to her not being able to feel when she needs to go at night.

http://www.huffingtonpost.com/steve-hodges-md/potty-training_b_1424826.html

[daisymommy]

Great article! I must say that all of my 3 year old DS withholding problems started when he was 2 and I was pushing him to be PT because I was pregnant and didn't want 2 in diapers. I thought he was ready, but I guess not; he's still in PullUps and on Miralax!

[karstmama]

i bought the kindle version of his book this week - wow. i was starting to get suspicious that ds had some hidden constipation going on, and this week he has been actively withholding poop which is driving me crazy. sigh. miralax will be purchased today...

[♥ms.pacman♥]

Wow, thanks so much for sharing this. I read the entire article and then had my husband read it, and he thought it was a real eye-opener. When he lays the facts out, it really does make a ton of sense.

Plus, now I feel less bad over my almost 2.75 yo not being fully PTed (he will wear underwear for an hour or two without major accidents, but nowhere close to being fully PTed, and he still wants to wear a diaper most of the time). Whereas in my moms group the vast majority of moms pushed their girls to be 100% PT (even at night) literally the week they turned 2, and while they successfully PTed, i know of at least one that is already dealing with UTIs! I never thought of the correlation but now it makes sense. I'll happily deal with a few more months of spraying off poo from prefolds to avoid pricey doctor visits and other issues that might arise!

eta: i also really like how he contrasted kids in China, Africa etc being PTed early vs those in the US...i know many moms I know use that reasoning to say that their DC has the capability to PT from an early age. But as he pointed out, kids in the US usually have crappy diet (low fiber) plus are often in preschool for long periods of time and aren't old enough to communicate when they have to go.

[american_mama]

Hmm, I'm not sure I'm a fan of this article. He is kind of absolutist. A very minor point, but he says he never treats kids in diapers with a UTI, but I know my niece had a UTI when she was less than a year due to a common problem that I can't recall (some kidney/urethra thing that necessitates a VCUG). This is not an uncommon kidney/urethra problem and I think UTIs are a common sign of it in babies and toddlers of all ages.

And I think it's too absolutist to say it's better to train when kids are closer to 3. They are generally more resistant to paretns and independent at that age, whereas younger, they are more motviated just by pleasing mom and dad.

And I really dislike how he keeps mentioning that little girl Izabella by name. He doesn't know her or her parents, and I suspect the parents feel legitimately proud of the work they have put into infant toilet training. To be mentioned repeatedly by name as setting your child up for problems is, I think, both way too personal and even foolish. If little Izabella does just fine, does that negate his whole article? Presumably not. So why make her the focus by name?

I am assuming this is the author who talked about hidden constipation as a cause of accidents, which was dicussed on BBB. As I recall, many brought up the question, If there are no signs, how are you supposed to know if your child is constipated? I still have that question.

I also wonder if his clinic focuses on regression/late potty training/holding problems and thus he sees a skewed sample. My kids were all potty trained by 2.5, I think. I remember DD1 being 2 years and 2 months and using the potty on vacation, DD2 don't really remember but she was night trained just before age 3 and potty trained well before that, and DS was finally reliable in the fall when he was 2.5 exactly. I don't think any of them had mushy poop when we started. None of them have had problems since. So this doctor may never see kids like mine.

In my opinion, later potty training is so much more common these days that if waiting until 3 was better, I think his clinic would be less busy. Maybe the culprits are the other factors - constipation, holding, being in day care/preschool - rather than the age of potty training. I'm not sure what I think of the preschool/day care argument. Some places have kind of scheduled potty time, right, so a kid doesn't have to discipline himself to ask to go to the potty? And if a kid holds pee for 3 hours at preschool, that doesn't seem like a crazy long amount of time to me, although I would agree that holding much longer than that is probably unhealthy. And do kids feel gunshy in a strange bathroom? Some do, some don't. Some preschools and day cares have kid-sized toilets and sinks that make it all easier and more fun.

Definitely some food for thought, but the article didn't match my experience with three kids and kind of rubbed me the wrong way.

[HannaAddict]

I haven't read the article but did not stress about potty training at all and our pediatrician said three and half was average age for boys, to chill out, ignore in-laws and friends who asked about it, and said don't get caught up in the race. So glad too. We felt that gut instinct and our main stream ped said e disnt get the rush since developmentally three was better for most kids (but great if they wnt to). Both of mine, boy and girl, were out of diapers right after age three (she was right before or at three) and stayed dry at night without any issues within the next several months, and don't have the issues with withholding and pull-ups for years that so many of their friends who were "trained" earlier have. We offered and made sure to take them, but it was like a light switch, one day they asked to go and it was done. No days or weeks of wet pants or "accidents" they just did it when they were ready (not me) and didn't look back. I am amazed at how many kids we know that have issues and they were all "trained" and had stress doing it. I know our nanny is confused by our mellow approach (er also have a two year old) since all her friends are frantically offering stickers, m & m's, going naked or taking away things in their Herculean efforts to train two year olds. I vote just relax.