俺问的不外就是俺娃3岁多了还老尿裤裤拒绝上厕所云云。

以下是医生答复.

我真的觉得这位儿医的意见很专业。有需要的妈妈请耐心一点读完。我翻译了几句，终于发现自己打字无能，翻译也不到位，所以索性原文奉上。

This is normal（to have potty accident) at 3. I\'d relax and not make an issue of it. Set an example, be positive and she\'ll likely train herself when she\'s ready. Just make sure she\'s not constipated (which can interfere with urine training as well). Please read the following which might help:

这对3岁多的娃很正常，放松放松。大人态度要正面，娃大点自然会好。然后下面大段都是怎么判断娃生理上是否准备好了以及该如果帮助娃的，我觉得很有帮助。

倒是最后儿医指出一点家长常犯的毛病，就是over instruction,或逼孩子定时上厕所都没有任何帮助，甚至会有反效果。
又：如尿湿了，让他/她自己换裤子。
又：如果便秘，就要看医生。
不记得还讲了啥了。大家自己看吧。医生专业意见，真的很专业。

TOILET TRAINING READINESS

If your child is at least 20 months of age, he or she may be ready for toilet training. You can give three simple tests to determine if your child is ready: one for bladder control, one for physical development and a third for instructional readiness.

BLADDER CONTROL

1. Does my child urinate a good deal at one time or does he dribble throughout the day?

2. Does my child stay dry for several hours?

3. Can I tell if my child is about to urinate by his facial expressions or postures he adopts?

If your child can do the first two, he or she may be ready for toilet training. Not all children indicate their desire to urinate.

PHYSICAL READINESS

1. Can he or she pick up objects easily?
2. Can he or she pull his/her pants up and down?
3. Can he or she walk from one room to another without assistance?
Your child should be able to do all three tasks.

INSTRUCTIONAL READINESS

1. Point to nose
2. Point to eyes
3. Point to mouth
4. Point to hair.
5. Ask him/her to sit in a chair.
6. Ask him/her to stand up.
7. Ask him/her to walk to a particular place with you, like another room.
8. Ask him/her to imitate you in a simple task, such as playing pattycake.
9. Ask him/her to bring you a familiar object, such as one of his/her toys.
10. Ask him/her to place one object with another, e.g., put the ball in the box.

Your child should be able to carry out eight of these ten instructions.

Adapted from Barton D. Schmitt, MD, pediatrician and author of Your Child\'s Health, Bantam Books, a book for parents

TOILET TRAINING RESISTANCE

Description

Children who refuse to be toilet trained either wet themselves, soil themselves, or try to hold back their bowel movements (thus becoming constipated). Many of these children also refuse to sit on the toilet or will use the toilet only if a parent brings up the subject and marches them into the bathroom.

Any child who is over 2-and-1/2 years old, healthy, and not toilet trained after several months of trying can be assumed to be resistant to the process rather than untrained. Consider how capable your child is at delaying bowel movements (BMs) until he or she is off the toilet or you are on the telephone. More practice runs (such as you used in toilet training) will not help. Instead your child needs full responsibility and some incentives to spark his motivation.

The most common cause of resistance to toilet training is that a child has been reminded or lectured too much. Some children have been forced to sit on the toilet against their will, occasionally for long periods of time. A few have been spanked or punished in other ways for not cooperating. Many parents make these mistakes, especially if they have a strong-willed child.

Helping Your Child with Daytime Wetting or Soiling

Most children less than 5 or 6 years old who have BMs in their pants or wet their pants and have no symptoms of illness are simply engaged with you in a power struggle. These children can be helped with the following suggestions. If your child holds back bowel movements and becomes constipated, medicines will also be needed, so first talk with your child\'s physician. If your child also wets the bed, work on the daytime wetting first because it will be much easier to change.

1. Transfer all responsibility to your child.
Your child will decide to use the toilet only after he realizes that he has nothing left to resist. Have one last talk with him about the subject. Tell your child that his body makes pee and poop every day and it belongs to him. Tell him that his poop wants to be in the toilet and his job is to help the poop come out. Tell your child you\'re sorry you punished him, forced him to sit on the toilet, or reminded him so much. Tell him from now on he doesn\'t need any help. Then stop all talk about this subject. When your child stops getting attention for not using the toilet, he will eventually decide to use the toilet for attention.

2. Generally stop all reminders about using the toilet.
Let your child decide when he needs to go to the bathroom. Do not remind him to go to the bathroom and do not ask him if he needs to go. He knows what it feels like when he has to poop or pee and where the bathroom is. Reminders are a form of pressure, and pressure doesn\'t work. He should not be made to sit on the toilet against his will because this will foster a negative attitude about the whole process.
Some children have never used the toilet and in the beginning will need a pleasant reminder once a day when they are clearly holding back. You can say, Do you know how you can make your tummy feel better? After your tummy gets rid of the poop, it will feel good. However, don\'t go with your child into the bathroom or stand with him by the potty chair. He needs to get the feeling of success that comes from doing it on his own and then finding you to tell you what he did.

3. Give incentives for using the toilet.
If your child stays clean and dry, he needs plenty of positive feedback, such as praise, smiles, and hugs. This positive response should occur every time your child uses the toilet. If a child soils or wets himself on some days and not others, reward him only when he is clean for a complete day. On successful days consider taking 20 extra minutes to play a special game with your child or take him for a walk to the playground. Sometimes special incentives, such as favorite sweets, can be invaluable. One of your main jobs is to find the right incentive. For using the toilet for BMs, initially err on the side of giving him too much

(for example, several sweets each time). If you want a breakthrough, make your child an offer he can\'t refuse.

Incentives work best if they are special and not available as rewards for other tasks or as a part of daily life. Additional motivation can come from making a carefully orchestrated fun trip to the preschool. Clarify for the child that regular preschool attendance requires toilet training.

4. Give stars for using the toilet.
Get a calendar for your child and post it in a conspicuous location. Place a star on it every time he uses the toilet. Keep this record of progress until your child has gone 2 weeks without any accidents.

5. Make the potty chair convenient.
Be sure to keep the potty chair in the room he usually plays in. This gives your child a convenient visual reminder about his options whenever he feels the need to urinate or have a BM. If your child has been wetting his pants, the presence of the potty chair and the promise of treats will usually bring about a change in behavior. If your child has been having bowel movements in his pants, he may need a pleasant reminder only when he is clearly holding back. You can say, The poop is trying to come out and go in the toilet. The poop needs your help. Tell your child that you want sitting on the potty to be lots of fun. What would they like to do? A few children temporarily may need treats for simply sitting on the toilet and trying.

6. Diapers, Pull-ups, or underwear.
Whenever possible, replace Pull-ups or diapers with underwear. Help your child pick out some underwear with characters on it that don\'t like poop or pee. This usually yields the correct decision on the part of the child. Even if your child wets the underwear, keep with the plan. If your child holds back BMs, allow selective access to diapers or Pull-ups for BMs only.

7. Remind your child to change his clothes if he wets or soils himself.
As soon as you notice that your child has wet or messy pants, tell him to clean himself up immediately. The main role you have is to enforce this rule. If your child is wet, he can probably change into dry clothes by himself. If your child is soiled, he will probably need your help with cleanup. If your child refuses to let you change him, ground him until he is ready.

8. Don\'t punish or criticize your child for accidents.
Respond gently to accidents, and do not allow siblings to tease the child. Do not put your child back into diapers unless he is taking laxatives or stool softeners. Punishment or criticism will only delay successful training and it could cause some emotional problems.

9. Ask the preschool or day care staff to use the same strategy.
Ask your child\'s teacher or day care provider to let your child go to the bathroom any time he wants to. Keep an extra set of clean underwear at the school or with the day care provider.

Call Your Child\'s Physician During Office Hours If:
o Your child holds back his bowel movements or becomes constipated.
o Pain or burning occurs when he urinates.
o Your child\'s resistance has not improved after you have followed these suggestions for 1 month.
o The resistance has not stopped completely after 3 months.