Many toilet training problems result from using improper training techniques or applying too much pressure on the child. Improving the technique used and avoiding pressure can help. Anxiety can also be a problem. The toilet can be very frightening to some children. They may believe that pieces of their body are being flushed away or that they will be sucked into the toilet. Explaining the purpose of body wastes and allowing the child to flush pieces of toilet paper or say goodbye to the waste as it is flushed can help relieve these anxieties.

Common problems associated with toilet training include:

• Constipation. If a child is experiencing hard, painful stools, he or she may be constipated. Maintaining a nutritious, well-balanced diet with plenty of fiber and water can help. Sometimes, reducing the amounts of dairy products that the child consumes can also help. A pediatrician can recommend treatment options.
  
  
• Withholding. Holding back bowel movements. Children may do this when they are under too much pressure, have constipation or have some other physical problem (e.g., anal fissure). Withholding can also cause constipation. A child who is withholding may also be testing parental limits or rebelling. Consulting a pediatrician can rule out or treat physical problems.
  
  
• Resistance or refusal. Occurs when the child continues to use diapers or have bowel movements in clothing or elsewhere and refuses to use the toilet. The child may even ask specifically for a diaper to have a bowel movement in. This may occur because the child is not ready, is under too much pressure, is afraid of or anxious around the toilet, or is constipated. A positive feedback system (e.g., praise, encouragement, rewards) often helps.
  
  
• Enuresis or encopresis. The involuntary leakage of urine (enuresis) or stool (encopresis).  Bedwetting, or nocturnal enuresis, is common until about age 5. This is because nighttime bladder control often takes longer than daytime control. Frequent daytime leakage may be due to a variety of factors and a pediatrician should be consulted.
  
  
• Playing with stool. Some children attempt to play with their stool. This can be prevented by informing the child in a non-accusative manner that stool is not a toy and it belongs in the toilet.