Body Awareness & Sexuality: Advice On Dealing With Preschool Fears

Dear Dr. Heather,

I am worried about my 3-year-old daughter, who has made 2 comments about her "bottom" in the last 2 weeks. She didn't want me to look at her bottom when I was putting a pull-up on her. When I asked her why, she said "I don't know." And visiting her grandparents' house, she was getting dressed for the day and told her grandma that she didn't want grandpa to see her bottom. I know that her grandpa would NEVER EVER do anything inappropriate...as a matter of fact, he has never even changed her diaper when she was younger. There is nobody else who she is in contact with who would EVER do anything inappropriate either. But I am concerned. I have never used the word "bottom". I do not leave my girls alone with men or even just grandpas or other children (like playing in their room by themselves). They have to play where I can see them.

What I want to know is this: Do preschoolers develop a self-awareness of their body to a point where they don't want certain people seeing them in their undies, or in the bathtub....at what age and is this normal? What should I be doing at this point? My number one priority is protecting my young daughters.

Signed,

Anonymous -- and Fearful -- Mom

Dear Fearful Mom,

Sometimes it's hard to see our babies venture into territory like this. Body awareness, along with a sense of "private parts", is a first step in a child's developing sexuality. This can trigger strong feelings in us as parents, especially for those who have lingering issues over sexuality, or perhaps have experienced some sort of sexual abuse or inappropriateness in our own pasts. The natural response is to hypervigilant about any possible danger, and to protect your child at any cost. But this can get in the way of your child's growing -- and normal -- awareness of his or her own body.

So YES, children do start to develop a beginning sense of body awareness -- and privacy -- by age 3. It's not a fully-formed sense yet, but preschoolers do start to pick up on the fact that some areas of the body are "private". It's a complicated idea and so at first they can get confused. They might not totally understand whom you DO and DON'T show your private parts to....it would not be unusual for a 3-year-old to act shy about her "bottom", even with a parent. Then there may be other times where she will run around naked, with no inhibitions. They're trying to figure out the "rules" about who can view which body parts. It's a long process that takes at least a couple of years to really come to grips with what is a complicated -- and "loaded" -- concept.

You mention that you're worried about where she heard the word "bottom", since you don't use it in your family. You might think about where else she might have picked it up. Does she go to preschool? Or have friends that use the word "bottom"? Those are possibilities. She could have even overheard a mother talking to her child about it at the grocery store, for instance, "Sit on your bottom when you are in the shopping cart." Of course I can't know, but I'm just thinking of how often you hear parents talking to toddlers and preschoolers about stuff like that in public. Maybe that's where she heard it.

Now, it sounds as if you are afraid something inappropriate might have happened. Of course I cannot say one way or another if that is the case; I'm not evaluating your daughter, only giving you some parenting information. But I can tell you that, usually, children who have been sexually abused show MANY signs of disturbance and regression including sleep, appetite, behavioral, and other problems. Simply using an unfamiliar word -- by itself -- would not necessarily concern me. I would look at her OVERALL behavior over a period of time. Of course if you have reasonable suspicion, you should report those suspicions to her doctor and the authorities. But hopefully this is just part of the normal process of your daughter learning about "public" and "private" body parts -- a task that all preschoolers do work on at this age.

You might also want to check out another article of mine on the normal development of sexual sensations in preschoolers. Click here for it. I hope that helps. Let me know if you need more help.

Aloha,

Dr. Heather The BabyShrink

Post updated 12/2/2010

More on Potty Training: When Your Preschooler Poops in Her Sleep

Dear Dr. Heather, I have a question for you regarding my daughter, who turned 3 in October. She has been potty trained (pee at least) since August. Here is the problem….she poops in her sleep. She also poops on the potty if she has to go while she is awake. But mostly, she is pooping in her pull-up during naptime. She also has pooped twice at nighttime. I don’t know if she is holding it to do it while she has a pull-up on, or if she is sleeping so soundly that she doesn’t realize she is doing it. Since she also poops on the potty, I don’t know what to think. Is it possible to influence the time of day she poops? She will be starting preschool soon and I am concerned that she will poop in her underwear at school during naptime. When she does poop in her pull-up, she apologizes profusely. I used to say that she needs to poop in the potty, not in her pull-up, but I don’t want to turn her into a neurotic kid, so I just clean her up and say nothing. Any suggestions?

Thanks for your help.

Marcia

Hi Marcia,

It sounds like you are being sensitive to your daughter regarding her poopy-timing. I'm glad you're not pressuring her about the issue. And the fact that she apologizes profusely shows you that she knows what she is supposed to do, but isn't there yet. You're right; lecturing her about it won't help. And I wouldn't suggest doing anything to somehow manipulate her potty schedule; this would likely be felt as intrusive by her.

It also seems that it wouldn't concern you as much if it weren't for the preschool issue. Many preschools have rules that state the child must be "toilet independent" before starting school. The pressure to be "completely" potty trained before starting preschool MAKES ME CRAZY! It's really unrealistic for many kids, and parents feel compelled to get their kids trained before they're ready. This can cause problems later on.

That said, many schools WILL work with you, if you approach them directly. Believe me, this isn't the first time they've dealt with this! They can support your daughter on her way to being fully potty trained. If her school won't work with you on this -- look elsewhere. You want a place that understands the developmental issues of preschoolers.

In the meantime, continue to praise her efforts, and be neutrally supportive when she has an accident. I wouldn't dwell on it much with her; it sounds as if she KNOWS what is expected, and that's what matters. It sounds like she's well on her way to having full control over her potty needs, and I'll bet that soon, she'll be making good progress.

Good luck and let us know how it goes!

Aloha,

Dr. Heather The BabyShrink

Toddler Behavior: Tips for a Toddler Tinkling (and Screaming) in the Bath

Hi Dr. Heather, My husband and I are hoping you can shed some light on a concern we have for our son who is 27 months old.

Over the last month during bath time, my son has peed in the bath 3 separate times, and without fail he would then 'hold himself' while crying/screaming hysterically! This has continued during every bath time where he is screaming like we have never seen. He doesn't necessarily pee every time, but since the first occasion... then a second, and a third... his screaming has continued.

Even when he doesn't pee in the tub, he still holds himself and is screaming almost like he doesn't like the water hitting his 'manhood'? We have tried new toys and bubbles; to all of which have not work or helped. We even tried to have him try to go potty before the bath but doesn't go.

I must say also, that he is not potty trained yet but we are working on it.

We are not sure why he's continually freaking out with or without the pee.

If you could please help and how we can overcome it we would be extremely grateful.

Regards,

Atlanta Mom

Hi Atlanta Mom,

Sudden fears of the bath at this age are quite common. One of my most-Googled posts has to do with sudden bath fears; I'll post the link below. In regards to his "manhood", perhaps he's upset that he couldn't control it; on some level he's starting to get the idea that "pee-pee does not belong in the tub", yet he was unable to control himself those few times. So he's really upset with himself and in conflict about the whole bath/potty training thing. (And of course I assume his penis doesn't bother him any other time -- like there's not a urinary tract infection or something -- also, some kinds of soap and bubble bath can be irritating. I assume that's not it, but check it out.) Talk to him about potty training, where pee-pee belongs, and how he accidentally peed in the tub; use a matter-of fact tone, with no scolding or worry in your voice. See if you can make it like a silly joke, so he doesn't feel so bad. "Does pee pee belong in the tub? NO, silly! But that's OK! We'll keep trying and one day for sure you'll get it!"

In the meantime, try some of the tips in my post linked below for bathtime fears, including letting him stand by the bath and playing with the water, until he feels comfortable getting back in the tub. Keep reassuring him, and go at his pace. Hang in there, I promise this will pass!

Here's my Bathtime Fears Post: http://babyshrink.com/2008/08/help-my-toddler-suddenly-hates-the-bath.html

Good luck and keep usposted!

Aloha, Dr. Heather The BabyShrink

Toddler Behavior: Baby's Sudden Fear of the Bath -- Another Hot Topic

One of the FAQs here at BabyShrink is about your toddler's sudden, inexplicable fear of the bath. Readers Noelle and Dana recently joined in the chorus of parents who are mystified about the radical change in their baby's bath-time routine. I've had plenty of first-hand experience with baby's bath fears, and I know it can be a hassle ("It interferes with our evening routine, and they NEED that bath!") and also worrisome ("She never got upset like this before -- is this a symptom of something much more concerning?") But when you understand the normal developmental process driving these fears, a little flexibility -- and empathy -- can go a long way to restoring your toddler's enjoyment of the bath. So thanks for your nice comments about this article, and for making it one of BabyShrink's most popular posts over the past year.

Click here to check it out!

Aloha,

Dr. Heather The BabyShrink

Sleep & Nap Issues: Older Kids and Bedwetting

My most recent group of posts on Attachment Parenting have been fueled by a fire that caught me by surprise. And while I do obviously have some strong opinions to share on the subject, I'd like to get BabyShrink back to where I think we'd all rather be...right smack dab in the middle of a potty-training problem! So without further ado, here's a case that was accidentally published to the March archive, but should have appeared here first: Dear Dr. Heather,

I have a seven-year-old who has peed in his bed forever. I have tried numerous attempts to get him to stop, like waking him up to go, buying him a night lamp, etc. However, none of these have worked, and now I am thinking it might be psychological, or that maybe something is happening to him and I don't know about it. Whenever I ask him why he wets his bed, his only answer is "I don't know". Can you help me? The medical doctors have ruled this out as "normal" and tell me that one day he will stop, but WHEN??? Thank you for your time.

In desperate need of help,

Gabby

Hi Gabby,

I know it's hard, but bedwetting is common and fairly normal for a lot of kids this age, especially boys. There seems to be a genetic component, as well. It's important to not get into shaming him or trying to control the wetting....you have to leave it up to him. He should wear big-kid size pullups and be responsible (or at least help with) changing sheets when necessary, but the motivation to be dry has to come from him. Leave him in the nighttime pullups until he's dry consistently, so there's no pressure or worry about it.

They have those "bell and pad" things that go off when the kid pees, but it seems like they only serve to wake up the rest of the household, EXCEPT the kid himself....since bedwetters usually sleep really deeply. In fact, some doctors think that bedwetters' brains are a little different, in terms of their ability to transition between sleep and wakefulness. Bedwetters may simply not have developed the ability to awaken yet from sleep in order to go to the bathroom. This ability usually develops over time, though.

In later childhood, by about age 7, bedwetters may start to worry about what others think of them, and feel upset that they can't control their bodies at night. Reassure these kids that you will help them to do what it takes to eventually gain nighttime control; help them restrict fluids after 6pm, make sure they empty their bladder right before bed, and limit nighttime sweets, which can have a dehydrating effect. Getting a little extra sleep at night, even as little as 30 minutes more, can help for some. You can also keep trying to awaken him a couple of hours after going to bed to have him empty his bladder. But this should only be done with the child's cooperation and agreement. Let them know that you have faith in their bodies, and their ability to gain nighttime dryness when they are ready. And try to eliminate sources of shaming or ridicule. He's doing the best he can, and shame only worsens the problem.

We worry more about trauma, a medical condition or psychological stuff when there is an abrupt change...as in, they USED to be dry, and NOW...it has suddenly changed. But if he has always more or less been wet at night, and if there are no other indications in his daytime life that things are amiss...well, then, it looks like you're just gonna hafta be patient.

Of course, for something like this, you always need his pediatrician's blessing that nothing else is wrong, but other than that, all I can do is assure you that it WILL stop.

Let us know when that happens, we'd like to hear how it goes!

Aloha, Dr. Heather The BabyShrink

Toddler Behavior: Body Awareness & Sexual Fears In A Young Boy

Dear Dr. Heather, My 3-year-old son gets upset with his penis gets erect. He says "mommy my pee pee go big." It's like a question/concern/fear all rolled into one statement. He then pulls down his pull-up or underweare (whatever he is wearing) and shows me...no matter who is around. I tell him it is ok and it will go back down. Is this normal, and if so, when does this stop?

Mel

Hi Mel,

At 3 years of age, your son now has an awareness of his body. He also is sensitive to any changes in it, and worries whether the changes mean something is wrong. Children crave consistency, and when things are different -- they can get upset and worried.

Your son is not alone. Most toddlers and preschool-aged boys show an interest in the sensations and changes happening in their penis. (I guess it's an interest that starts in early childhood -- and never goes away!) It's a perfect opportunity to convey the overall message that:

Your body is a good thing; The sensations your body produces are healthy and normal; and It's OK to touch and explore your body -- in private, by yourself.

Talk to your son about his private parts. Use short, simple sentences, and don't try to convey too much at once. "Yes, sometimes your penis gets big like that. Sometimes it is small. But we don't take off our clothes in the living room. You can go look at it in your room, if you want."

Make sure nobody is giving him a negative message about his body; check with sitters, grandparents and others to see if this has "come up" with them, and how they've handled it. You want to make sure he's getting a consistent, positive message.

Of course girls show the same interest in their bodies; check out this post. It also describes the limits of "normal", and when to worry.

It's not too early to begin to send a healthy message to young children about their bodies. Aim for striking a balance; you don't want to instill a sense of shame or negativity about the body. Yet you want them to internalize the sense that their bodies are private and should be respected. It will help them to eventually feel a sense of physical integrity and safety, and to set appropriate boundaries later on.

Aloha, Dr. Heather The BabyShrink

Parenting Tips: How To Handle Masturbation in Young Children

Dear BabyShrink, Lately I have been getting very concerned by my 3-year-old daughter’s annoying habit. She lays on the sofa and puts her hands between her legs and does this kind of "bop pushing action". She sometimes uses objects like her blanky or teddy bear to help her bop between her legs. It doesn't seem to change her attitude or behaviour any, but I find it annoying. Some people have told me that maybe she is developing sexually too early; and this is very scary for me, can this be true? I am very worried as this is embarrassing and I know to ignore the problem may make it go away, but I would really like to know WHY is she doing this?

Sincerely,

Mama A in Canada

Hi Mama A,

You pose a very interesting and important question. How do we handle the sexual development of our very young children?

Young childrens' bodies are actively developing in every way. As they develop, they learn that their bodies have different kinds of sensations. It’s a normal part of their own self-exploration. Young children do experience immature sexual sensations, and masturbation is quite normal. It does not mean that the child is developing sexually too early.

However, it’s a difficult balance to strike, as parents. We want to send the message that sexual feelings are healthy and normal. But we also want our children to have a strong sense of boundaries and understanding of what is “good touching” and what is “bad touching”. We also want them to know that there are appropriate places for self-exploration. For instance, your daughter can feel free to explore her body when she is alone in her room. But it’s not an activity for the living room, or with other kids. It’s not too early to begin conveying those messages now. You can say, I know it feels good when you do that. But it’s for you to do in private, in your room, OK?

We want them to learn to feel comfortable with their bodies and the pleasurable sensations they experience. But we also want them to develop a strong psychological sense of privacy and safety in experiencing sexual feelings. This is a good time to start mentioning little facts about her body, and who is allowed to touch whom, and where.

The emotional message you send about the issue is at least as important as the words you use.

If you feel uncomfortable talking about bodies and sexual feelings, perhaps practice first. You don’t need to give her a big lecture. You should simply mention little facts now and again, such as Oh, you’re wearing a bathing suit now. Who is allowed to touch you under your bathing suit? Only you. Or Mommy, Daddy or your doctor, to make sure you’re clean and healthy.

You also need to talk to your daughter’s pediatrician about it, since little girls can have irritation caused by a urinary tract infection or rash. This may cause itching and the kind of behavior you describe. So check that out, too.

One last comment about masturbation. Some may worry that their child was sexually abused or somehow learned this behavior inappropriately. But how do you know if that’s true? If your child masturbates excessively, to the exclusion of other usually interesting activities, and can’t keep her behavior to herself privately, you might want to ask your doctor for help. (And don’t feel embarrassed asking about it; your pediatrician hears this question several times a day!)

I hope this helps!

Aloha, Dr. Heather The BabyShrink

Sleep & Nap Issues: Bed Wetting... For How Long?

Dear Dr. Heather, I have a seven-year-old who has peed in his bed forever. I have tried numerous attempts to get him to stop, like waking him up to go, buying him a night lamp, etc. However, none of these have worked, and now I am thinking it might be psychological, or that maybe something is happening to him and I don't know about it. Whenever I ask him why he wets his bed, his only answer is "I don't know". Can you help me? The medical doctors have ruled this out as "normal" and tell me that one day he will stop, but WHEN??? Thank you for your time.

In desperate need of help,

Gabby

Hi Gabby,

I know it's hard, but bedwetting is common and fairly normal for a lot of kids this age, especially boys. There seems to be a genetic component, as well. It's important to not get into shaming him or trying to control the wetting....you have to leave it up to him. He should wear big-kid size pullups and be responsible (or at least help with) changing sheets when necessary, but the motivation to be dry has to come from him. Leave him in the nighttime pullups until he's dry consistently, so there's no pressure or worry about it.

They have those "bell and pad" things that go off when the kid pees, but it seems like they only serve to wake up the rest of the household, EXCEPT the kid himself....since bedwetters usually sleep really deeply. In fact, some doctors think that bedwetters' brains are a little different, in terms of their ability to transition between sleep and wakefulness. Bedwetters may simply not have developed the ability to awaken yet from sleep in order to go to the bathroom. This ability usually develops over time, though.

In later childhood, by about age 7, bedwetters may start to worry about what others think of them, and feel upset that they can't control their bodies at night. Reassure these kids that you will help them to do what it takes to eventually gain nighttime control; help them restrict fluids after 6pm, make sure they empty their bladder right before bed, and limit nighttime sweets, which can have a dehydrating effect. Getting a little extra sleep at night, even as little as 30 minutes more, can help for some. You can also keep trying to awaken him a couple of hours after going to bed to have him empty his bladder. But this should only be done with the child's cooperation and agreement. Let them know that you have faith in their bodies, and their ability to gain nighttime dryness when they are ready. And try to eliminate sources of shaming or ridicule. He's doing the best he can, and shame only worsens the problem.

We worry more about trauma, a medical condition or psychological stuff when there is an abrupt change...as in, they USED to be dry, and NOW...it has suddenly changed. But if he has always more or less been wet at night, and if there are no other indications in his daytime life that things are amiss...well, then, it looks like you're just gonna hafta be patient.

Of course, for something like this, you always need his pediatrician's blessing that nothing else is wrong, but other than that, all I can do is assure you that it WILL stop.

Let us know when that happens, we'd like to hear how it goes!

Aloha, Dr. Heather The BabyShrink