How to Be Free of the Pacifier!

When the majority of us started out on this roller coaster ride of parenthood, we LOVED the pacifier for its amazing ability to calm our little ones, lull them to sleep, and provide comfort when mommy isn't enough (scratched knee anyone).  However, as our littles grow up we begin to despise the pacifier.  Most of us find it becomes an extra appendage for our little love bugs.  Often times in their mouth obstructing their speech (and therefore making it impossible to understand) which increases everyones frustrations.  And then, there is the inevitable lost pacifier right before bedtime, which results in a mad scramble to find said pacifier so you can finally watch ONE show from your DVR.  Now trying to get rid of this silicone menace can often times lead to tantrums, crying, and sleepless night that remind us of our early days of parenthood.  However, I have developed a very simple way to ween your little one off of their pacifier with minimal tears! As with anything in parenting, consistency is key to everyones success, but I used this method with my daughter and it was not difficult at all...and she is STUBBORN.

The first thing you have to assess is your child's ability to self soothe.  If the pacifier is still the primary way your child can be soothed after a bump or fall, you may need to wait a few months before starting.  Also, I would suggest waiting if at night the pacifier falling-out of your little ones mouth results in him waking up to search for it.  You need to make sure your child is emotionally capable of soothing himself before starting this process, because you don't want to make this any more stressful than it needs to be.

Process

1) The first thing you need to do is talk to your little one, very casually, about how he is a big kid and big kids don't use pacifiers all the time.  Explain to him that pacifiers are just for bed and not for around the house. (If the pacifier is not an issue outside the bed then you can substitute this with it's for nap time only)

2) After a few days of casually talking about the change that is coming, if your little one appears to be comfortable and relatively open to the change (some resistance is expected, but here is where you need to read your child and see if he needs more time), you can begin to fade the pacifier.  You will first need to whittle down your pacifier stash to one or two pacifiers only. You can always let your little one choose which one or two he wants to keep to make it less scary.

3) Once you have decreased the pacifiers to a select one or two you will begin to fade the pacifier out.  You will first start with the times your little one will be sleeping for the shortest amount of time-naps.  This should be less stressful for him because he doesn't need to deal with it being dark, or with having to stay in his crib for a very long period of time.  Tell him that because he is a big boy (or girl) the pacifier is only for bedtime at night and not for nap time.  Do your regular nap routine, it is VERY important to keep everything in your nap time routine the SAME as it was before.  This will help to reduce any stress and it will also help signal to your little one that the expected behavior (sleep) is the same even without the pacifier.  For more information on this read sleep training your child and functions of behavior. You will want to put the pacifiers somewhere your little one can't reach-I put ours on the top shelf in the closet-during all times except for bedtime.

4) If your little one has a hard time in the beginning that is OK, in fact, it's to be expected. Continue with the routine and pacifier schedule for about a week. If you are not seeing an improvement (a decrease int he length or intensity of crying or whining) then can change the way you are fading.  If your little one takes more than one nap, then remove the pacifier for the shortest nap only.  If he only takes one nap, then you can give it to him for a few minutes until he falls asleep and then take it and put it away, so he won't have the opportunity to use it when he wakes up.  After a few days of success then move back to the schedule in #3.

5) Once your little one has mastered naps without pacifiers and is not asking for them (this may take a few weeks)  you can begin to transition away from the bedtime pacifier.  There are two ways you can do this:

• Cut the pacifier:  This is exactly what it sounds like. You will cut a small portion of the tip of the pacifier completely off (when your little one isn't looking) and put give it to him at bedtime.  If he asks what's wrong with it, you can answer with something like "I don't know, maybe it's broken" and then walk out.  DO NOT MAKE A BIG DEAL OUT OF THE CUT PACIFIER.  The reason you cut pacifier is if the tip is cut your little one can't get any suction and the child can't get the same sensation out of the pacifier.  With my daughter it only took about two nights for her to bring it to my attention that her pacifier "wasn't working" I then proceeded to look at the pacifier and say "oh yeah, it looks like it's broken I guess we need to throw it away. That's okay you don't need it because you're a big girl not a baby." Stick to this line if your little one asks about the pacifier, this is likely to happen for the first couple of nights.

• The pacifier fairy:  If you don't think your little one will be able to "get over" the pacifier without a little incentive then this is the way to go.  You explain to your little one that he (or she) is now a big kid and doesn't need a pacifier even for bedtime.  You then tell him that there is a pacifier fairy that takes all of the old pacifiers from the big kids and gives them to the new babies that need it. You and your little one will then put all the pacifiers on a string and tie that string to his doorknob before bed.  While your child is sleeping take the pacifiers off of the doorknob and leave a small toy outside of his bedroom.  This way when he wakes up and sees that his pacifiers are gone, he will have a toy to help ease the transition.

Either of these final methods will work, however I suggest you go through steps 1-4 first to make the transition as easy as possible.  Yes, you can cut the pacifier cold turkey and have it be effective, however that usually results in a longer time of crying and difficulty sleeping which often times results in the parent giving in.  When you start this process YOU CANNOT GIVE IN. If you do then you have just strengthened you child's behavior of crying for the pacifier which will only make the next time you try more difficult.  Also, note that the time frame for this fading is very CHILD SPECIFIC.  How long this process will take depends on your consistency, your child's readiness, and understanding of what's going on.  Some kids go through this within a week others can take a month or more, it all depends.  My daughter took about a month from start to finish, but that was mainly due to my hesitation to move to step five for fear of having to move back.  I hope this helps all of you out there who are struggling with this.  If you have any questions feel free to ask in the comments!

*NOTE:  If your child suffers from a medical condition or a psychological (emotional) condition please speak with your pediatrician before starting this routine to make sure that it is safe and something your little one can physically handle.

How to Potty Train in THREE DAYS!

Aside from getting your little one to sleep through the night, potty training is one of the most exasperating, and stress inducing tasks a parent can take on. Many a blog post has been written about how to potty train your child, and I have heard so many myths, including boys are harder to train than girls.  As a BCBA who has worked in the field for several years, I can tell you potty training is not difficult if it is done correctly.  The potty training method I used with my clients, and that I use with my own children, is scientifically proven to be effective. It is important to note that this method was originally developed to help the mentally handicapped in an institutional setting, however don't let that deter you from using this method.  Like I have said, I have used this method with my own, typically developing child and it was very simple and effective.  Just be aware that this method does require some preparation and commitment on your part, so make sure you are prepared; the majority of potty training failures are due to parent mistakes and lack of preparedness.  If you want to be successful in your potty training, you have to be consistent and follow through, no matter the messes.

The first thing you need to do to prepare for potty training is mark out 3-4 CONSECUTIVE days that you and your little one can be at home all day to do this method.  The reason fro this is you need to make sure you are able to set up as many A-B-C pairings as possible, and that you are able to consistently match the appropriate behavior (i.e., going in the toilet) with an appropriate consequence (i.e., reinforcement).  To be successful in this method, you need to create as many pairings as possible.

The second thing you need to do is buy a TON of children's underwear, because when you start this method you need to take your kiddo out of diapers PERMANENTLY, with the only exception being diapers at night, because night time wetting isn't about training, it's about age,  Studies have shown that children who switch between diapers and underwear (yes pull-ups count too) take longer to potty train, then their peers that are only in underwear.  The reason for this, is the A-B-C contingency isn't consistently being reinforced.  Sometimes, it's okay for him to pee in his pants, sometimes it's not-you see how that can get confusing for our little ones.  Once all of that is done you can begin your potty training adventure!

Materials Needed:

1) Timer (your microwave timer is fine, just something you can hear)
2) Reinforcers- These should be something your child really likes but they also need to be small and simple to remove. I used chopped up Reese's Pieces for my daughter and these worked great.  You also need to make sure your child doesn't have access to the reinforcer before hand, they need to be in a state of deprivation.
3) Chart-Something simple for you to write down when your child sat on the toilet, when he got off, and if he was successful or not.
4) Potty seat
5) Books, toys, movies, things small and portable you can have in the bathroom
6) Chair for you
7) LOTS of water
8) Salty foods

Steps:

1) Wake your child up and immediately put him on the toilet. DO NOT give him an opportunity to go in his diaper. When you put him on the toilet begin feeding him salty foods to make him thirsty and then giving him lots of water (this will make him pee more and increase your opportunities to pair the desired behavior with a reinforcer).

2) Write down what time you put him on the toilet. Continue to feed him salty food and water UNTIL he pees in the toilet, this is now your baseline time.  This is the longest you will let him sit on the toilet without peeing. Write down the time when he went pee and also that he peed. NOTE: It may take several hours to get your baseline, that is okay, that is why you have all the toys and fun stuff in the bathroom. (That's why we call it a "potty party").

3) Immediately after he finishes peeing, give him tons of praise, and his reinforcer, and take him off the toilet (he should be in his underwear now).  Set the timer for 5 minutes and let him go and play.  During this time be right next to him.  This is done for two reasons: first, you need to continue to feed him salty foods and water (to make him pee again), and second, you need to make sure he doesn't have an accident.

       3A) If he does not have an accident when the time goes off, tell him something to the effect of     "good job not having an accident". Then put him back on the toilet, you will continue to feed him salty food and water until he either goes pee (then repeat steps 2-3) or until you hit baseline time.  If baseline time is hit then take him off the toilet and set the timer for another five minutes.  If he pees on the toilet let him off.  If he has three consecutive times at 5 minutes WITHOUT an accident, you can increase his next time off by 5 minutes (i.e., he now has 10 minutes off).  With each three consecutive breaks without an accident you will increase the time off by 5 minutes until he is at the typical length of time between urination for his age.

       3B) If during any of the times off he has an accident, DO NOT SCOLD HIM. Help him change out of his underwear and into a clean pair.  Then have him help you clean up the mess.  It is important that he help you to clean up, this shows him that having an accident result in a non-preferred activity i.e., cleaning up pee, while going pee in the toilet results in a preferred activity i.e., access to the reinforcer.  Once the mess is cleaned up restart the time for another 5 minutes and continue to feed him salty foods and water until the timer goes off, then go through steps 2-3 and 3a or 3b.  Remember he needs three CONSECUTIVE successes in the toilet to increase his time off, so any accidents mean you start over in your success.  That means if he's had two consecutive success and then has an accident you CAN NOT increase the time upon his next success because you don't have three consecutive success.  If you notice you have increased the time and he is not having any success, go back to the last successful time to create those pairings again.

4) Once he has reached the typical amount of time between urinations (usually 2-3 hours depending on age) and is consistent with his success you can start working on him telling you he needs to go potty.  This usually happens on the second day or so, when the time goes off you will ask him if he needs to go potty.  if he says "yes" take him, if he goes give him lots of praise and a large portion of the reinforcer, for example a large piece of Reece's.  If he doesn't go, tell him it's okay and let him off, no punishment, no big deal.  If he says that he doesn't need to go don't force him.  Keep an eye on him and if you see him doing the "pee dance" ask again.  If he has an accident help him change and clean up like you did in step 3B and reset the timer.  Doing this will help him to recognize the sensation of needing to go pee, without a diaper.  If he INDEPENDENTLY comes to you and tells you he needs to go pee (you didn't ask him) and he actually goes, give him LOTS of praise and a HUGE piece of the reinforcer, for my daughter I gave her half of a Reece's Pieces (pretty big for an 18 month old).

NOTE: This training is focused on training for urination, this is because it is a lot easier to bring about urination (by salty food and water) than bowel movements.  You will have to read your child's visual ques for BM's.  This may be straining, hiding, squatting, etc and ask him if he needs to go poo. Then put him on the toilet and reinforce when he is successful.  It usually doesn't take that long to potty train a child for BM's because the concept usually generalizes from urination training.

Since you will NOT be putting him in diapers or pull ups during the day I suggest getting a small backpack for him to wear that holds all of his accident accessories.  I purchased one for the first time I took my daughter out after our third day of potty training.  I put a few extra pairs of underwear, pants, socks, and shoes  in it, along with some paper towels.  I had her carry it and I told her she was a big girl and these were her accident supplies but that we didn't want to use them, and she needed to tell me if she needed to go potty.  I also showed her that her Reese's were in the bag as well so she new she would get a prize if she went in the toilet. This worked great!

After you have been going about town for a couple weeks, depending on the child, you can begin to fade the reinforcer. Instead of giving him a treat every time he goes pee in the toilet, fade to a treat every other time.  Still give vocal praise, but have it be more subdued, not a full parade but a happy "good job, you're amazing".  If he asks for his treat tell him "next time".  Once you know he can still be successful with a treat every other instance, then fade to every two times, then every three times, etc until he is at a more typical reinforcement schedule, of subdued vocal praise.

I also suggest you get a pee mat for your car seat (image below).  The slide very easily onto the seat and can hold unto a liter of fluid, which makes it so you don't have to tear your entire car seat apart just so you can wash the cover.  Instead you just pull of the pad and throw it in the washer, super easy! This was by far my favorite potty training accessory I purchased during this entire thing. Babies R Us has a really cute one with pockets for storage that I like a lot.

I hope this post was easy and helpful for all of you venturing into this amazing milestone.  If you have any questions, please feel free to comment below and I will respond as soon as I can. I will also be creating a potty readiness post and linking it here for you all to know when your little one is ready to "be a big kid."


*NOTE: Before beginning any potty training routine, you should consult with your pediatrician to make sure there are no dietary or physical issues which may impede the potty training process i.e., constipation, lack of bladder control due to sphincter development issues, etc.  If any concerns arise during potty training you should consult your pediatrician immediately to make sure your little one is healthy and thriving under this new condition. I can not provide medical information and advice as I am not a medical practitioner.