Moms Talk with Dr Varisa Perlman [episode #3]: Potty Training

Cecile: Hi, everyone. This is Cecile.

Fanny: And Fanny.

Cecile: From La Petite Creme. And we are here today to talk about—

Fanny: Potty training.

Cecile: Yay! Potty training, yes. It's an important topic for babies and for kids and for parents.

Fanny: Yeah.

Cecile: So please come on in. Hello, hello.

Fanny: Hi.

Cecile: Hi. We're going to add to the chat our [inaudible] Dr. Varisa Perlman. She's going to join us in a second so that we can talk about all this beautiful milestone of potty training.

Fanny: Yeah. Can be beautiful or challenging, depend on what side. [laughs]

Cecile: I wouldn't necessarily call it beautiful. But it can be rewarding. It can be convenient for parents because once you go through that step, it's—

Fanny: Yeah, once you're done, [laughs] it's a better phase for the parent.

Cecile: It's an important milestone because that's one of the first steps to regain or to gain some of that independence for your kid, which means as a parent, it gives you a little more comfort.

Fanny: Yeah.

Cecile: Hi. Good morning.

Fanny: Good morning, everyone.

Cecile: Have a good day too. [laughs]

Fanny: Thank you.

Cecile: Thank you for your comments. So while we're waiting for Dr. Perlman, if any of you have current challenges with potty training, if you are about to face the period of potty training, write down in the comments why you're here besides knowing us because I know some of you know us. Hi, Dr. Perlman.

Dr. Varisa Perlman: Hi, how are you?

Cecile: You're sideways.

Dr. Varisa Perlman: Here we go.

Cecile: There we go.

Fanny: Perfect.

Dr. Varisa Perlman: Sorry about that.

Cecile: Good morning.

Dr. Varisa Perlman: Good morning.

Cecile: We were just asking everyone to write down in the comments what is their—

Fanny: Challenge or question.

Cecile: Yeah, or current journey with potty training. If you're about to embark on this topic, if you are deep into it right now, if you are done with this and you're here to just share your knowledge, please write down in the comments so we can tackle that. We're curious to see why you are here and we are really appreciative of everybody being here. Hi, everyone. Yeah, we're trying to wave at everyone. [laughs]

Fanny: [laughs] We're still learning about the live.

Dr. Varisa Perlman: [laughs] Good.

Fanny: We're getting better and better.

Dr. Varisa Perlman: I think each time we get better and better.

Cecile: Yeah, yeah. Practice makes it perfect.

Dr. Varisa Perlman: Yeah, I think we get better and better at it. Yeah, I kind of caught a little bit of what you're saying while I was trying to get on. The idea is that, again, we had talked about picky eating last time.

Fanny: Yes.

Dr. Varisa Perlman: And we talked a little bit about different—I feel like there are moments or arenas where you're negotiating your relationship with your kid. I don't want to make it more than it should be, but in many ways, I feel like the whole process in the—You're completely joined to them, obviously, because they come out of your womb, right? [laughs] You're as joined as you could be. And I feel like the first 20 years of your life with them is negotiating how you and your relationship with them is gonna be. There are moments that you'll dance very closely and there are moments where you do need to be a little apart, that you need your independence, they need their independence.

So in many ways, that dance comes through in different situations. And I think one of them, the first one, I think, is food. I think that's a place where you give them their space to express themselves and to also fumble and to learn and to grow. It should be, again, a joyful experience. These should be joyful experiences. Potty training, people don't usually describe it as a joyful experience, right? [laughs] It's not something that we really attach joy to.

Cecile: It's like whatever comes in has to come out, right? It's the cycle of life.

Dr. Varisa Perlman: [laughs] But that being said, I think that in many ways, it gives you a really interesting view in that moment to understand a little bit about the temperament of your kid. And I think that all of those glances and those glimpses, they really inform you at different points as you go along in this journey or path with this person that you're growing, literally, and allows you to understand what are their needs.

And so much of potty training, when we look back at maybe a generation before us, there was a book and everyone was like, "They should all be potty trained by this age exactly." And it was a lot of pressure. There was a lot of pressure. It varied from culture to culture, but I felt like that as we came to another generation, we started realizing that we have a lot of kids that really did struggle with their stools, their bowels and the control of it. And it wasn't one size fits all by any means. And in that process, I think that we started broadening the time so that—

Some kids, really, potty training came to them very early. It is a strike of independence, you know what I mean? To be able to not be changed and to go on your own when you feel like you have to go. That's a huge statement for a kid to make. [laughs]

Cecile: Yeah, it is.

Fanny: It is.

Dr. Varisa Perlman: A huge decision. It's a big deal. And I think that we have a responsibility as a parent to not only listen to our kids and see what their needs are but to also create this very judgment-free zone. Because if we attach it, similarly to food, like, "Oh, if you're really good, I'll give you this food." You know what I mean? It's food and nutrition. It should not be that bargaining tool.

And I'm not saying that there is a bargaining with potty training, that's not what I'm saying. But it's that thing of like, "Why can't you do this? What's wrong with you?" And I think that that's where we start to walk into a space where the tug and pull, it becomes much deeper and more complicated than it needs to be.

Cecile: Yeah.

Fanny: Yeah.

Cecile: So let's tackle some of the questions or comments or questions we got also through emails and our social feed. So one of the questions is, "How do we know when?" So let's talk first about people who are about to embark on this journey, they're currently changing diapers, they know it's coming. What are the trigger? What's the right timeframe? As you said, it's not by the book with a number. But how do parents know when the time is there?

Dr. Varisa Perlman: Yeah. So I try to make things simple because as parents, we have very little head space for complicated explanations. So something snappy always seems to stick in your head a lot better. I say three different things. One is fluffy, happy poop. I'll go back to describe that. Fluffy, happy poop, okay? Lots of speech, okay? And lots of interest.

And I start with the fluffy, happy poop because one of the things that we see, especially as pediatricians, is that when it's a situation where there's a little bit of a tug and pull and there's a little bit of constipation, there's a little bit of a hard stool, kids are not trying to make this complicated, but what they'll do is that they'll just withhold. If it hurts when it comes out, they're like, "Well," just as you're trying to encourage them to go when they should, "but I can also stop it when I want to." It's a double-edged sword. So a lot of times if you have constipation, I always pause us for maybe about a month to really correct that constipation so poops are fluffy and happy so that when they come out, they don't hurt because—

Cecile: So that tied back, I would say, then to the conversation we had last time about food then on Episode 2 when we talked about eating, where to manage some of that flow of feces is also through the food then. Again, it's tied together, right?

Dr. Varisa Perlman: Absolutely. This is all linked together. We're doing different talks, but they all link together because, again, if they're not eating well, they're eating a lot of processed foods, they're eating a lot of grains, they're drinking a lot of milk, things that tend to be—they're not drinking a lot of water, especially as toddlers, you have a situation where it's not just the frequency, it's the consistency of the poop. So I say fluffy. I know it sounds weird, but fluffy is better.

Cecile: Fluffy is cute.

Dr. Varisa Perlman: Fluffy is fantastic. When it's just fluffy—

Cecile: Sounds like a pillow. [laughs]

Dr. Varisa Perlman: Yeah. And then fluffy and happy where it just pops out. That's how you know that you have good healthy stools. If you're having a situation where they're straining, there's small stools, the small stools are a product of the fact that the movement, the transit through the colon is slowed down. So instead of going through and then the water being absorbed, it's staying in the colon. And the longer it stays there, the more water comes out of it. And then water comes out of it, it gets harder and smaller.

So harder stools will actually make them—they just can't move them, it just can't go through. And so in that scenario, it's a very—you're just potentially walking into trouble.

Cecile: So what's an okay frequency for poop? 'Cause I know when we go to pediatrician visit, the pediatrician asks, "How many stool a day? How many pees?" And I'm always like, "Three," like I don't know. But what's a reasonable number for people to know, "Okay, that's a regular flow and that's—"

Dr. Varisa Perlman: I would love for them to poop every day, but not everyone does that. So I would say maybe every two to three days at the most. I'd like for them to do at least once a day. Some kids do it twice a day. That is a very personal thing on them. That being said, it's not just the frequency. We should be actually asking about the consistency.

So look at the kid, if they're really straining, they're literally having to hide, and they're really, really straining in their diaper, let's correct that. Let's get that a little bit softer where it just shows up, and you're like, "Oh, did he—", "Oh, yeah, I guess they pooped." That's the best scenario. And it's a little bit messier, but in many ways, that is a much easier stool to pass.

Cecile: Okay. So you mentioned then also speech and lots of—

Dr. Varisa Perlman: So lots of speech. And it doesn't have to be a ton of speech, but there has to be some speech. I think there was a hot stack where a lot of people were training at 9 months, 10 months. And I think that that is a little premature because I think the speech and the communications piece is just evolving there. So I think that that's a really hard one. But speech only because they do need to be able to articulate a little bit about what they need to do. They're about to go, and your interaction has to be there. It's not a non-starter, but in many ways, the more speech you have, the better in terms of having a good productive communication.

And then lots of interest, put the potty out there, read the books. If you have friends who have kids who are potty trained, send them in the room with them. I know my son will be completely—But we would send them in the room with older cousins and be like, "Hey, look what he's doing." "Look at what your sibling is doing."

Cecile: Peer pressure.

Dr. Varisa Perlman: Yeah, peer pressure.

Cecile: Inspiration competition.

Dr. Varisa Perlman: Sometimes that's why school is good because in the school setting—Somebody was asking about school, and in the school setting, when they're starting to see other kids going, there is a little bit of a piqued interest, like, "Oh, but why do they get to go there and I have to lay down here and get changed?" So peer pressure can sometimes be good. So that's not always a bad thing.

Cecile: Okay.

Fanny: Just to—Because we got a question on the chat regarding the school and preschool. So there is a mom who is telling us, and I think is asking, that her 3-year-old son refused to use the potty. And that's a different experience from her daughter who was potty trained overnight at 2 years old. And her problem is that she cannot enroll him in preschool because preschool require most of the time your kid should be potty trained. So what would be your advice? Because you were speaking about speech. And so that's the question that we got.

Dr. Varisa Perlman: Yeah, I saw that question, so I wanted to address that. So first of all, that's a good lesson. You didn't clone them, right? Unfortunately, one will do one thing and literally sometimes the second will do the opposite. So every kid is from scratch. You have to [inaudible]

Fanny: Yes, every kid is different.

Cecile: Unfortunately.

Dr. Varisa Perlman: There's no cheating. They're all going to be different. So that's the first little lesson of that one. And the second one is that yes, there are schools that will not allow you to go in if you are not potty trained.

Now, 3 years old is an interesting age because there is a good amount of speech development, a decent amount. It's interesting because sometimes you can see through the eyes of the kids. Sometimes some kids are like—Again, my husband will be completely flabbergasted by this. He had a much older brother. And his much older brother realized when he was like, my husband would be like, "I have to be changed." He was very vocal. And the older brother was like, "If you can tell me, 'I need to be changed,' you can go." And he said, "No, I watching you take my diapers out to the trash." [laughs] [inaudible]-

Cecile: Oh, that's intense.

Dr. Varisa Perlman: -a lot of times. Sometimes there is an actual thinking, they're actually at that age, they have their like, "Wow, I want to be the baby still. I want to stay on the diapers." And I know I'm like—But kids have these ideas. I know that sounds like—At one moment, you might say, "Hey, sweetie." And I'm not trying to say that judge them, but say, "Hey, why don't you want to go potty? If you go potty, you get to go to school." And some of them may say, "I don't want to go to school."

Fanny: Yeah, maybe that's the point. Maybe you should go—

Dr. Varisa Perlman: There's always a little something. Now, you always have in your back pocket, we call it the diaperless weekend where it's cold turkey, where it's literally like, "I'm going to take their diaper off." I mean, we've all heard people do this, right? No diapers for the whole weekend. Now, they might have little—

Fanny: The French people do that often. It's very common in France to do, okay, this weekend, no [inaudible] house and we leave the diaper out.

Dr. Varisa Perlman: Yeah. So it becomes a situation where they can actually—you can get into their head. I always believed—First of all, every kid's different. So don't use the same strategy that you used for the last one. That's a really big rule because a lot of times we try to go from our past book. It doesn't work. Look at the kid and do their perspective. What would incentivize them?

You may say, "I'm going to take your diaper off and if you go potty into that potty—" So sometimes the reward system works not on the negative, not that "I'm going to punish you if you don't go," but "Every time you sit on that potty, I'm going to give you a star." After 10 stars, buy something that you can taunt them. Be like, "Hey, that thing is yours after 10 stars." That's something that you can do with a 3-year-old. That is possible to do with a 3-year-old.

And, again, I'm really not encouraging you to punish them if they don't go to it. But you want to do a positive reinforcement, where like, "You sit on that potty, and you may or may not go. You may or may not go. But to sit on that potty, and you should try, then you get a star." And you can try it one time a day.

Cecile: One tip that I read, and I didn't apply it for myself because it was after my potty-training years, but I thought was different from anything I had read was sitting the kids with the diaper on the toilet or the potty. Because then it came to my mind that they used to stand or lay down when they're pooping and maybe that position of being sitting might not be the most natural. So would you say that that's also a good transition step to be you're sitting, you're in your diaper, so there is nothing about anything coming out, but at least you're experiencing pooping in that sitting position?

Dr. Varisa Perlman: I think what we're all saying is that it's not going to happen overnight.

Fanny: No.

Dr. Varisa Perlman: If you have to kind of like a little trial and error. And if you do have a situation where it's like, "Okay, by the fall of next year, I need to have a potty-trained kid," then give yourself goals. Okay. So this month, this is what we're going to do. Next month, this is what we're going to do. Because sometimes you have to be a little bit more deliberate with yourself even because it is a bit of a sacrifice, the whole are we going to carry?

I had some families that were like, I'm about to potty train, but literally we're going on a 24-hour flight. You have to know your schedule. Maybe the holidays is not a good time because there's 35 people in the house.

Cecile: You set yourself for success and you try to put you in a situation where you have the most chances of succeeding.

Fanny: Otherwise, you're going to put more pressure on your kids because—

Cecile: And on you.

Dr. Varisa Perlman: Yes.

Fanny: [inaudible] on your kid.

Dr. Varisa Perlman: Pressure on you ends up being pressure on the kid, right?

Fanny: Exactly.

Dr. Varisa Perlman: You're just so anxious for them to do it and then they can feel all that energy. And then it becomes more than it needs to be. The last thing you want to do is have them withhold or get weird on it, just to prove a point to you. You don't want this to be an arena. Giving someone independence and confidence is very different than creating a power struggle. And you can do one of two ways and you don't—I found many forks in the road [laughs] where I'm either gonna create this to be an empowerment moment or I'm gonna make this a power struggle.

Cecile: And sometimes that line is very blurry-

Dr. Varisa Perlman: Very blurry. [laughs]

Cecile: -because you didn't have control, as you said earlier, when they are inside us, we have full control. And then it's giving more control, more control. But we also have full power over them when they are little. So giving away some of that strength to control them is hard.

Fanny: It's hard and scary.

Dr. Varisa Perlman: So hard. It's hard. It's scary. But I have to tell you, from the long game, it works. To create a confident, healthy adult, a healthy 18-year-old that feels confidence about what they can do, it's small tweaks, small steps along the way that you have literally placed some of your confidence coins into their bank. So that as you go, you're like, "You were able to do this, you were able to do this," but I think that the power struggle—

I'm not saying that you should never punish kids, but I think that boundaries is something that we talked about with the picky eating. There are obviously boundaries. We don't want a 10-year-old who can't poop. We're not talking about that. Everyone does eventually get potty trained, so have that in mind. But you also want to make it a situation where they feel like they are gaining something from it. And that can only be figured out if you are sitting in their gaze, in their body, in their space.

Cecile: That's interesting because I think that's one of those instances where as parents, we feel we are driving. And the [inaudible] example is really good where society is telling us it's now so we have to pressure, and it has an impact on the whole family. So now the kid is taking on the pressure when it's not his goal or her goal.

Dr. Varisa Perlman: It just isn't part of—It's their body. They're learning how to control their body at the right time.

Cecile: And they don't want to feel guilty about it if they can't because sometimes it's just difficult to be mindful of it if they're playing and then all of a sudden, it's like, "Oh, the potty," so we're interrupting. So it's hard for them to even know how to do it.

Dr. Varisa Perlman: Well, I think that schedule—This is something else that might help the person that we were talking about. Schedule is really important. So some people go in the morning, some people go when they come home. And I'm talking about number two. Number one is also the same idea. You have to know your kid. And if you have a situation where, "My kid really likes to poop in the morning, but we got to go. So I'm rushing them to go and go poop, go poop." If everyone's yelling, "Go poop" at someone, everyone will not poop. I don't care who you are, no one's going to poop.

So in many ways that's on you. That's not on them. You have to wake them up maybe another half an hour earlier so it's a nice calm judgment-free zone because honestly, if they don't poop in that morning, they may actually start to get constipated because now they're at school and they can't go the whole day. It becomes this very strange pattern.

Someone just wrote, "Can you bring your child in with you?" I don't see a problem with that because, again, we're just normalizing the pattern. Like, "When mommy wakes up in the morning, mommy pees because we haven't peed all day. Do you want to pee with me?" The same thing with picky eating. It's the kind of thing like, "Let's eat lunch together." "Let's eat breakfast together." There's a lot of that good modeling.

Cecile: And they see something is different than using words because we also sometimes don't understand how much of the world they understand. The kids are super smart and they understand, but you don't know if the one word that you're putting in front of them is the one that they don't understand. So seeing it, that's what peeing is, that's what pooping is, that's what a potty is, that's what the bathroom is, then they can experience it through somebody else and mimic it, right?

Dr. Varisa Perlman: Yeah, completely. Modeling, again, going back to that modeling, making something normal, something a part of life like, "This is good for your body because it gets rid of all the stuff so that—use all the energy that it needed to, so it needs to get it out." It's a good thing, versus like, "You'll make mommy so happy if you do this." Do you see how there's a subtle difference there? It's like you're trying to teach them that they're trying to do these things so that their body will be healthier. Very similar to food, like, "If you eat this, mommy's gonna be so proud of you." No. If you eat it, it's actually really good nutrients for your body.

Listen, we need to think that. [laughs] We need to think like that too because in many ways, we've emotionalized a lot of stuff when really these are bodily functions. And if they don't go well and you can't hear your body and listen to when your body needs you to listen to it, life gets funky later. So the sooner you can teach them that process so that it's not so emotionally laden, I think that you create a healthier context in the way that they actually learn how to potty train.

We talked a lot about poop, but pee is just as important because, again, a lot of times with peeing, there's a whole issue where, "I'm playing. No." It's a lot easier sometimes to hold pee. "Oh, no, I'm playing, I'm playing, I'm playing." The problem with that—and it's the same mechanism with constipation—is that they're stretching. So there's either stretching of the bladder or the stretching of the rectum.

The problem is that when that mucosa stretches, there's nerves that run along the muscles, and what ends up having is those nerves get pulled. And when those nerves get pulled, they don't know when to work. They don't contract when they should. They don't really message the body that well. So what ends up happening is that they have a very—especially with pee, they have a bladder that's really full, and all of a sudden, it spasms and now you've got an accident.

And it becomes a situation where there might be guilt in there, there might be embarrassment. There's a lot of things that can happen. And so, with poop too, that's too similar of a mechanism. So learning, "Hey, listen, it's been an hour. You gotta go pee." I had a problem during COVID because there were 7-year-olds, never had had a UTI before, and they were on-screen during COVID for hours, whereas normally, they would be in one class, they would get up to go to another class, "Oh, I have to go pee." They were literally sitting in the same seat for six hours. And they would get a UTI because they didn't pee all day.

Adults, we do that all the time. That happens, right? When we talk about what can you do as a parent, look at your kid. If they haven't peed in one or two hours-

Fanny: We have to remind them.

Dr. Varisa Perlman: -some way you got to go, "You got to pee."

Cecile: I'll put a timer so you don't have pressure on you, but every hour, put a cuckoo clock. Every time the clock is—

Dr. Varisa Perlman: [laughs] Maybe that's what the original—

Fanny: It can be part of the fun thing around the body, like, "When you hear that sound, that's your call. You're gonna be in control and go by yourself."

Cecile: Or at least be reminded. Oh, are we questioning around the room. "Do you need to pee? Do I need to pee?" Everybody?" "No, we're good." "Then let's keep going with what we're doing." That's great, right?

Dr. Varisa Perlman: Yeah. The UTI situation is a very real thing. It's a real problem. And we almost expect it, frankly, especially in girls, for whatever reason, it just doesn't—If you have a UTI while you're potty training, it's actually "normal" for girls. Now, a boy at any point to get a UTI is actually abnormal. A boy should not get UTI. So I don't know—'cause there is withholding with boys and they can get some, but most boys, I don't know, for whatever reason, they don't have as much of a problem.

Cecile: So for boys, before I think we're gonna talk about girls, because as you said, there are some things specific to girls, just the physiology of it, but for boys, there is something that we do in France, which might get very controversial, and I know we had trouble with that here in the US, is something that we call the country pee, where you just go outside and you go by a tree and you just pee. And we found that—at least I use that with my boy—it's a great incentive for little boys.

I know somebody in the comments was mentioning that her boy was having a hard time. It becomes fun to be like, "Let's go outside and you can pee outside." And they just, you know, I don't know if it's the air on their private or just being outside or the fact—So to us, it was a way to get my son being like, "Oh, that's a fun thing to do. And I want to do it."

The backlash of that is you don't want them to do that in school. [laughs]

Fanny: Yeah, they have to understand the—

Cecile: Because every single French expat who has a kid, had that call from school being like, "Hey, your boy just—was peeing outside in the playground and now you have to talk to them about not doing that." But to some extent, if you can maybe use some of that to create, as you said, the interest. That has worked for my boy. And you play outside on rocks or whatever.

Fanny: To raise the highs around the big topic.

Dr. Varisa Perlman: It's interesting because, again, it goes back to the same idea. And I'm going to force this idea on you as a parent over and over again. So many times, when you're raising them, just close your eyes for a minute. If I was this kid, what would make sense to me? It's just a really kind exercise because the world looks very different through different eyes. It really does. And what you're describing is that you were like, "I know my kid and he would get a kick out of this. He would love it." And I would say, I'm like, "Do whatever seems to make sense for the kid."

Cecile: And the freedom of being like, "Go outside and just pee wherever," it has that feeling of being primal. Very back to basics of no gear, no nothing, I just put my pants down, I'm just gonna pee. And for boys, it's very easy.

Fanny: And you know, on that topic, when you say, "Put yourself in your kid's shoes," I think for myself, it's always easier to do it for fun things, like, "Oh, she would love that," when you want to buy a toy or do an experience thing. But for things like potty training or big topic and that you have the society pressure on it, I think we just switch and we are not able to do it, we prefer to follow the pressure and you know to put your kids in a "normal" frame. And it's a very good advice to say, "Okay, step back, close your eyes," and like you do when you visualize fun things for your kid, do it for a big topic.

That makes sense because for me, for myself, I realized that for fun things, I'm always like, "Oh, she would love that." I never questioned myself for potty training or what I put on her plate, what she would like.

Dr. Varisa Perlman: I think it's that kind of thing where, again, if you don't do it, who else will?

Fanny: Yeah, exactly.

Dr. Varisa Perlman: As a parent, you know this kid better than anyone. But I think the reason why I love being a pediatrician is because I love thinking like a kid as much as I can because I think it does keep you really young and I think that there should be joy and fun and games in everything that you do. There should be that imagination space. And I think that when we access that information, we really, again, get a beautiful glimpse as to what this kid is about. What is important to them? What makes them laugh?

So my kid—and again, my kids join these talks. Sometimes I don't even know which ones, or my husband, so I just love embarrassing them because I just think it's so fun. [laughs] Because I just can. And so my son—my husband will attest to this. We were at a playground. We're outside of the older sibling's school, and literally, he has to pee. Of course, he has to pee. And we're five blocks from home. So my husband's like, "Fine. Do you see that building? Pee on the building." We're at the park. What are we gonna do? And he was like, "I will not pee on my older sibling's school."

To him, the idea of—like he was going to be doing graffiti. He was like, "No." So they had to walk away. But this same kid, Izzy turned to me one day, and they were in the bath together, and Izzy turns to me and gives me this warm cup. And I was like, "What is this?" And Izzy turns and says, "This is Andre's pee." [laughs] He's potty training. So I turned to him. I'm like, "If you can pee into this cup, you can definitely pee into the toilet."

Again, maybe your kid likes to aim when they're in the bath, take a cup and be like, "Pee into the cup." That's fun. They think that that's a lot of fun. Then give it that way. And that might give them a sense of like, "Oh, is that all that is?" Really, that's all that is—just peeing into a vessel. That's all that is. I think that that's what we should all do for each other is try to see what makes sense to them, because in many ways, it really is—

As I see my kids grow older, they're not that different. [laughs] They're really still that kid. They're thinking and learning. But, again, one of the things you said earlier was the idea of you know showing versus talking and I think we sometimes over-talk about everything. There's always discussions and there's just so much to be held in the quietness in example, just the quietness of leading a life that they understand and that we work through.

We talk in this generation of something called performative parenting, where we're always thinking about how do we impress other parents. And it's not something that we want to think about, but it's, like you said, cultural. There's this whole thing. I want to be able to tell everybody that my kid was potty trained at this age. That shows how wonderful I am. Ridiculous, right?

We've really transitioned from helicopter parenting, where helicopter parenting was a little different. Helicopter parenting was like, "I wanna focus all my energy on my kids. I'm gonna hover with my kids. Everywhere they go, I'm gonna be there." This is like, "I don't care about my kids." [laughs] I want everyone else on Facebook to experience how wonderful my family and my life is.

Cecile: That's also because as parents, there is so much pressure that we want to show off to say, "Hey, I'm doing my best." Because we feel like everybody's also scrutinizing what you're doing and trying to know your business because they don't know any better and making people feel bad about what they do makes also them feel good because they do better. So it's a whole-

Dr. Varisa Perlman: The whole cycle.

Cecile: -overstimulation of like, "I do better, so you do better, so you do better," when the kid is not asking for any of that.

Dr. Varisa Perlman: No.

Cecile: The kid doesn't care of the comparison.

Dr. Varisa Perlman: Instead of spending that time imagining what other people are thinking about you and your family, spend that time imagining what the world looks from your kid's eyes. It's the same energy, right? It's the same energy that you're putting in.

Cecile: Same amount of time, too, because a lot of those discussions, sometimes people come back and say, "I don't have the time for that." But you're right. There is a lot of time spent to impress or trying to see what other people are thinking or trying to see like, "What should I do? What should I do?" when that time could be maybe put better into that funnel of, okay, what does the kid want, need, and—

Fanny: Enjoy.

Dr. Varisa Perlman: What makes sense to this kid? What makes sense? I think that it's, again, another pivotal moment. I feel like there's just—What we haven't done, I think that when we look back on where helicopter parenting—'cause what helicopter parenting does, it strips away the confidence. When you're doing everything for your kids and making sure that nothing bad happens to them, in many ways, there's no learning. So then they jump out in the world, they're 18 years old, and they're confused as to like, "Well, what can I do? What am I able to do? Did my parents do that for me or did I do that?"

Where was that line? They don't they don't feel it. They can't understand. So now they're out there and it sounds terrible, but they're naked. They're out in the middle of a college campus or they're out in the middle of the world and they're like, "Well, what can I do by myself?" You never, you don't want to send your kids out to the world like that. You want them to feel like they have crossed and achieved things on their own, maybe with a little bit of your guidance, with a lot of your support, but in the end of the day, they're the ones who have to climb that wall.

Cecile: And you talked about in the first episode of our series, you talked about the boat.

Dr. Varisa Perlman: I love that.

Cecile: What we're doing as parents is crafting a boat, so that when the sea come and they can just ride that wave without being like they all just have to swim into the ocean. And that image stuck to my head because it is what it is. And just putting that mindset in mind of being, "Okay, I'm just here to craft that boat," meaning I'm not here to sell the boat, I'm not here to make it pretty, I'm just here—it has changed my parenting in the past four weeks that I heard that because I'm like, "Okay, what I'm doing is just making them to where they can do it themselves."

Fanny: Yeah.

Dr. Varisa Perlman: Yeah, I think that you made a good point because people will say, "I don't have the time. I don't have the time." But the difference is, do I check the boat? Do I sand the boat? Do I make sure that all the balance of the boat is good? Or do I just sit there painting the boat all day? We were talking about that metaphor. And to me, we spend too much time painting the boat-

Cecile: And taking pictures and selfies in front of it. [laughs]

Dr. Varisa Perlman: -making it look pretty, tying it in a bow. Right? [laughs] It's funny because people will say, "Oh, I have such wonderful kids. I'm just so lucky." And I practically jump up from my chair when people say that. And I said, it is not luck. It is blood, sweat, and tears. There's no way—luck has this much to do with anything. That's crazy. And I think the sooner that you recognize that and you give yourself a little bit of that credit, that like, "Hey, listen, I am crafting a human being."

I think I felt really guilty because my husband and I, really, we would see people get sucked into child rearing and you couldn't even have a conversation with them and you could tell that their soul was just like [laughs] diluting into this. And we were like, "We will not be like that. We'll still read newspapers." [laughs] We did all these things. And then we have these wonderful kids, but at the same time, we're exhausted. We're just regaining—

It's funny when we went to reunions and we see all these people who are our age and our kids are around the same age. And we haven't seen each other for 20 years. I mean, it's been a long time, right?

Cecile: Yeah, since you had kids. [laughs]

Fanny: Everybody was painting the boat. [laughs]

Dr. Varisa Perlman: We haven't seen them. We were all busy making the goddamn boat. And literally, we get together and we're like, "How are you doing? Are you okay still?"

Cecile: "Did you make it?" [laughs]

Dr. Varisa Perlman: "Did you make it?" "Oh, it's so good to see you. I'm so glad." We have gone through something. And I was feeling strangely guilty about that, again, because I'm just really good at feeling guilty about a lot of stuff. But I was feeling guilty about that. And I realized, what is that? We're exhausted because we actually grew human beings. We actually took a package and we are contributing to the world this package. That's some hard work.

Fanny: That's a lot. [laughs]

Cecile: [laughs] It is.

Dr. Varisa Perlman: [laughs] That's some hard work. So don't waste your energy trying to make everything look cute, dressing it up for Facebook. No, don't do that. It is hard work, and that's the kind of work, the listening, the being present, just seeing the world from their point of view as much as you can. That's the foundation. That's the soil.

Cecile: Back to potty training.

Dr. Varisa Perlman: Yes.

Cecile: So we learned something about little girls. Yes. So there is this whole—for people who now they embark on this journey, they find out how to get it, there are—specifically with girls—sometimes issue with how to wipe properly, how to make all of that properly because learning takes time. And it is sometimes a little difficult, even for boys when they do number two and-

Fanny: Yes, wiping.

Cecile: -how to clean yourself. So what is your take on that to make that transition as easy and smooth as possible?

Dr. Varisa Perlman: Yeah. So one thing that—First of all, let's do boys—they're easy, right? First of all, they should wipe. I don't know where is this where boys don't wipe, men don't wipe. I don't know, I can't even really speak to that. I don't even know how that happens. So let's just—yes, you should wipe. Walking around, especially in Miami, if you're in a hot place, there's a lot of sweat there. And so , yes, please try to wipe anyways.

But one of the things that we talked about, because one of the things we talked with your product is that you don't always have—it works as a wipe and a barrier. And I find that rashes and also infections and everything like that can really be a problem at this age because they're doing their own thing, and it can be a mess. So the one thing that's nice about your product for this stage of their life is that you get a two-for-one without them even realizing it.

And one of the things that we had talked about is that you can use tissue paper. You don't have to use wipes that can be flushed. You can just use tissue paper and you can have the product right next to the bathroom and they can use that to do their wiping. And then you feel their skin is also getting taken care of as well, that they're not just—

So the boys, yes. For the girls, one of the things that I think is really important is that you have to change their underwear frequently because, again, there's a little dribble here, a little dribble there, there's a little sweat there, lots of rashing happens. So I love using something like your product to do as a preventative and not just as a treatment because the more that you keep in a barrier, even more important than when they were babies because they're doing their own thing, it becomes a situation where they have a hard time getting to where they need to get to.

I remember my oldest, when they were wiping, they were getting rashes, and I'm like, "Where are you wiping?" And they literally patted their hip. And I'm like, "This is the pediatrician's kid? And you think you pee out of your hip?" I felt like such a failure on so many levels. And I literally had to be like, "No, this is where you pee from. You don't pee from your hip." [laughs]

And if you watch the girls, they have a hard time. Everyone says from the back, like, go from the back.

Fanny: Yeah, it's very hard to do.

Dr. Varisa Perlman: They can't even reach. [laughs] Yeah, they can't even get there. So literally, you're going to have that whole area just still exposed. So in many ways, you can use a little bit of the product on a tissue paper and they can use that but you have them push from the front to the back, obviously. And poop, they can do on their own. I mean, you'll have to help them, but they can do from the back. But from the front, pee is—I often say pat and drop. Just pat and drop is not bad.

I am a fan, you got a water bottle, we've all got those spray water bottles everywhere. You got a little portable bidet there. I know that sounds crazy.

Cecile: Oh, no. We're French. We're all about bidets. [laughs]

Dr. Varisa Perlman: [laughs] I don't know.

Cecile: Come on. [laughs]

Dr. Varisa Perlman: It's funny because my parents are from Thailand, and my parents always had a bidet in their bathrooms. And I thought that was normal until I grew up and I realized Americans think that that's crazy. What is that thing? And they just can't even—it's very foreign. But in France, bidets are very common. I think pretty much everywhere else besides the United States, [laughs] bidets are actually pretty common.

But to me, a portable bidet means that you have a squeezy bottle and you just spray it a little bit and then they can use it to pat and drop with the oil. And I think it works really well. I think that combination of products gives them a good habit. Obviously, they can't always do it at school. So the minute they come back from school, just get them rinsed out, changed out.

I'm not a fan of bubble baths for girls for obvious reasons. For boys and girls, just because it's an irritant. So soap should be there and then get it off because it is an irritant for that area. But the more that you can air that area out, teach them good habits, again, from the front, pat and drop for pee, from the back, poop for girls, I think is the way to go because the rashing gets tough. It hurts when they pee. They start to withhold their pee. They get a UTI. Boom, boom, boom. [laughs] It's just one right after the other.

Fanny: A circle of nightmare.

Cecile: And for girls, I know that even when they're potty-trained and they're happy because at some point, you're not with them in the bathroom, you let them do their thing. I know for me, my girl always complained when she was getting to bed at night, is when she was cooling down, sitting down. She's like, "Oh, mommy, it hurts." Again, I was using our own product to be like, that's a little bit of a barrier, which is nice and stuff and breathable. And then she would go back to sleep right away because she just needed that soothing there.

So it's not only what's happening in the bathroom or when they are peeing and pooping, it's also everything that develops after that. So it's a whole cycle of what's going on, right?

Dr. Varisa Perlman: And some people, because it gets irritated, some girls, they'll just have them sleep without underwear on just to air it out. The ventilation down there is really essential. And so many girls—I don't know why in Miami, it's so freaking hot, so many of the young girls love wearing tights, you know, [laughs] the tight kind of things. It's the style now. But that doesn't air out. You need to air out that area.

Cecile: I guess it also doesn't help—and it's a cultural thing, but we were surprised when we got to the US that girls here always have a pair of shorts under their skirts, for example, while in France, every little girl-

Fanny: Just have their underwear.

Cecile: -before 6, 7, 8, they have their underwear. And when they sit down, you'll see their underwear and everyone is just fine with that because that's where underwear is supposed to be. That's why you have underwear. But always having something tightening everything up down there is also not healthy.

Dr. Varisa Perlman: Tricky, right? It's tricky.

Fanny: And also, for my girl, I realized that the underwear, mostly in cotton, good quality of underwear is also helping a lot because all of the synthetic fabric, it's not helping.

Dr. Varisa Perlman: And it doesn't air out. Again—

Fanny: Yeah, the cotton ones are better for my experience.

Dr. Varisa Perlman: Yeah. And the thing that's a little bit annoying too is that they grow, [laughs] so make sure that when they're having trouble putting on their underwear because it's too tight, okay, it's time to go back to Target and just get some other underwear.

Fanny: And get new one, yes.

Dr. Varisa Perlman: But I think the barrier piece of it, maybe mixed with a little bit of the day piece, I think is a really good way to keep that area from getting irritated during the potty training. The potty training is complicated because it just requires—This is, again, just an incredible—With the food, same idea. They have to actually chew the food and swallow it. So you start to feel like, "Okay, I've got to give them some of that independence," right?

I think that the evolution of your life with this child is in these incremental steps so that it prepares you for when you have to give big decisions, like, "Okay, I guess you are going to go to France for the summer by yourself." That eventually has to be a decision that's made. So this is a good exercise as you as a parent to be, "Okay, well, these are the things that you're going to do to make sure—This is the responsibility that I'm putting on for you for your life. And there might be consequences. Maybe you don't do it and then you get a rash." And then you're like, "Oh, so this happens. This is how we try to prevent it."

Again, just trying to always focus on the positive versus like, "I'm going to punish you because this happened."

Cecile: I think a lot of the punishing sometimes happens, and I know I'm guilty of that, is trying to put the fear of the punishment so that we don't have to deal with the falling in the first place and trying to prevent because we know from experience that if we go this route, we're going to deal with a rash or we're going to deal with a itchy private part. If you go my route, it's going to be an efficient one. And sometimes my desire for efficiency makes them not experience why I got to this conclusion.

Dr. Varisa Perlman: So, again, just to circle back to what we said from the very beginning, is that sometimes actions and consequences speak more than words.

Fanny: Exactly.

Dr. Varisa Perlman: Because not that I want your kids to get a UTI. [laughs] But it's that kind of thing where you can draw that line without being like you're judging them, but you can be like, "Listen, one of the reasons why I do this is so that you don't get a rash, but you have a rash now. It hurts, right? It's not fun, right? It's not a good rash. So let's see, maybe next time we can try to prevent it by doing this." And then they start to draw that line, right?

I think the hard thing that came out of helicopter parenting is that consequences do not exist. And in the end of the day, consequences are the way that we learn, mistakes, pain. It is what it is. It's just the human way. You can tell all you want. I can read book after book after book, but the consequences in the end speak volumes. That actually is what you remember. Like, oh, yeah, that sucks. [laughs] I don't want that happening.

Fanny: It's better for them to experience pain and failure when they are small that you can guide them and support them and when you will be on this boat, they will be able to face and understand that failure is okay and if you get some emotion, it's better for them to have it when they are small.

Dr. Varisa Perlman: Yes.

Cecile: And they are in your house and they are within control of stuff that you can repair. It's not the bigger problem of older kids that may deal with experiencing stuff and boundaries later in life when the risk is even bigger.

Dr. Varisa Perlman: Yeah. And I would say it just to, again, be catchy, that I would rather it be me than your boss. Because the boundary will be there. You will feel a consequence. Something will happen. But in the end of the day, I would rather be giving it to you in small doses and letting you understand that. Actually, to me—and again, it's just something that I'm still crafting even with kids who are in college. It's hard for me. It's hard for any parent to watch your kids not get what you think they should get or achieve. And in many ways, it's their life, it's their way that they have to learn. And that has to tell you, I'm still learning. I'm still working on that. It's still so hard. Because, again, I think that—

It's funny because my husband's father was a teacher. And he would tell my husband, "You didn't do well on this test. Do better. You should do better. Because if you don't, then you may not get into a college and it's going to be tough for you." You see, nothing in that comment was like, "You'll make me sad."

Cecile: Yeah, it's not about that.

Dr. Varisa Perlman: "I'm going to be disappointed in you." It wasn't. It was just like, this is just the truth of it. You don't wipe after you pee, [laughs] you're going to have a rash.

Fanny: You're going to get a rash, yeah.

Dr. Varisa Perlman: To me, that final step is saying like, "You decide how you want this to go." I think it's something that we have to practice. [laughs]

Cecile: Yeah, because when you give them option A, option B, and have them decide, I feel like kids, they don't want—they never—I hear that with my kids many times. They never say, "I'm not deciding." They want to decide. They decide whatever. And sometimes they decide the thing where it's like, really, that's what you pick? You made something very difficult, something super easy. I'm going to go the hard route. Yeah. Whatever.

Dr. Varisa Perlman: Yeah, exactly.

Cecile: That's fine because they want to prove a point. I think that I'm going to run with that. Like, okay, whatever.

Dr. Varisa Perlman: Yeah. But you're absolutely right—they want a piece of it. They do want a piece of it. And I think that that's something that we just started—We started ignoring that. And they have this whole thing with toddlers. The more that you can give them to decide and hold on to, they become prouder. There's a certain something to it. And I think that we underestimated how important that one step was.

Because we do have a lot of kids right now who are older, who are filled with anxiety and fear because they're like, "I don't know what I can do. Can I do this by myself? I'm not sure. I've never done this by myself." I think that that's not fair. That's not fair. Yeah, maybe we made it, like you said, "more convenient," "a little easier for us" when they were younger by saying, "I guarantee. Don't do it this way because this is what's going to happen." That was easier for us instead of wanting them to actually go through it. That's a lot easier for us.

But in many ways, it cuts their legs and then you send them out. It's as if you took their ship and you just punched a big hole in it and you're like, "Let's see when that ship starts—" [laughs] Enjoy that.

Fanny: Yeah, it's not fair.

Dr. Varisa Perlman: It's not fair.

Cecile: And all those little choices, I think potty training—besides the end goal of having them being potty trained—is a great opportunity to bring those choices, like, "Which underwear do you want, the pink or the blue?" Or like, I don't know, "Do you want to sit on the toilet, or do you want to sit on the potty?" Do you want the potty in this room or in that room?" And all of these are decisions so that if there is a point where one thing you have to decide for them, they're probably gonna be willing to listen to that because they decided some things before they get to the point of like, now you have to pick. [laughs]

Dr. Varisa Perlman: That's it. I will tell you that the more headstrong your kid is, the more that you better back off because I have seen headstrong kids and literally, they'll drag [laughs] the whole thing. And I just keep telling the parent, I'm like, "You got to back off because they'll do it when they're ready." And sure enough, those are the kids that potty train the fastest. Literally from Friday to Sunday, they just decided that weekend that they were going to train.

Fanny: Yeah, [inaudible].

Dr. Varisa Perlman: Versus you dragging them for months.

Cecile: And probably the more you push, the more they're like, "You're not going to make me do it." [laughs]

Fanny: That's their way to control something.

Dr. Varisa Perlman: Yeah. It reminds me of that kid that refuses to eat if you feed them, but if you let them touch the food and feed themselves, they eat forever. But there are just some kids who are like, "This is just the way that I'm programmed."

Fanny: Yeah, the way they function.

Dr. Varisa Perlman: Yeah. "This is the way I'm threaded. This is the way that I'm wired." And I have to tell you, that kid doesn't change. [laughs] Have fun in 6th grade. Enjoy [laughs] because this is not a one-off, this is the same freaking kid. And I think that that's the reality, that you do get a glimpse, and you're like, "Okay."

And I think it's good because when my kids were teenagers, especially in high school, I felt so overwhelmed. And the whole time, I kept looking in the mirror. You know how you have to manifest something? I was like, "I have been training for this. I am ready for this. I can do it." Because it's true, I have been trained at various junctions in their life. I have been doing this dance. I've been training to be the best parent that I could be for them at that time.

So you are just getting information, you're giving information, you're setting out that foundation so that when you hit that ground and now you can see the ocean, you're about ready to push this ship out to the ocean, you're like, "Okay, yeah, yeah, I got you, I'm ready. We've got a good ship here."

Cecile: And with that being said, you also have to—as you said, it's a training for parents as well. We are all learning along the way. So we also need to accept and give grace to ourselves if we do make mistakes. If somebody is listening right now and had a less-than-ideal experience with potty training with their first kid, it's okay. It's a piece of who you are, and you probably have learned from that. You have learned from that. You've learned to be a better parent for the next time something comes up.

So let that guilt out of the way so that you can move on and be like, "Okay, that was part of my own learning," because nobody's trained to be a parent. So it's okay to make mistakes, to fail with your kid, without your kid, and then just move on and continue building that boat.

Dr. Varisa Perlman: Yeah, absolutely. Absolutely. This is the first time we're parents. This is the first time they're a kid. So as long as you recognize, like you said—Again, just to go back to the performative parenting. The mistakes are learning experiences. They're not things to be embarrassed about. They're not things that you hide, that you wanna make sure that nobody knows. No, the mistakes are actually learning experiences.

And the same way that if you had a really bad potty-training experience for yourself, your parents were really hard on you and you struggled with your bowels for a long time, that is great information for how you wanna address your kids. So listen, we only learn from mistakes, honestly. We don't always learn from success. We learn really from mistakes. So mistakes are just basically an opportunity.

Again, the times that I've been proudest of myself as a parent started with some mistake I made. That's where I learned like, "Oh, yeah, I gotta work on that." And then when you do do it, you're like, "Okay. I've been listening. I'm good. I've been present," and that's all you can ask for, for yourself.

Cecile: That's a good closing note.

Fanny: Yeah. If we have to give some tips just to make a recap of everything we said. So the best tips for potty training would be to take time. Don't feel the pressure of the society. [laughs] Listen to your kids because they know when they will be ready. Try to organize, to choose a right period in your life, not holidays if you're gonna travel. So try to think ahead a little bit of how you're gonna organize that thing. Try to not punish and prepare rewards for them. That would be a good thing. And try to give them choice.

Cecile: Choice and options, yeah.

Fanny: With choice, they're gonna think that they have control.

Dr. Varisa Perlman: And from their point of view.

Fanny: So that's what I remember and we'll try to apply. And also, you said—and I think it's very important for people who have several kids—do not compare kids because yeah, every kids are different. And something that worked for your first one may not work for your second one.

Dr. Varisa Perlman: Yeah. And that's not a failure. You didn't fail or something. This is the way this game works is that you don't—no repeats. Everything is no repeats. [laughs]

Cecile: Our final question for you, which is the one we always want to get back to is, when is it worrisome? When does it come from like, "Oh, we're talking," to, "Okay, now we need to do something and consult a pediatrician or any professional." What are the alarming signs?

Dr. Varisa Perlman: I think that where we start to have a little bit of a problem, both because they can't go to school so well, is really the 4 or 5-year-olds. But even starting with 3, if you're finding that they have consistent—they almost can't control it, they actually have some bowel issues, don't always chalk that up to potty training. That might actually be that they don't evacuate fully, they're not really able to control their bowel.

I think at 3 to 4 is when you start to be like, "Okay, is there something more?" The playfulness doesn't work, a lot of things. But I think that by 4, if, really, you're not getting any headway, then you should really have a discussion with your doctor, whether they see a GI or see urology, because at that age, they should be really getting the memo.

And I'll be honest with you, there are some kids who will pee, but then they need the diaper to potty, to poop. And I find that sometimes, especially when I have situations where constipation has been an issue, or withholding has been an issue, I will accommodate that. I will say accommodate that for a couple more months until we get—because the last thing you want them to do is start withholding again.

Fanny: Yeah, correct.

Dr. Varisa Perlman: So they'll play that game. It's not unusual for them to do one, and then maybe not the other. You have to be flexible. And just to add what you were going through, Fanny, I think the thing—Again, this is just a great opportunity to see the world from their perspective and be playful. Some of it is actually fun. So have that positive outlook with it and it can be a great learning and fun experience, strangely. [laughs]

Cecile: So we opened with that, we can close with that. So potty training can be beautiful. See? That was my first comment. [laughs]

Fanny: Yay. [laughs]

Cecile: She was right from the get-go.

Fanny: I still have one kid to potty train, so sorry.

Dr. Varisa Perlman: But you feel like a hero, right? [laughs]

Cecile: Thank you, everybody, for joining. Share with us your successful or your unsuccessful potty-training experience. As you know, Fanny and I are the pee and poop expert. We love everything around pee, poop, diaper, all that good stuff. So we're going to post that live onto our social media. Feel free to share with your friend or whoever you think could benefit from it. And I also put the link to our product, which you referred to, which is our wiping lotion for toddlers, which is a fantastic assistant to potty training. So we'll put that in there as well.

Thank you very much, Dr. Perlman.

Dr. Varisa Perlman: We need to make La Petite Creme portable bidets.

Cecile: Oh, yeah. [laughs]

Dr. Varisa Perlman: [laughs] Yeah.

Cecile: With our face on it. How about that? [laughs] That sounds perfect. Thank you very much.

Fanny: Thank you very much, everyone.

Dr. Varisa Perlman: Thank you.

Cecile: Have a good day.

Fanny: Bye.

Dr. Varisa Perlman: Bye.

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Watch other episodes here: https://www.youtube.com/playlist?list=PL1dpfz3OiZoOwHuST-GmH9sTD0TfF3rIp