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Potty Training 101

When to Start Potty Training
When to Start Potty Training
Is it Time to Try?

If you're not sure when to introduce the potty, consider more than your child's age. Watch for these six important signs, says Elissa Levine, MD, a pediatrician in Charlotte, North Carolina. (It may still help to know that girls are typically ready to start training at around 2 1/2 and boys at about 3.)

  • Your child shows an interest in the potty process. For instance, he follows you into the bathroom or wants to flush.
  • She tells you when she's about to poop or pee or you can see from her squatting, grunts, or facial expressions that she's about to go.
  • He wants to be changed after pooping.
  • She's not constipated.
  • You have a reasonable amount of time and energy to devote to this intensive, sometimes frustrating process.
  • There aren't any major events going on in the family, such as a new baby or a recent move.

Pre-Training Training

Before the "official" toilet training begins, warm him up to the idea with these tips from Parents advisor Ari Brown, MD, a pediatrician and coauthor of Toddler 411.

  • Explain the bathroom routine in positive, child-friendly terms. During a diaper change, you can say, "When we eat or drink, our body takes what it needs and then the rest gets turned into pee or poop. It's like our body's garbage."
  • Be a role model. Let your child watch you use the potty. Although it might seem strange, Dad may want to sit down while peeing at the beginning in order to simplify the process for your toddler.
  • Pretend that her doll or stuffed animal is using the potty. Seeing her "friend" go through the motions in a relaxed, playful setting can relieve any stress she may feel about graduating to the potty.
  • Practice sitting on it. Suggest visits to the potty first thing in the morning, before her bath, and before bedtime. Just don't expect success at this point. Getting her on a schedule early may save you from constantly asking her to go when the real training kicks in.

Sanity Savers for You

Do the following:

  • Roll up your favorite area rugs.
  • Expect accidents.
  • Set up frequent playdates for older siblings during the first few weeks.
  • View this as a bonding opportunity -- not something to race through.
  • Forget training for a few weeks if your patience is shot. When you're in a calmer place, tackle a small job first, such as flushing. This allows both of you to experience the joy of success.

6 Essentials to Have on Hand

  1. A potty chair or a padded insert that reduces the size of the toilet's opening. You can buy a basic one or a model with all the bells and whistles.
  2. A step stool. She'll need it to wash her hands at the sink. If you're using an insert, she'll need it to reach the toilet -- and also to give her feet support when she's pooping.
  3. Training underpants. Choose cotton training pants, which are thicker, slightly more absorbent versions of regular underwear (usually found near the baby socks and undershirts in big discount chains) or the disposable pull-on kind.
  4. Easy-up, easy-down clothes. Dress her in elastic waistbands, drawstrings, and two-piece pj's. Skip zippers, buttons, bodysuits, and hooks for now.
  5. Fun underwear. Pick colors or favorite characters that your child will like.
  6. Flushable wipes. They'll make cleanup much easier for everyone.

Techniques That Work

Your Child Sets the Pace

  • How it works: Wait for your child to show signs of readiness (at anywhere from 18 months to 30 months or older, according to the American Academy of Pediatrics), and then slowly introduce the potty. If he's not interested, back off for a few weeks. Don't pressure your child, and offer lots of praise along the way.
  • Consider if: Your child is a self-starter who likes having choices and can't wait to be a "big kid."
  • Find out more: Read The American Academy of Pediatrics Guide to Toilet Training or Toilet Training: The Brazelton Way, by T. Berry Brazelton, MD, and Joshua Sparrow, MD.

Naked and $75

  • How it works: When your child is between 20 and 30 months, hang around the house for about a week and let him go naked from the waist down. Have a potty chair nearby at all times. According to John Rosemond, PhD, a family psychologist who advocates this approach, the uncomfortable feeling of "gooshy stuff" running down his legs will make him want to use the potty the next time. The $75 is for the carpet-cleaning bill.
  • Consider if: Your child tends to be uneasy with new sensations and is ready to train in warm weather (so he's less likely to have accidents inside).
  • Find out more: Read John Rosemond's New Parent Power!, by John Rosemond, PhD.

Toilet Train in One Day

  • How it works: There are many takes on this, but here's the general idea: Once your child seems ready, just pick a day to give her lots of salty snacks and fluids, so she has to keep going to the bathroom. Frequently sit her on the potty and give her a reward when she has success.
  • Consider if: Your child responds well to direction and structure, and the anticipation of new challenges tends to make her anxious.
  • Find out more: Read Toilet Training in Less Than a Day, by Nathan H. Azrin, PhD, and Richard M. Foxx, PhD, or Potty Train Your Child in Just One Day, by Teri Crane, MD.

Rewarding Experience

Praise is probably the best way to motivate your child, but giving tangible rewards can add an extra incentive. Eventually, she'll go without any treat.

Label all rewards as "special." For instance, say "You did a great job sitting on the potty. Let's play a special game of Candy Land or take a special trip to the store to pick out some new underwear."

Choose developmentally appropriate awards. Stickers won't motivate a 3-year-old forever. Instead, let the stickers add up to pennies, M&M's, or a prize from a grab bag. And a young 2-year-old can't wait until the end of the day for a sticker; he needs it immediately. Print a sticker chart at chartjungle.com.

Don't go overboard. Promising extravagant gifts -- such as a trip to Disney -- for wearing underwear places too much pressure on a child. It makes the task seem so important that she ultimately may say, "I can't do this."

Have a Dry Night

Even if your child is day-trained, it could take up to a year before she's dry at night, says Lisa Spiegel, codirector of Soho Parenting, in New York City. By kindergarten, most kids can wear undies around the clock. The two determining factors are how long your child can hold her pee and how deeply she sleeps. Here's the best strategy for giving it a try.

  • Cut way back on drinks after 6 p.m.
  • Lay a few towels or a mattress protector over your child's fitted sheet before bedtime.
  • Tell your child what's going on by saying, "You know what? We're going to see if your body is ready to wear underwear at night."
  • After a couple of nights, if it doesn't seem to be working say, "No problem. Your body isn't quite ready yet." Try again in another month or two.

Accidents & Setbacks

When accidents happen...

Do

  • Hide your frustration.
  • Use a neutral tone of voice to acknowledge the accident, and leave her with a feeling of encouragement. For example: "Oops, you peed on the floor. Let's clean you up. Next time, I hope, you'll get to the potty in time."
  • Put any poop that's on the floor into the potty, so your child makes the connection.

Don't

  • Make your child feel ashamed.
  • Threaten her with diapers.
  • Continue trying if your child is constantly having accidents.

Dealing with Setbacks

You thought diapers were history, but suddenly your child's having accidents. Unfortunately, regression can happen after weeks of dryness. To deal: Calmly handle accidents the same way you did before, and avoid going back to diapers, says developmental behavioral pediatrician Alison Schonwald, MD, coauthor of The Pocket Idiot's Guide to Potty Training Problems. Remind yourself that this is a learning process and that it's normal for your child to need an occasional "lesson review." However, if your child was fully trained for months and is having frequent accidents, check in with your pediatrician.

Tough Questions

Q. Should boys sit or stand?

A. Asking your son to stand, hold his penis, and aim into the toilet is a tall order. Even trickier: switching from sitting while pooping to standing for peeing. The potty process is a bit confusing for boys at first. Bottom line: Follow your son's lead. Dad can show him how to sit (and push his penis down to avoid spraying the room) and stand.

Q. Someone told me that it's a mistake to start off using a little potty because it creates the extra step of transitioning to the big potty. Is it better to use an insert on the toilet instead?

A. Unless your child is begging to use the big potty (which often happens with younger siblings), it's actually best to start with a potty chair, says Spiegel. For many children, the toilet can be scary: There's loud flushing, whirling water escaping to "the unknown," and your child may feel unsteady sitting up high. With a little potty, her feet are on the floor, making her feel physically grounded and relaxed. Also, being able to get to the potty without your help will let her feel more in control -- and cut down on accidents. Down the road, switching to the big toilet (with or without an insert) shouldn't really be a big deal, since she'll probably already use one outside the house.

Q. My child pees in the potty but refuses to poop there. What should I do?

A. There could be a few things going on, says Dr. Brown. Could she be constipated? If she had a painful pooping experience on the potty, she may think that sitting there is what caused it. Consult with your pediatrician. Does she have unrealistic fears? Some kids view poop as a part of themselves and watching it get flushed can be disturbing. In this case, take a gradual approach. When she needs to poop, keep her in her diaper but have her go into the bathroom. Next, have her sit on the potty in a diaper. Finally, cut a hole in the diaper before she sits on the potty. Is she more comfortable standing to poop, like she did in diapers? Encourage her to sit on the potty, explaining that it makes pooping easier.

Experts' Tips

"Put a pull-on diaper over her underwear for naps or big public outings. If there's an accident, she'll still feel the wetness and you won't have a puddle to clean up."
--Elissa Levine, MD, pediatrician in Charlotte, North Carolina

"I have my preschoolers sing a few rounds of a certain silly song at the sink to keep them washing their hands longer. It follows the tune of "Row, Row, Row Your Boat," and goes, "Wash, wash, wash your hands, wash them every day. Use the water, use the soap, rinse the germs away!"
--Dawn Pothos, preschool teacher in East Northport, New York

"To make sure your child uses the perfect amount of toilet paper, teach her to count out four squares when it's time to wipe."
--Ari Brown, MD, pediatrician in Austin, Texas

"Keep your child's teacher posted about his potty progress at home, and find out how his training works at daycare or school. When everyone's on the same page, your child probably won't get as frustrated and will do a lot better."
--Allison Zolotorofe, daycare teacher in Mahwah, New Jersey

Copyright © 2007. Used with permission from the November 2007 issue of Parents magazine.

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