Introducing the potty and overcoming inevitable struggles.
Few milestones are as daunting or (excuse the pun) loaded for parents as the task of toilet training. One of the reasons it's so challenging is that every child is different, so what worked for your neighbor or those three kids at day care may not work at your house.
That said, it's still useful to know what they all did, because one of those tricks may be what works for your toddler. And there are some general guidelines agreed upon by parents and professionals alike that can help you achieve the goal of dry underpants 24-7. Here are some guidelines:
When to Start
A generation or two ago, most kids were potty trained by age 2. Now, however, the pendulum has swung quite far in the other direction, says Don Barich, MD, a pediatrician and clinical professor of pediatrics at Case Western Reserve University in Cleveland. Most children today master the potty between the ages of 2 and 3, though a sizable bunch are still wearing diapers well after they turn 3.
Although it may be tempting to start your child according to some predetermined schedule (right when he turns 2, for example), experts advise waiting until your child shows signs of readiness. Starting too early or pushing too hard, they caution, will be counterproductive. Not only is it frustrating for everyone, but the entire process could end up being prolonged. Studies cited by the American Academy of Pediatrics found that kids who start potty training at 18 months may not be fully trained (day and night) until after age 4, while children who start after age 2 are often done by age 3.
Signs of readiness can include:
- Showing discomfort when wearing a dirty diaper
- Choosing a particular area to have a bowel movement
- Staying dry for at least two hours straight
- Showing an interest in or asking questions about the bathroom
- Wanting to sit on the toilet
How to Begin
Once your child seems ready, it's time to buy a potty. The biggest advantages to a mini stand-alone potty are that the child can plant his feet on the floor comfortably, making it easier to push during poops, and parents can move the potty to the den, kitchen, or bedroom as needed.
Some kids don't take to the child-size version. The advantages to the grown-up seat are easy cleanup (just flush!) and perhaps an easier transition to toilets outside the home because your child is already used to a big toilet. If you go this route, get a small step stool so she can climb on and off the toilet and place her feet on the stool while pushing. You can also buy an adjustable seat that fits onto the toilet to make it more child-friendly.
Start out gently, having your child sit on the potty fully clothed when you are in the bathroom. Toddlers learn through repetition and encouragement. There's a myriad of children's books that can be read on the potty during attempts or at any time of day to keep the process in your child's mind. Good choices include Taro Gomi's Everyone Poops (Kane/Miller, 1993), Alona Frankel's Once Upon a Potty (HarperCollins, 1999), and What to Expect When You Use the Potty by Heidi Murkoff and Laura Rader (HarperCollins, 2000). Let her watch you go (narrate what you're doing if you're comfortable!), play with a toy while sitting on her potty, and become comfortable with it at her own pace.
Dressing Your Child
Once your child's accepted the idea of the potty, the next step is getting him to use it. First you'll have to decide whether to start with disposable training pants or go straight to underwear. The advantage to training pants is that your child can pull them up and down by himself, but if he has an accident, it's no big deal. However, some parents complain that disposable training pants are so absorbent that kids don't see them as any different from diapers.
Whatever you decide, make sure the rest of your child's clothes are easily removable (sweatpants are a better choice than overalls). After all, toddlers are still learning to recognize the sensation of needing to go and often have to make a mad dash to the potty. Some families actually skip the clothing phase altogether and train naked. For some kids, it's actually easier to recognize the sensation of having to go if they're not wearing clothes. If your suspect your child might be having an easier time recognizing that sensation when she's naked -- but you don't necessarily want to take the fully naked route -- you might be better off trying to potty train in the summer when she's wearing fewer and lighter clothes.
If your child tends to be fairly regular, you can head to the bathroom when you think he has to go or when you notice him tugging at his pants or making a face. Or you can try taking him at regular intervals. Jennifer Shoquist, MD, advises devoting one whole weekend to training. Put your child on the potty every one to two hours to "try" and offer praise for every effort -- regardless of its success. Beware, though, of putting too much pressure on your child.
It's not uncommon for a child who has been successfully using the potty for a few days to say he wants to go back to diapers. To avoid a power struggle or a situation where your child actually starts a pattern of withholding bowel movements, which can lead to constipation, you might agree to a brief break. But try to build in a plan to resume by asking your child, "Would you like to wear underwear right when you get up or wait until after lunch?"
Some families find that praise itself may not be enough motivation and move on to other rewards. Many experts suggest creating a sticker chart, with a new sticker for every success and, after a certain number of stickers, offering a small toy. Less tangible rewards, like finally living up to the promise of "being a big kid" are enough for some kids. Remind your child about the benefits of "being a big kid," such as if he wore underwear, he would never have to stop playing in order to get his diaper changed.
Unfortunately, all the rewards, encouragement, and praise in the world are not going to work for a child who doesn't want to give up diapers. The reasons vary. Some kids are stubborn and become more so as soon as they discover how important it is to you; some are reluctant to let go of babyhood, especially if there's a new sibling in the house; and some just aren't interested. Alas, the adage is true: "You can take a kid to the potty, but you can't make him pee."
If your child is on the younger end of the spectrum (3 or younger), put the potty away and reintroduce it in a month or so. If he's older, let him wear diapers, but keep the changing process quick and businesslike. Some experts suggest that diaper changes take place on the bathroom floor. Your child should also help put the diaper in the pail and even help wipe his own bottom (after you've finished). The idea is to make wearing a diaper less about being babied and more about taking responsibility.
Working Out the Kinks
Even if your child is willing and enthusiastic, don't expect the process to be seamless. It doesn't come easily to all kids. Pull down your pants, pull up your pants, flush, wash your hands... it's a lot for a toddler to remember, points out Diane Stafford, coauthor of Potty Training for Dummies (John Wiley & Sons, 2002).
Be prepared for accidents. Don't give them a lot of attention, and be matter-of-fact as you clean up -- even if you suspect it was on purpose. Dr. Barich, tongue in cheek, tells parents in his practice to employ the "scotch and soda" method: "Soda water gets the stains out of the carpet, and the scotch is for the parents to drink." Yes, toilet training can be stressful. For the parents, that is! If you do it right, it won't be stressful for your child.
But keep this in mind when you're searching for new Powerpuff stickers for the sticker chart or reading Once Upon a Potty for the umpteenth time while waiting for something -- anything -- to happen on the potty: All those big kids and all those grown-ups you see walking down the street every day use toilets. All the time. So will your toddler. As with so many other firsts of parenthood, you'll wonder why you ever got stressed about it at all.
The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.