How to Potty Train
What is Potty Training
Potty training, or toilet training, is one of the biggest milestones in a child’s early development. It is about much more than staying clean and dry, although that is often the parent’s main concern. As s/he achieves potty training, your child learns about his or her physical abilities and body signals. S/he learns about social interactions with other children and adults. S/he learns about handling pressures from inside and outside the self and the family. As your child takes the steps towards toilet training, s/he also takes big and important steps towards growing self-esteem. Toilet training is one of your child’s earliest and most important opportunities to get control over his or her own body and environment.
Control over him or herself in general is one of a toddler’s most important achievements, but it has to happen at his or her own pace. One of a toddler’s biggest jobs is to establish independence. Toddlers generally feel independent before they can really do many things for themselves. They want to feel in control. Most of the conflicts between parents and toddlers happen over control issues. When parents have one set of expectations and toddlers have another, a power struggle can result. This can cause anxiety and anger in both parties, and will quickly work to make the problem worse rather than better. For these reasons it’s important to understand the stages that your child goes through as s/he moves from infancy to childhood. These stages happen at predictable ages in most children. You can learn to build realistic expectations of your child’s behavior if you understand where s/he is at a particular age, and what developmental job s/he is trying to do.
Please remember that there is no such thing as a “normal” age for achieving a milestone as complicated as toiled training. Pediatric experts strongly recommend that parents not “push” their children into toilet training. Children who toilet train early aren’t smarter or more advanced than children who get there later. Children who take longer to train are not “lazy,” “stupid,” “bad,” or “unmotivated.” Reinforcement and praise work much better in the long run than punishment or humiliation. It is helpful to remember that if your child resists or has “accidents,” s/he is not challenging your authority or doing it to embarrass you or get back at you. Potty training takes time, and there are many occasions when you take 2 steps forward and 1 step back. That’s normal. It’s also normal to feel angry, hurt, frustrated or betrayed by a child who seems uncooperative, or who goes backwards for a while. It’s a very good idea to have someone you can talk with about those feelings, so they don’t come out in actions that hurt your child.
Doctors today recommend a child centered approach to toilet training. This means that the child’s developmental stages determine the child’s progress. It also means that age alone has little to do with toilet training. When parents hold on to specific expectations that a child by a certain age should be toilet trained, they are likely to feel disappointed.
Three important areas of development control how and when a child is ready for potty training. Children have to make progress in all of the following areas:
- Physical maturity – the child’s body has to be capable of doing the work involved in potty training. This usually means s/he must be able to sit, walk, dress, and undress (at least the important parts).
- Response to external feedback – the child has to reach the stage where s/he understands what a parent wants him or her to do. S/he has to be able to respond to instructions and requests.
- Response to internal feedback – the child has to reach the stage where s/he wants to be “grown up,” and where s/he values self-esteem and praise. Children gradually learn to want independence and to control what goes on around them.
What is the biggest concern?
Parents’ have many concerns about their child’s potty training. They naturally worry about the child’s comfort and cleanliness. They worry about the child’s “maturity” and intelligence. Many practical matters depend on toilet training, such as day care and outings. Most parents take pride in their child’s toilet training success, which is fine. Please remember, though, that success is a step-wise process, and that toilet training takes time and is filled with disappointments as well as rewards. Once a child reaches the stage in which s/he wants to stay dry, s/he will work as hard as s/he can to get there. Your little person is trying hard to grow up, to establish his or her independence, and to please you at the same time. If you can keep all this in mind, the accidents are much easier to take.
How to Potty Train
Take a deep breath. This will take time, energy, patience, and a sense of humor. The more relaxed you and your family can be about this, the easier for everyone. It may help to think of the potty training process as a long conversation between you and your child. Every action your child takes around potty training is his or her effort to communicate with you. Children start by showing interest, and then move on to wanting to get involved in this part of their lives. Finally, they want to gain control themselves. If a child seems to lose interest, or to resist, s/he is telling you something important. It may be that s/he really wasn’t quite ready or that s/he feels pressured to do it too soon. It may be simply that something else was a higher priority at that moment. Please try to communicate back to your child that it’s ok, and you’ll just check back with him or her in a few more days or weeks. Chances are s/he will relax about it and make good progress soon. Tantrums around the potty chair or toilet are a big flashing message saying “Back Off! – I’m feeling overwhelmed. I need to get some control over my body and my life.” If you can keep yourself under control and display patience, you’ll be sending an equally powerful message that says “I love you and I respect your limits. Let me know when you feel ready to try again.” You may then need to go blow off some steam to an adult – this is not about squashing or stuffing your own feelings!
To give you a ballpark estimate of what to expect, here’s a general timeline of when kids tend to reach the various stages in toilet training:
- Readiness – your child has to reach the developmental stage where s/he understands the idea of being dry, and can let you know about it. This requires a combination of physical control, communication skills, and behavioral development. Most children won’t show signs of readiness until about 18 months. If your child seems ready earlier, by all means encourage it.
- Desire to train – your child next has to show you that s/he wants to take part in the training process. You’ll show your child a potty chair, talk about the bathroom and about urine and stool. Please use the language that your child and family are comfortable with, so everyone knows what you are talking about. When your child isaround 24 months old you can start the step-by-step approach that we give below.
- Daytime dryness – the first big milestone for most children is staying dry by day. With good encouragement and patience, most children are dry by day between 30 and 36 months. Boys tend to be a little older than girls when they reach this stage.
- Nighttime training – most parents consider their children “completely” potty trained when they are dry both day and night, and can control their bowel movements. This doesn’t usually happen until children are between 3 and 4 years old.
Please remember – you and your potty training child are having a dialogue. It will help if you can learn to listen to what your child is telling you through actions as well as words. Remember, you know a lot more words than s/he does, so lectures aren’t fair play. Here are a few communications tools that parents and doctors have found useful over the years:
The Potty Chair
The potty chair is one of the most useful communication tools you can use with your child. When you bring it out, you are saying “this is just for you.” When you invite your child to look it over, touch it, and become familiar with the potty chair, you are saying “this is important for both of us.” You are also letting your child know it’s ok to ask questions about it, or to have opinions about it. Please help your child feel that the potty chair is his or her very own property. You can introduce the potty chair months before you expect the child to learn to use it. This gives your child a chance to feel comfortable about it without any pressure to do something “right.” You can also purchase fun-to-read books about potty training. These can stimulate your child’s interest in the potty chair and in potty training. When your child starts to take a regular interest in the potty chair, s/he is ready to consider being dry.
When your child starts to show interest in using the potty chair, encourage him or her to sit on it fully clothed. This helps the child to associate the need to urinate with the chair, again without pressure. Some experts recommend that as a next step, you put the child’s urine or stool in the bowl of the potty chair, so that s/he can see where you want it to go. Children love to imitate grown-ups. This helps them feel that they are growing up and feel in control. You can show your child how you sit on the toilet, and encourage your child to do the same on his or her very own potty chair. Again, the more you can make this a partnership and a conversation, the less stress all of you will feel about it. Expect mistakes – messy ones. Please – try to keep a sense of humor alive. It’s the only way to survive!
Reminders and Reinforcement
You can take advantage of natural patterns to help remind and reinforce your child’s use of the potty chair. Most children tend to urinate and/or have a bowel movement when they first wake up and soon after a meal. Once your child has shown some interest in the potty chair, you can try “practice runs” to the chair at these times. Explain what you want your child to do each time. If nothing happens, that’s ok. If your child uses the chair, compliment him or her on a good job. To keep your child from getting bored or fidgeting on the potty chair, you can make it fun by reading a favorite book or story.
As s/he learns to feel body signals that s/he is about to urinate or have a bowel movement, your child will learn to let you know in time. It might be useful to know that children have more episodes of urinating the younger they are. This means that you may want to ask your younger toddler-in-training about whether s/he needs to urinate more often than your 3 year-old. When children get busy, they need more reminders as well.
Children often develop fears about toilet training. Some of these fears are not very obvious to parents. Toilet flushing frightens many children. When their urine or stool goes away, they may become anxious. You can help the child through this by having him or her practice flushing the toilet with just toilet paper. You can help your child wave “bye-bye” to the urine or stool as it goes down the drain. If you then add “good job” or a similar compliment, your child will beam with pleasure.
Also, please remember that your child needn’t master every part of toilet training at once. At first, just sitting on the chair is success and deserves a compliment. Later, when s/he is using the toilet, don’t make a big deal about not flushing at first. The success is in using the toilet at all. As your child gains confidence in mastering each step, s/he will be ready for the next step. Pushing too hard too early will almost always cause backwards progress. You can offer positive feedback and reinforcement by using a star or sticker chart. Put one new sticker on the chart each time your child uses the potty correctly. Then offer a small reward or prize when s/he has collected a certain number of stars or stickers. Some parents give their children “potty parties” as rewards for success.
Please bear in mind your child’s self-esteem and self-confidence. Toilet training comes at a delicate time in overall child development. Your child deeply wants to please you and to assert his or her own independence at the same time. Mistakes will happen. Your reactions will determine if the child feels safe to try again, or if s/he gets confused and frustrated. Praising success and joining your child in sadness about a mistake will get you to the goal much faster than discipline, shame, or humiliation.
All parents and children hit rough patches, when they aren’t very happy with each other for all sorts of reasons. When this happens, it’s a good idea to back away from focus on potty training. Both of you can use a break, and your child may need a chance to recover some self-esteem. Some experts recommend a full three-month break in toilet training if things seem to be going badly. This often results in a sudden return of control for the child.
Diapers and Potty Training
Once your child is reliably dry during the day, you can try letting him or her go without a diaper for part of the day while s/he is awake. Many children look forward to wearing “big girl” or “big boy” underwear instead of diapers. This can help in giving your child encouragement. If conditions are appropriate, many parents choose to let the child wander the house without any bottom covering. This reduces the risk of diaper rash, which can often be worse in toddlers because their constant motion rubs the diaper on the skin. When you do use diapers, please remember to change them frequently.
Nighttime Bladder Control
Younger children sleep very deeply. This means that they often don’t wake up when their bladders are full. This is the reason that children reach “dry by day” months or even a year before they can start to be dry at night. You can help a bit by encouraging a trip to the bathroom before bedtime or naptime. If you put the potty chair next to the bed your child might be able to get there in time. Again, please remember that this is a process and takes time.
“Regression” means having a setback during toilet training. It is a powerful communication tool that you child will use to let you know s/he is feeling pushed to hard or too fast. Children regress by insisting on wearing diapers even after they’ve been using the potty chair or toilet for a while, by having “accidents” during the day, or by refusing to have a bowel movement. Regression often happens during times of family change or stress, like moving, a new baby at home, or parents fighting. Many children regress when they get a new child-care provider. Some parents interpret regression wrongly as “acting out.” It’s much more likely to be fear or anxiety. Your child is telling you that s/he wants to move back to a safer, more familiar place or time. Regression is a completely normal part of toilet training. Its another good time to try to practice patience and understanding. Please try to keep reinforcing the good things your child does, and be sure to let him or her know that s/he’s not a failure in your eyes.
When should I be worried?
Toilet training is never uneventful, but it is rarely dangerous or a cause for concern. Children who make slow progress are usually normal and catch up over time. As we’ve said, children who regress are often just responding to some new and temporary stress. Children who are not at all toilet trained by the age of five years, or who begin wetting or soiling after more than a year of complete control, could have a more serious problem, however. Here are some things to bring to your doctor’s attention:
- A child who seems to be having pain during urination or bowel movements
- A child who goes without urinating or having a bowel movement for a long time (more than 8 hours for urine, more than 3-4 days for bowel movement)
- A child with abdominal pain
- Foul-smelling urine
- Blood in stool or urine
- A child who becomes fearful of the toilet or potty chair
- A child who becomes suddenly quiet, shy, or withdrawn from people
- A child who seems fearful or uncomfortable around a particular person
Please schedule a visit with your doctor to talk if any of these things occur.
Other points of concern
Every adult went through toilet training at some time in his or her life. Going through it with their own children can stir up feelings parents did not know they had, especially if they had a rough time with it themselves. This can cause parents to be either too strict or too permissive with their children. If parents feel a great deal of shame about the bathroom, they can transmit that feeling to their children even without talking about it. If this sounds familiar, talk it over with your partner, your physician, or a close friend. Please try to avoid shaming language around toilet training – a child who hears that s/he is “stinky or “dirty” will take that feeling to heart.
If your child has never had a dry night by the time s/he reaches school age, she may have a physical or emotional problem that your doctor should know about. Please discuss it with your doctor.
PLEASE NOTE: It is never ok to punish a child physically for toilet training accidents or “failures.” This means it is never ok to spank, whip, or beat a child. Some people try putting the child’s bottom in hot water, or doing other painful things, to “teach them a lesson.” This can cause severe and disfiguring injuries. Please be sure that everyone who takes care of your child knows that you will not tolerate any of this treatment. If you have any suspicions that someone has done anything like this to your child, please keep the child with you until you can have a doctor see him or her.
Other Conditions that Might Be Present
When children have been making good progress and then seem to go backwards, it is usually just normal regression. In some cases, however, there can be some other serious concern going on. If your child has a fever, abdominal pain, or burning or itching with urination, s/he may have a bladder infection or vaginitis. You may want to read our Aftercare Instructions on Bladder Infections and Vaginitis.
Unfortunately, another reason that some children regress or have problems is that someone else is hurting the child or touching them in wrong ways. Children sometimes have “accidents” as a way to make themselves seem less appealing to an abuser. Some children have injuries from abuse that make it hard for them to control their bowels or bladders. If your child develops a sudden problem with toilet training, and you can’t find an obvious reason, please talk with your doctor right away.