For most children, toilet training is a major accomplishment of the toddler period. Around 18 months of age, toddlers start to recognize the sensations that accompany urination and defecation. They may clutch at themselves, momentarily stop playing, or even go off into a corner. Most children this age know the words for body wastes and are aware that they "go pee pee" and "poop." This awareness alone will not result in toilet training.
Unfortunately, there is tremendous pressure on parents to have their children out of diapers soon after age two. Realistically, however, children acquire this skill much as they do any other—gradually and at their own paces. Author and pediatrician T. Berry Brazleton did a study of normal children and found that virtually all children achieve bowel and bladder control between two and two-and-a-half years of age. He also found that starting early did not guarantee early achievement of training: Half of the children in his study who had begun toilet training at 18 months were still having accidents at age three.
When training starts a bit late—at two-and-a-half or three—it is a much faster process than it is when started early. In this, as in many other facets of child rearing, it's important to pay more attention to your child's signals than to outside pressure. Let your toddler know what grown-ups and big kids do when they need to urinate or have a bowel movement; teach him the names for these functions and demonstrate. (If possible, have an admired older sibling or friend demonstrate—repeatedly—as well. Toddlers want to feel that they are "big boys" and "big girls," too.)
A few other things to keep in mind: Children tend to achieve bowel control as long as six months before bladder control. Also, girls become trained a bit sooner than boys. It is a good idea to start toilet training during a period when the child is in a relatively compliant phase. Of course, it's hard to predict when (or if) such a phase will occur, but you will get much better results if you start training when your child is being generally cooperative than during a stubborn period.
Once your child is on the way to being trained, expect some setbacks in times of stress. Also, toileting, like eating, is an area you should try to keep free of power struggles. If your child regresses, be patient and matter-of-fact, and remember that virtually all children are out of diapers soon after age three.
TOILETING TROUBLES
No child goes through toilet training without hitting a few snags. Here are some of the problems that commonly arise, along with suggestions on how to deal with them.
GETTING HELP
Speak to your pediatrician if:
• Your two- to three-year-old child seems to be unaware that he is urinating or defecating
• Your child has made no progress in learning to use the toilet by age three
• Your child has tantrums or other strong, negative reactions to being encouraged to use the potty
SIGNS OF READINESS
Your child may be ready to start toilet training when he:
• Is aware of urinating and defecating
• Has childhood words for urine and feces (e.g., pee pee, poop)
• Requests diaper changes when needed
• Is interested when parents, friends and siblings use the bathroom
• Is able to pull down elastic-waisted pants
Potty Training Issues
Problem:
Solution:
Your child balks at any suggestion of using the potty.
Leave the potty in sight and bring up the subject tactfully every few weeks. From time to time, stress how nice it is not to have to fuss with diapers. Let the child go without pants or diapers for a few days (be prepared to do some cleaning up), then tell him that if this freedom is to continue, the potty must be used.
Your child will use only his special potty, not anyone else's and certainly not a grown-up one.
Take the potty with you for a few weeks. If the seat section detaches from the base, you may be able to take it alone and fit it over the toilet seat. Alternatively, you can shop for a toilet-seat adapter (a child-sized seat that fits over a regular-sized one) that may be easier to carry. If your child doesn't mind, put him in diapers when you go out. Find out if the children's room in your library or a local toy store has a child-sized toilet, and let your child use it a few times.
Your child will urinate in the potty but will not defecate there.
Continue using diapers unless your child is adamant about staying in pants. Calmly explain that feces go in the potty, not in underwear. If the child is over two and a half, insist that he help you with cleaning up accidents. (Note: Call your pediatrician if constipation is part of the problem. Being constipated can set up a vicious cycle of painful bowel movements, followed by stool withholding to avoid discomfort, followed by fecal soiling, more severe constipation and worse discomfort. You may need to change your child's diet or take other measures prescribed by your pediatrician to alleviate the problem.)
Your child stays dry for several weeks, then starts having frequent accidents.
Handle accidents calmly and patiently. Determine whether there is a pattern to their pattern to their occurence, and see if you can break the pattern by reminding the child to go to the bathroom at a certain time, limiting drinks at a certain time or making some other change.
TRAINING TIPS
Here are some general guidelines for toilet training. You may want to follow some of these steps and omit others, and you may develop your own techniques that work particularly well with your child. Before your child starts toilet training, be sure your sitter or day-care provider knows how you want to proceed.
• Take your toddler with you to purchase a potty, and let him help make the selection. Buy the potty a few months before you expect the child to start sitting on it.
• Read your child books on toilet training, such as ONCE UPON A POTTY (in boys' and girls' versions) by Alona Frankel (Barron, 1987) and SAM'S POTTY by Barbro Lindgren (Morrow Junior Books, 1986).
• When your child has a bowel movement in a diaper, place the feces in the potty and say, "This is where we put them." Then let him see you flush them down the toilet.
• When you want to start more formal toilet training, begin by having the child sit fully clothed on the potty for a few minutes each day. If the child refuses, don't insist; wait a few weeks and try again.
• Note the time of day your child generally has bowel movements.
• After the child has been having a daily practice-sit on the potty at a time when he may need to go—after a meal or a couple of hours of staying dry, for example. Again, if you meet with resistance, back off and wait a while.
• Start looking for signs that your child needs to urinate or defecate. Many children become quiet or hold themselves. Ask the child if he wants to try the potty.
• Offer praise—and perhaps a small reward—when the potty is used, but don't go overboard. For one thing, your enthusiasm will wane when success becomes more frequent. For another, your child may fear letting you down when he doesn't make it to the potty.
• When your child is using the potty occasionally, go shopping for big-boy or big-girl pants. Training pants, which have double thickness in the crotch, are the best bet. Diaper manufacturers also have introduced disposable training pants with elastic waists and legs. Again, let the child have some say in the selection.
• When the child is using the potty several times a day, tell him it's time to try a day without diapers. Have the child wear training pants, or forget about pants entirely, a particularly good option if it's summer and you can stay outdoors. Expect numerous accidents, which you should handle matter-of-factly.
• When you go out for extended periods, be sure to take a couple of spare pairs of pants and underpants. Early on, you may prefer to put the child in a diaper for outings, but this strategy can cause some confusion. If he resists the diaper, don't insist. And never put your child in a diaper as a punishment for an accident.
