Toilet Training Advice

ANSWER

I believe that the best advice on toilet training is that if the child is ready, it happens very easily. If not, a power struggle often ensues, since you can lead a child to the potty but you can't make him go. And we all know that no one wins a parent-child power struggle.

They all get out of diapers sooner or later. Fights with your child about his or her body are fights you will never win.

What are the signs that your child might be ready for toilet training? Most importantly, be sure that your child is not in a reactively negative stage, saying NO to everything. Most kids are not ready to be toilet trained until they are between two and three and a half years old, with boys on the later end of this.

You'll know your child is ready when he or she:

• Can express and understand one-word statements, including such words as "wet," "dry," "potty," and "go"
• Has "dry" periods of at least three or four hours, which shows that his bladder muscles are developed enough to hold urine
• Wakes up dry after a nap
• Demonstrates imitative behavior
• Shows interest in others' bathroom habits
• Likes to flush the toilet
• Dislikes the feeling of wearing a wet or dirty diaper
• Gives a physical or verbal sign when he's having a bowel movement such as grunting, squatting, or telling you
• Is anxious to please you
• Has regular bowel movements
• Is coordinated enough to walk, and even run, steadily
• Can pull his pants up and down

Once a child is ready for potty training, your goal is to make it as easy and effortless as possible. Here's a step by step guide:

1. Begin by reading books about toileting. One great one is Toilet Learning by Alison Mack.
2. Start talking about what you're doing in the bathroom. Let your child watch. Boys will benefit by watching other boys or their father use the toilet.
3. Kids love to copy other kids who are already toilet trained; slightly older cousins can be invaluable.
4. Potty training dolls can also be very helpful.
5. Give your child as much control of the process as possible, including choosing her own potty or toilet seat and new "big-girl" underwear.
6. I strongly recommend having a potty on each floor of the house.
7. Let your child choose the potty. Many toddlers squat to poop and prefer a potty that allows them to assume a similar position. They may prefer a potty because they are afraid of falling into the big toilet or are afraid of the flush. Some kids, however, will want to get a seat that goes right on the big toilet. If so, be sure her feet rest securely on a stool, because dangling legs tighten rectal muscles and make defecation difficult.
8. Flip seats have a regular toilet seat plus a training seat. Some kids will love a seat that makes music when something is deposited in it. One source of all kinds of seats is PottyConcepts.com.
9. Don't be in a hurry to start training. First encourage your child to sit, fully clothed, on his potty. It builds muscle memory for your child to get on and off the toilet, so you want to encourage it as many times a day as possible. Make it fun. For instance, sing a certain song, or give her a cheerio, or cheer loudly each time she gets on and off the potty. You might give two cheerios if she sits there for awhile. But never force your child to sit on the potty, or to stay there.
10. Next get him used to sitting naked on his potty, so he is completely comfortable. Read potty books and other books while he sits there. If you feel comfortable with treats, you might give him a small candy each time he sits on his potty naked and reads a book with you. Toddlers are busy. You have to make the potty a place they love being if you want them to spend any time there. And of course if he actually uses it, celebrate in whatever way he loves most!
11. Once she's totally used to sitting on her potty, begin dumping the contents of her diaper into the potty each time she goes. Explain that every day her body is making poop and pee, and they belong in the potty. Admire it there, don't be in a hurry to dispose of it. After awhile, let her help you empty the potty into the toilet and be the one to flush it. Cheer happily each time and wave goodbye to the poop.
12. Notice when she gives signs that she is about to defecate: becoming quiet, withdrawing to squat in private. Give her language for what's happening: "Are you ready to poop? Tell Mommy so we can go to the potty." It may take her awhile to begin telling you, but she will begin to learn the concept that when she feels like this, it's time to tell you and go to the potty.
13. If you can catch her just before she begins to defecate, grab her and put her on the potty. If she actually goes, praise and congratulate her. She'll begin to associate the potty with the act. But don't assume she's toilet trained. Toilet-trained is when she knows when she has to go and gets herself there.
14. Finally, ask your child if he wants to begin using the potty on his own. Tell him he'll have to pay attention and as soon as he might need to pee or poop, yell for you and run to the potty. If he agrees, let him run around naked from the waist down on a day when you can pay constant attention. At the first sign that a bathroom visit might be in order, grab his hand and go! Greet any success with warm approval.
15. But don't express any disappointment at "accidents," or you'll make the stakes too high and your child may rebel. Instead, respond to accidents by shrugging, "Oh well, accidents are how we learn. Soon you'll get it in the potty every time. Let's go in and try again."
16. If your child has herself noticed the accident as soon as it started, but hasn't made it to the bathroom, praise is in order. "You noticed as soon as you started to pee! I am so proud of you! Let's go quick to the bathroom in case there's more to come out. Then we'll clean this up together. You noticed yourself when you needed the potty! Next time you'll probably notice sooner and get all the way to the bathroom!"
17. Be enthusiastic but never pushy. Pushiness complicates toilet training. NEVER punish or disapprove of your child when he has an accident, or it will backfire.
18. If your child poops in her pullup or pants, help her to put the poop into the potty and admire it there. "Poop belongs in the potty."
19. Make it a game by using targets in the toilet for boys -- and even girls, although they won't be able to view it till they get off the toilet -- to pee on. Hitting the target takes practice, but that's what you want -- an incentive for them to practice! Targets are available from PottyTrainingStuff.com.
20. At first your child will probably need help recognizing the signals that mean its time to head to the bathroom. If you notice him getting antsy, or starting to squat behind the couch, you'll need to remind him. Every time your child does notice and tell you that he needs to use the bathroom, even if he doesn't make it in time, is an opportunity to praise his progress in the right direction.
21. What about pull-ups and Pods? Many parents feel that pull-ups are too much like diapers and mask the feeling of the accident, but Pods are useful. Sometimes pullups are a good intermediate step but toilet training can get stalled until you get into real underwear. There's certainly less clean-up with pull-ups than bare-bottomed, but they tend to drag out the whole process because they confuse the child. My recommendation would always be to try bare-bottomed, but I should add the caveat that this may not work well on a carpeted floor.
22. Usually bowel training is easiest to control and happens first. If your child has mastered peeing in the toilet but not bowel training, he is probably afraid of the toilet and needs some reassurance.
23. Don't begin toilet training under pressure. Wait till you have some time when you can be relaxed and attentive to your child. Many preschools demand that children are toilet trained; that kind of pressure can only be bad for you and your child.
24. Toilet training is a partnership. You can set the stage, but your child has to do the work. Handled with good cheer and confidence that he will master it in good time, toilet training can be enormously empowering for your child. This is a big step for him. It's your job to make it a positive one.

  -- Dr. Laura