Toilet Training!

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Toilet training is a major milestone for your toddler – and for you! It is no wonder there are so many questions and concerns that arise on this topic.

Some basics to consider

There is no right age. Some children are ready as early as 18 months or two years, while others are not ready until age three or even older. Your child needs to be ready to train and show readiness signs. Pushing your child to use the potty sooner than she is ready may actually slow the process of training. Also, often a move to a new home, a new sibling or a recent transition to a toddler bed, for example, may be a reason to wait to train until a more stable environment is in place. Any change for your child can often delay the process.

Readiness signs to look for

Your child:

  • Will let you know when he is ready to go. Often, initially, your child may tell you after he has gone, but this is also a good sign
  • Is able to follow directions and able to cooperate with you
  • Is able to physically take off her own diaper, take clothing on and off, and able to climb and sit on the potty
  • Will stay dry for longer durations at a time during the day (minimum 2 hours). This is a good sign that your child is controlling her bladder muscles
  • Shows interest in big boy/big girl underwear and in using the potty

Now that your child is ready, how do you start?iStock_boy_on_potty

There are two types of potty seats. You can get the ones for the floor that you will manually have to empty, or the toddler seat that can go right on top of your toilet seat. For the latter you will need to get a step stool for your child. Make sure your child can comfortably reach the potty. I recommend getting a potty for every bathroom in the house (and a seat for the on-the-go when you are out as well).

Start speaking with terms for using the toilet. This will help your child understand, and also start using words, to use the potty. Show your child where to dump the contents of the diaper so she can learn about the toilet and its purpose and how to flush. Teach her to wash his hands after he goes as well.

Practice with your child sitting on the potty, even clothed in the beginning. You can start practicing on the potty first with clothes, then diapers, then when ready to go, without a diaper. Often showing your child how you go on the toilet helps, and if you have a floor potty, he can practice sitting with you at the same time.

Start to look for signs that your child is ready to use the toilet and if she does need to pee or poop. This can vary per child, but you know your child. Some hold themselves, some squat, etc. You need to act fast and move to the toilet. Boys often learn to pee sitting first since it is easier, but not always necessary. For girls, it is important to remember to wipe front to back still, as similar to how you did with diapers, to prevent germs and infection.

Positive reinforcement! When your child tells you she has to go, praise her. Even if she doesn’t have to go when she gets to the bathroom, you can stay there for a few minutes. Praise him for his great effort. Remind him that he can go again later. Often, stickers or potty chart help – or other incentives that your child likes. I find often that praise and telling children how exciting it is that they are on the potty like big kids is very helpful. Seeing older siblings or friends on the toilet and in big kid underwear is often a great incentive as well.

Set some time to sit on the toilet. An hour or so after drinking fluids may be a time your child will need to pee. You can also sit your child on the potty after a meal. There is a gastro-colic reflex in which the body has a natural tendency to have a bowel movement after a meal. However, do not pressure your child if he does not want to go on the potty. If your child is not ready, do not push him. As previously mentioned, this just delays the process and the child’s interest in toilet training.

Another important note is to ensure your child is dressed for potty training. Be sure she can undress herself easily and quickly. Another option is no diaper and clothes at all. Some parents like to have their child without a diaper during the training process and find it is helpful. In this summer time weather, it is easier to have no diaper – although you should expect accidents.

The question of using pull-ups before transitioning to underwear often comes up. Pull-ups for some are just bigger diapers, and children learn that and may not be motivated to use the toilet as much. Others feel the pull-ups are the next step from diapers to underwear, and a great transition, and helps children train faster.

I personally find the diapers easier. The children (and adult) can take them off easier when the child has to go, since often this needs to be done quickly. This helps with getting on the potty before they actually go. The decision, however, is a personal preference – whatever works for you. The end result is the same – big kid underwear.

Once your child is dry in diapers or pull-ups for a while, you can try underwear. How exciting! Let your child know how excited you are. Do something special. Expect accidents. Training is a process. The important thing is to ensure the experience for your child is always positive. Don’t show disappointment if he has an accident. Continue to show your excitement and praise and let him know he is almost in big kid underwear and accidents sometimes happen.

Some kids can regress once trained. Often, a move to a new home, a new sibling or a recent illness may be reasons to have accidents once trained. My daughter is a good example of this. She was showing many readiness signs at 18 months and was trained by 20 months. Then, with back-to-back winter colds at around two-years-old, she regressed. Then, add a new sibling at 26 months of age, and she continued to show no interest. Even after a sticker chart with success and a new Barbie, she still now shows no interest at 2 ½ years. I’m not concerned and not pushing her, since, as I mentioned, this will just delay the process. I know she can do it, but when she is ready. She is excited to tell me when she is ready and I’m excited too!

Toilet training can take a few days, or up to several months. Nighttime training takes longer. If your child is still not trained by three years, discuss it with your pediatrician. Age varies, but they can help determine if there is a specific issue or help you further with training. Do note: children still need your help with using the bathroom and wiping even after toilet trained.

In summary, toilet training is a process and can be summarized in one word: PATIENCE. Don’t feel pressure from parents, family or friends when to start. All kids are different and ready at different ages. There is no right age. It is whatever is right for your child. Always try to stay positive and laugh. Accidents can be frustrating, but this is a milestone you and your little one will be proud of when he/she reaches it.

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Ali is a board certified pediatrician who practiced general pediatrics for five years in a busy private practice in Manhattan NY. She since has moved into the pharmaceutical industry and oversees and mentors many physicians globally. She enjoys sharing her knowledge and experiences as a pediatrician with other moms and dads. Ali’s outside interests include working out, acting, piano, guitar, dance and being a mom! Ali currently lives in NYC with her husband, 2 ½ year old daughter and 5 month old son.

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