How and When do I Potty Train?

Dr. Greene’s Answer:

One of the great adventures and accomplishments of childhood waits just around the corner. Even though learning to use the potty is a universal rite of passage, experts have wildly different ideas about when and how to proceed.

Some recommend doing almost nothing and letting nature take its course. Others consider the process of active potty training to be of critical importance to future psychological development. Who is right?

The truth is that sometimes kids do learn to use the potty with almost no help from parents. Most of the time, though, they need our guidance and encouragement.

No single method is best for every child. By understanding the underlying forces that surround this event, you will be able to understand which of the many recommendations are most likely to work for your little one.

I’ll outline for you here an approach that, with some individual variation, will work for most kids.

Ready…

With any adventure, it’s wise to be prepared before you set out. The time to start depends far more on development than on age. Here are some signs that your child is ready:

  • Cute moments when your little one mimics Dad or Mom.
  • Frustrated moments when a person or toy is in the wrong place (“No, Mommy! — Here!”).
  • A trail of clothes strewn across the floor as your toddler gleefully tries to undress.
  • A face glowing with pride at an accomplishment.
  • Curiosity about the toilet and the genitals – theirs and yours.
  • Talking about pee pee and poo poo.
  • Dawning awareness of when pee pee and poo poo are happening – especially just before the fact.

…Set…

As these signs of readiness are emerging, reinforce your toddler’s awareness of toileting. Watching parents, friends, or animals helps. Better yet – alert your child when you see that he has gone, is going, or needs to go.

When you notice behavior such as straining, tugging at the clothes or shifting from foot to foot, point it out! Even when it is obvious to everyone else, it may still be a mystery to a child. Help him learn his body’s signals. Let your child run around naked – watching it happen live a few times speeds everything up. When he does poop in the diaper, begin going together to put the stool in the toilet, so he will learn that pee pee and poo poo belong in the potty.

…Go!

When you are ready, introduce a potty as follows:

Dress for Success

The long-term goal is to enable your child to go to the potty on his or her own body’s signal, and to need little outside help with any part of the procedure, from sitting down to washing up afterwards. While the complete process may take a couple of years (the ability to wipe oneself effectively is often the last skill to be mastered), there is no time like the present to set your child up for success. Dress kids in loose clothes that they can easily take off by themselves.

Keep diapers off as much as is practical during toilet training. This will increase awareness and motivation for success. Big boy underpants are great! Pull-ups can prevent messes, but if you use them, I recommend cotton ones if you used paper diapers or paper ones if you used cloth diapers, so that they do not feel like diapers to your child. Nighttime diapers are still appropriate until your child begins to have dry diapers in the morning. This can normally take a couple of years after daytime control. If it lasts longer, talk with your pediatrician.

The Age-Old Question

A child is happily playing with blocks, but suddenly an intense expression appears on his face. The room gets uncharacteristically quiet. He squats behind the couch, and his cheeks begin to get red. “Honey, do you need to go potty?” you ask.

“No!” declares the toddler automatically. The question doesn’t help anything. Instead, tell your child what you observe, and tell her, “It’s time to go potty!”

Potty Time

At the beginning, you might want to set a timer for every 2 hours. When the timer goes off – “It’s time to go to the potty.” If he appears to need to go, or says he needs to go – “It’s potty time.” Make potty time something to look forward to. Keep your child company while he or she sits on the potty for a few minutes. You may want to have books, toys, or a box of dress-up accessories that are only used during potty time. Your undivided attention is the key ingredient.

Encourage your child to celebrate successes. If nothing happens, smile and say he’s learning. When accidents happen (and they will – poop on the carpet is part of the learning experience), don’t scold your child, but scoop it up, put it in the potty, and say, “Soon you’ll be able to get it in the potty every time!”

After a week or so of success, change potty time to “Head into the bathroom and sit on the potty – I’ll be there with you in a minute!” When this is working well, progress to “Let me know when you’re done, I’ll check your bottom.” Gradually encourage his independence.

And make no mistake – independence is what is happening here. Toilet learning is a wonderful, bittersweet snapshot of growing up. Changing his diapers for him was a central part of his life (and yours) up until now. Soon, for both of you, it will be time to celebrate no more dirty diapers!

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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