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Potty Pointers

Ask parents from different generations when their child was potty trained and you’re likely to get answers ranging from fourteen months to four years. Relatives moan that you missed your opportunity not starting when your daughter was one, but her playgroup companions are still in diapers at two and a half. Who’s right? What’s normal?

Parents of toddlers now have some reassuring information, thanks to a study reported in the January 1997 issue of Pediatrics. Only 4% of the children studied were toilet trained by age 2. By 2 1/2 years, 22% were trained, and by age 3, 60% had achieved this developmental milestone. At 3 1/2 years, fully 88% were trained, with only 2% of children still untrained by 4 years old. These numbers project realistic goals for your child’s potty training efforts. Take a deep breath and relax. Your child will not go off to college wearing diapers. Using the potty is a developmental step, just like walking. Don’t think of it as a race. Remember that some children walk at ten months, more by a year, and a number of them closer to fourteen months. The process is different, but the end result is the same.

Take the child to the bathroom every single time any family member goes number one or number two. Have a potty chair to explore, take the diaper off (the most important step) and watch what happens!

In a nutshell, the watch-me approach is the simplest approach. Make a big deal about the new (or borrowed) seat. Many children prefer a potty seat on the floor in which they can easily get on and off of, compared to a seat that fits onto the toilet. For boys, skip the urine deflector. An injury from this often sharp piece of plastic can be quite a setback.

When your child shows signs of readiness, such as interest in adult toileting activities or a dry diaper after a nap, you may begin having him sit on the potty first fully clothed and later without a diaper. Suggest that he proceeds to the potty when he indicates that he has to go or he shows signs of preparing to do so. Praise him for sitting whether he has produced something or not. Some children like to see their stool and urine placed in the toilet and flushed away; others can be spared this reinforcement if they find it upsetting.

During potty training, parents may elect to use pull-ups or training pants. The former can be easily changed after accidents by tearing down the sides, while the later are reusable and promote that big kid feeling. Sometimes the allure of decorated underwear can speed training. Whatever you and your child choose, keep clothing simple during training–elastic waist pants are best. Tucson’s warmer months are better times to train for this very reason.

Aim for daytime dryness first because, for many, night dryness will happen simultaneously. Investing in a waterproof pad for the mattress is not a bad idea. Keep in mind that 20% of normal five year olds can still have accidents at night. For children who insist on being put in a diaper to have a bowel movement, reinforce that their character underwear don’t want to be stooled or urinated on! They only get to wear underwear when they stool or urinate in the potty. Avoid forcing or coercing your children during potty training. Children can resist your demands by holding their stool in—“withholding.” This can then lead to rock hard stools and constipation–a problem that then needs to be solved before potty training can resume.

Despite all the talk about the “terrible twos” and toddler negativism, your child really wants to master toilet training for him and for you.  Give him every opportunity to succeed. I am well versed in toilet training, so if you run into any road blocks, contact me so I can help you to troubleshoot your child’s passage from diapers to dryness.

Potty Trainers

Your child is toilet trained when he or she is able to recognize the urge, get to the
bathroom, disrobe, urinate or stool and redress. The order of a child being able to
attain the ability to stool or urinate in a toilet may vary. Bladder control through the night normally occurs years after a child learns how to stay dry during the day.

Toilet training readiness

This question pertains more to the parent than the child. With planning, persistence and patience, you can teach your child the joy of walking around in clean underwear all day long! This process can take a few days to a few months. Potty training skills can be taught at an early age.

As with most things involving parenting, your enthusiasm in word and action is what sells the lesson.

18 months… Begin teaching about pee, poop, and how the body works.

  • Teach the vocabulary (pee, poop, potty).
  • Explain to your child that everyone makes pee and poop.
  • Point out when dogs or other animals are peeing or pooping.
  • Clarify the body’s signals when you observe them: “Your body wants to
    make some pee or poop.”
  • Praise your child for stooling or urinating.
  • Don’t refer to poop as “dirty” or “yucky.”
  • Make diaper changes pleasant for your child so he will come to you.
  • Change your child often so he will prefer a dry diaper.
  • Teach him to come to you whenever he is wet or soiled.

21 months… Begin teaching about the potty and toilet.

  • Teach what the toilet and potty chair are used for (“the pee or poop goes
    in this special place”). Demonstrate by dumping poop from the diaper into
    the toilet.
  • Portray using the toilet and potty chair as a privilege.
  • Have your child observe toilet-trained children use the toilet or potty chair
    (an older toilet-trained sibling can be very helpful).
  • Give your child a potty chair. Encourage your child to sit on it with clothes
    on for fun activities, such as play, snacks, and watching television. Help
    your child develop a sense of ownership (“my chair”).
  • Move the potty chair into the bathroom and have your child sit on it when
    you sit on the toilet.

2 years… Begin using teaching aids.

  • Read toilet learning books and watch toilet learning videos with your child.
  • Help your child pretend to train a doll or stuffed animal to use the potty chair.
  • Introduce wearing underwear as a privilege. Buy special underwear and keep it in a place where your child can see it. If the underwear has superheroes or princesses on them, stress the fact that the superhero or princess prefers to be pee free!

The potty chair

Buy a floor-level potty chair. You want your child’s feet to touch the floor when she sits on the throne. This provides leverage for pushing and a sense of security. It also allows her to get on and off whenever she wants to skedaddle. Take your child with you to buy the potty chair. Make it clear that this pooper-keeper is her own special chair. Have her help you put her name on it. Allow her to decorate it with stickers or colors.

Steps in toilet training

Fluids in = Fluids out

Drinking juice and/or milk stimulates a child to urinate more than water. Adjusting when a child consumes either of these fluids can impact the success of potty training.

Encourage practice runs to the potty.

A practice run is encouraging your child to walk to the potty and sit there with her diaper or pants off. You can then tell your child, “Try to go pee-pee in the potty.” Only do practice runs when your child gives a signal that looks promising, such as a certain facial expression, grunting, holding the genital area, pulling at her pants, pacing, bunny hopping while focusing on a task, squatting, or squirming. Other good times are after naps, after two hours without  urinating, before meals or 20 minutes after meals. Say encouragingly, “Let’s use the potty to see if any pee (or poop) wants to come out.” Remember to  take your child to the bathroom with you anytime you have the need to use the toilet.

If your child is reluctant to sit on the potty, you may want to read her a story. Keep a certain collection of books to be  read only when she is on the potty. If she wants to get up after one minute of encouragement, let her get up. Never force  your child to sit on the potty. Never physically hold your child on the potty. Even if your child seems to be enjoying it,  end each session after five minutes unless something is happening. Initially, keep the potty chair in the room your child  usually plays in. This easy access markedly increases the chances that she will use it without your asking. Consider buying  two potty chairs.

During toilet training children need to wear clothing that makes it easy for them to use the potty. Girls can wear a dress  without underwear or a diaper. Boys can wear just a shirt without pants, shorts, underwear or a diaper. Avoid shoes and pants. (In the wintertime, turning up the heat is helpful.) Another option (though less effective) is loose sweatpants with an elastic waistband. Avoid pants with zippers, buttons, snaps, or a belt.

Praise or reward your child for cooperation or any success.

All cooperation with practice sessions should be praised. You might say, for example, “You’re sitting on the potty just  like Daddy,” or “You’re doing a great job trying to go pee or potty.” If your child urinates into the potty, you can  reward him with treats, such as animal cookies, or stickers, as well as praise and hugs. Although a sense of accomplishment is enough to motivate some children, many need treats to stay focused. Parading around the house singing your child’s praises is a sure success. Personally, dancing around with my child on my shoulders giggling reinforced a job well done.  Reserve big rewards (such as going to the toy store or buying new underwear) for occasions when your self-motivated  child walks over to the potty unsupervised and uses it or asks to go there with you and then uses it. Once your child uses the potty by himself three or more times, you can stop the practice runs. For a few weeks, continue to praise your child  often for using the potty. (Note: Practice runs and reminders should not be necessary for more than one or two months.)

Change your child after accidents as soon as convenient.

Respond sympathetically. Say something like, “I know you went pee in your underwear (or training pants). Your superhero is crying because he likes to stay dry. I know that next time you will make it to the potty in time to put all of the pee in the toilet. You have been doing a fantastic job staying dry!” If you feel a need to criticize, restrict criticism to mild verbal disapproval and use it rarely (“Big girls don’t go pee-pee in their pants.” Change your child into clean  underwear or training pants in as pleasant and non-angry a way as possible. Avoid physical or emotional punishment-yelling or scolding. Pressure or force can make a child completely uncooperative.

Introduce underpants after your child starts using the potty.

Underwear can increase motivation. Switch from diapers to underpants when your child is cooperative about sitting on the potty chair and has passed urine into the toilet spontaneously 10 or more times. Take your child with you to buy the underwear and make it a reward for his success. Allow your child to wear a new pair of underwear every time that she  stays dry for seven days. These seven days can be nonconsecutive. The goal is to provide a frequent reward for continued progress.

Buy loose-fitting underpants that he can pull down easily and pull up by himself. When your child is wearing underwear regularly, then use diapers only for naps, bedtime, and travel outside the home. Continue to encourage him to keep his diaper dry. Have him use the potty after eating and before travelling.

Indoor slip n’ slide: The bare-bottom weekend.

If your child is over 30 months old, has successfully used the potty a few times with your help, and clearly understands the process, committing six hours or a weekend exclusively to toilet training can lead to a breakthrough. Avoid  interruptions or distractions during this time. Younger siblings must spend the day elsewhere. Turn off the TV, and don’t answer the telephone. Success requires monitoring your child during training hours.

The bare-bottom technique means that your child does not wear diapers, pull-ups, underwear, or any clothing below the waist. You and your child must stay in the vicinity of the potty chair, which can be placed in the kitchen or another room without carpet. A gate across the doorway may help your child stay on task. During bare-bottom times, refrain from all practice runs and most reminders. Allow your child to learn by trial and error with your support.

Create a frequent need to urinate by offering your child lots of her favorite fluids; juice and chocolate milk are on the menu. Have just enough toys and books handy to keep your child playing near the potty chair. Keep the process upbeat with hugs, smiles, and good cheer. You are your child’s coach and ally. Carry your child on your shoulders with each success with caution!

If your child resists training-

Call or pay me a visit if:

  • Your 2 1/2-year-old child is negative about toilet training.
  • Your child is over 3 years old and not daytime toilet trained.
  • Your child won’t sit on the potty or toilet.
  • Your child holds back bowel movements.
  • The approach described here isn’t working after six months.