Potty training: What a huge developmental milestone for your child!

Mastering toilet training is an important leap toward independence. The process can be met with excitement, frustration, anxiety or a little bit of it all for both parent and child.

A question we often hear as medical professionals is: “My child is ‘X’ months/years old and is still in a diaper. Shouldn’t they be potty trained by now?” But when a child is ready for potty training has less to do with actual age and more to do with showing signs of readiness developmentally.

When is the right time for potty training?

On average, most children are able to stay dry during the day by two to four years of age. Before starting to potty train, a child should be able to do the following:

• Walk to the toilet
• Sit up on the toilet safely
• Stay dry for several hours or wake up dry after a nap
• Pull clothes up and down
• Follow simple instructions

They should also be showing an interest in learning.

Make sure they are clear of constipation

One important aspect to consider before beginning potty training is whether your child struggles with constipation. If they do, it’s advised to make sure their constipation is under control prior to starting as painful bowel movements may lead to them holding in their stool or refusing to use the toilet. If this happens, the level of frustration and anxiety increases which creates negativity around the training process that can lead to setbacks.

Offering foods that are high in fiber and limiting dairy to the equivalent of two eight-ounce cups of milk per day (this is the recommended amount for this for a toddler-age child) helps keep stools soft.

Plan to put in the time: Potty training can take an upward of six months

We all hear stories of parents being able to fully potty train their child in a matter of days. However, on average potty training can take upward of six months. It may take more time for some children and less for others. Girls usually complete potty training earlier than boys.

To start, preferably at least one parent should have the time and energy, emotionally speaking, to devote to potty training daily. During this time, offer plenty of positive reinforcement and know that accidents will occur which leads to an increase in laundry.

What can I do to help my child successfully make it through potty training?

Consider the following tips to help your child use the toilet:

• Select a stress-free/low-stress time in a child’s life. Avoid initiating potty training when it would possibly overlap with stressful events such as the birth of a sibling, traveling, moving and/or switching from a crib to a bed.
• Set the stage. If possible, buy multiple potty chairs for quick access, especially if you have a multi-level home. Keep your child in easy-to-remove clothing (try to avoid snaps and buttons). Keep an extra set of clothes with you so you can be prepared in the event they have an accident.
• Offer guidance. Remind your child to use the potty chair/toilet upon waking in the morning and throughout the day. Watch for clues that they may need to go such as squirming, holding their genitals or doing the “potty dance.”
• Be consistent. Use words for the bathroom consistently such as: pee, poop, potty. (Remember that your child will be using these words around other children and adults.) Ideally, all caregivers including babysitters, grandparents and child care workers use the same routine and words so as not to confuse the child.
• Focus on the positive. Avoid becoming angry with your child when they have accidents. A star chart can be used to help encourage your child to use the potty.
• Encourage good aim. A strategy that may work well for boys is giving them something to aim for in the toilet. “Target practice” can be fun and engaging. Consider putting cereal, such as Cheerios, in the toilet and asking them to aim for the cereal when they potty. By doing so, it encourages them to not make a mess. (Note: target practice really isn’t a go-to strategy for girls…if they’re looking down trying to aim their stream, they may fall off the toilet.)
• Avoid battles. If your child isn’t making progress or showing interest, back off potty training for two to three months before restarting.

Learn more about potty training tips from Parents.com

It’s not uncommon for a child to experience temporary setbacks, especially early on in potty training.

In general, it’s good to remind your child to slow down and take potty breaks.

Even after a child is fully potty trained, they may have occasional accidents. Things like changes in a child’s routine can lead to accidents. If your child has repeated accidents after they’ve been fully potty trained, contact your child’s primary care provider as there may be a medical issue such as a urinary tract infection.

The ability to stay dry at night may not happen at the same time as staying dry during the day. Nighttime wetting may continue for months or even years longer than daytime wetting. By five years of age, 20 percent of children are still wetting the bed. By six years of age, 10 percent are still wetting the bed. If your child is not dry at night by six years of age, talk to their primary care provider.

Just as with any other developmental milestone, if you have concerns about your child’s potty-training progress, it’s always advised to speak to your child’s primary care provider. If needed, there are specialists like our urology team here to help.

By Leigh Hamm, pediatric nurse practitioner, urology

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