Lesia Oesterreich, M.S. Family Life Extension Specialist Human Development and Family Studies Iowa State University
Learning to use the toilet is a big event in a young child's life. Most children are eager to learn how to use the "potty" and are proud of their achievement.
Toilet training is easiest when children are physically and emotionally ready, which happens between age 2 and 3 years. Girls usually gain physical control over their bowel and bladder muscles before boys do. On the average, most girls are potty-trained by age 2-1/2 and most boys about age 3. Don't be alarmed if a child doesn't follow this pattern closely; individual children mature physically at different rates.
The secret to success is patience and timing. Emotional readiness also is important. Many bright, normal, healthy, 3-year-olds may not be interested in learning to use the toilet. Learning is a full-time job for most toddlers, and learning to use the toilet may not be as important as learning to climb, jump, run, and talk. A toddler who resists toilet training now may be ready in 3 to 6 months - often learning almost overnight.
HOW DO YOU TELL IF A CHILD IS READY?
Check the following about the child:
Follows simple directions.
Remains dry for at least 2 hours at a time during the day.
Dry after nap time.
Regular and predictable bowel movements. (Some children move their bowels two to three times a day, others may go two to three days without a bowel movement.)
Walks to and from the bathroom, pulls down own pants, and pulls them up again.
Seems uncomfortable with soiled or wet diapers.
Seems interested in the toilet or potty chair.
Has asked to wear grown-up underwear.
If you placed a check mark beside most of the items, you may want to introduce toilet training. If you left most of the items unchecked, be patient a while longer. Rushing a child through the toilet training process will result in tears and frustration. Starting too soon may actually delay the process. Toilet training will be easier when the child is ready.
TEN STEPS TO TOILET TRAINING
Relax! A calm, easygoing approach to toilet training works best. Learning to use the toilet takes time, and each child is different. You will find that one child learns to use the toilet at age 2 and another learns at age 3-1/2. This is normal.
Show children what they are to do in the bathroom. Toddlers imitate adults or older children. Next time a toddler follows you into the bathroom, talk about what you do when you use the toilet. STEP 3 Teach toddlers the words their families use for body parts, urine, and bowel movements. Make sure it's a word parents feel comfortable with - others are sure to hear it. There is nothing quite like a toddler loudly announcing in the grocery store check-out lane, "Go poo-poo!"
Help children recognize when they are urinating or having a bowel movement. Most children will grunt, squat, turn red in the face, or simply stop playing for a moment. Children must be aware that they are urinating or having a bowel movement before they can do anything about it.
Borrow or purchase a potty chair or a potty attachment for the toilet. If you purchase a potty attachment, be sure to get one with a footrest. This will allow a child to sit more comfortable and make it easier to push during the bowel movement. The American Academy of Pediatrics suggests that parents and caregivers avoid urine deflectors because they can cut a child who is climbing on or off a potty chair. You may want to let the child get used to the idea by sitting on the potty while fully clothed.
Begin reading potty books to the child. Many good books have been written about learning to use the potty and may be found at your local library or bookstore. Reading a book together helps children understand the process and understand that other children also learn to use the potty. See book suggestions at the end of this chapter.
Encourage parents to purchase training pants and easy-to-remove clothing. Just getting to the potty on time is a major task for most children. You can help make the job easier by encouraging parents to dress children in easy-to-remove clothing. Ask them to avoid buttons, zippers, and belts. Some parents prefer to use diapers at first and switch to training diapers or pants when their child is urinating in the potty several times a day.
When a child tells you that he or she needs to use the potty, help with clothing and sit the child on the potty for a few minutes. Stay with the child. You might keep some books close by. Reading a book together helps pass the time and takes the pressure off for an immediate result.
After 4 to 5 minutes, help the child off the potty. Give hugs and praise for a successful effort. Comment simply that the child can try again later if the effort wasn't successful. Don't be surprised if the child has a bowel movement or urinates right after being taken off the toilet. This is not unusual. Accidents and near misses generally are not an act of defiance or stubbornness. It simply takes time to learn this new skill. If accidents seem to be frequent, it may be best of try toilet training a few months later.
Wipe the child carefully. Wipe girls from front to back to prevent infection. Teach children to always wash hands with soap and water after using the potty. Set a good example by washing your own hands.
If possible, plan to devote at least 3 to 4 days to begin toilet training. Maintaining the same routine for 3 to 4 weeks also helps.
Some caregivers find it helpful to establish a routine by putting a child on the toilet for 3 to 4 minutes right after snack time, before naps, after naps, and after meals. However, a child will not always use the potty at these times.
If a family is undergoing major change - anticipating a new baby, moving to a new home - you may want to encourage them to wait a few months. Toilet training is easiest when everyone can give it their full attention.
Remind parents that it's OK to keep a child in diapers or disposable training pants for sleeping. Nighttime control generally comes many months after daytime control.
It may be helpful to use a plastic mattress cover, tablecloth, or shower curtain between the sheet and mattress until children gain good bladder control.
Treat accidents casually. Avoid punishing, scolding, or shaming. Give children support by keeping a positive attitude.
Children often show much curiosity about bowel movements. If you find a child trying to remove fecal material from the toilet, or "finger painting" with it on the bathroom floor, try to remain calm. Explain that it's not OK to play with feces or urine; help the child clean up the mess and wash your hands and the child's with soap and water. It is generally a good idea to supervise clean-up and flushing for some time during the toilet training process.
THE BIG FLUSH
Children often have one of two reactions to flushing. Either they are fascinated by it (and will do it repeatedly) or they are afraid of it. Children who enjoy flushing will delight in emptying the potty chair into the toilet, waving bye-bye, and watching everything "flush away."Children who are fearful prefer that caregivers and parents take charge of this process. Before flushing the toilet, make sure the child is off the potty. Many children not only fear the noise and swirling water, but also think they may be flushed down, too. Reassure children that they are safe and that only body wastes and toilet paper will be flushed away.
BOOKS FOR CHILDREN
*No More Diapers*, J.G. Brooks - A popular book with toddlers. Toilet training is illustrated through two stories, one about Johnny and another about Susie. Simple text is used with black, white, and orange drawings.
*Your New Potty*, Joanna Cole - This book tells the story of two children, Ben and Steffie, who are learning to use their new potties. Illustrated by colorful photographs. Uses adult terms for elimination.
*Once Upon a Potty*, Alona Frankel - Simple text with cartoon-like illustrations. Available in both a boy's and girl's version. Comes complete with an anatomically correct doll and toy potty.
*All By Myself*, Anna Grossnickle Hines - One of the few books that talks about nighttime dryness. Josie, like most children, has successfully mastered daytime control, but at night still needs help from her mother to get to the bathroom. In time she learns how to manage by herself.
*Going to the Potty*, Fred Rogers - Part of the Mister Rogers Neighborhood First Experience series, this colorful book discusses toilet training. Photographs show children of all sizes, ages, and ethnic groups.
*KoKo Bear's New Potty*, Vicki Lansky - A "read together" book with cartoon bear illustrations. A useful companion to Vicki Lansky's Practical Parenting: Toilet Training.
BOOKS FOR CAREGIVERS AND PARENTS
*Parents Book of Toilet Teaching*, Joanna Cole
*Practical Parenting: Toilet Training*, Vicki Lansky
*Toilet Learning*, Alison Mack
National Network for Child Care - NNCC. Part of CYFERNET, the National Extension Service Children Youth and Family Educational Research Network. Permission is granted to reproduce these materials in whole or in part for educational purposes only (not for profit beyond the cost of reproduction) provided that the author and Network receive acknowledgment and this notice is included.