What should I know about Toilet Training?
[mme_highlight] Toilet training is a milestone in children development and for many parents it is a challenge. You should look for signs in your child which may indicate she/he is ready for toilet training. Do not push your child into potty training. Give positive reinforcement and rewards for each step completed in the process. [mme_highlight]
Toilet training is a milestone in children development and for many parents it is a challenge with difficulties in the way. Knowing if a child is ready to initiate toilet training and doing it with the required time and patience are not always easy to balance. The ultimate goal is a positive toilet training experience without punishment or too much pressure both for children and parents.
When should Toilet training be initiated?
There is no right or specific time to begin toilet training. However, there has been consensus that it the period between 18 months and 2.5 years seems the most adequate. There has been a major change in toilet training in the last 60 years.
The data shown below is from a population survey and indicates that the age at which toilet training began has been significantly postponed, suggesting more awareness and information on this subject among parents and caregivers.
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Population Survey on Toilet Training
“When did you begin toilet training (TT) your child?”
Respondents were divided into groups by age:
Group 1: > 60 years of age; Group 2: 40 to 60 years of age; Group 3: < 40 years of age.
| Group 1 | Group 2 | Group 3 | |
|---|---|---|---|
| Daytime TT < 18 months | 88% | 50% | 22% |
| Nightime TT < 18 months | 43% | 13% | 5% |
(Belgium Survey – 812 replies completed by 320 people)
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How do I know if my child is ready for toilet training?
To know if your child is ready to begin toilet training, the best option is to seek medical advice. Your health care provider will help you understand this, according to the achievements of your child regarding the other developmental milestones.
You should look for signs in your child which may indicate she/he is ready for toilet training:
- If your child walks confidently;
- If your child tries to imitate other people’s behavior;
- If your child starts trying to express the need to go to the bathroom;
- If your child is able to pull down and pull up pants and clothes;
- If your child starts being more independent;
- If your child shows direct interest in toilet training.
Parents have their role in influencing their children’s readiness for toilet training, not forcing or pushing their children directly into it, but giving encouragement and positive reinforcement. In addition, parents should find the right time both for them and children. Moments of changes or new milestones in life are not recommended to initiate toilet training (eg., moving into a new house, enrolling a new school, having a sibling).
What can I do to make toilet training easier?
Articulation between parents and caregivers
First of all, toilet training should be a commitment, not only for parents but also integrating the other caregivers or family members with whom children stays during the day. It is important that everyone is on the same page regarding potty training.
A pleasant moment
Parents should try to transform the moment for toilet training into a pleasant experience. If you can, let your child choose the potty in the store and make all the efforts so that she/he feels the potty is her/his propriety.
The color of it should be appealing and you may let your child put some stickers on it as a reward after that moment of toilet training is finished, as a reward for being on potty, even if there is not urine or stools in it.
You may put the potty wherever the child feels more comfortable in the house. Another tip is to put the potty next to you when you are using the bathroom, which can motivate your child to imitate you.
The correct time
Try to do toilet training at times with higher probability of bowel movements: when the child awakes or after meals.
The sequence matters
Try to make clear to your child that toilet training obeys a sequence, which you too should demonstrate: going to the toilet, undressing, wiping, dressing, flushing and, finally, washing hands. Note also that the flushing sound may frighten some children; make a joke of it, like saying “bye bye”.
The appropriate diet
During toilet training, you should pay closer attention to your child’s diet, which should be high in fiber. This will help soften stools. Hard stools are generally painful and difficult to pass, which can be a step backwards in toilet training.
Take your time
You can start toilet training with the child sitting in the potty dressed; parents can then put the stools from the diaper to the potty, to show children where it should be. Progressively, put your child undressed in the potty.
In addition, if pressure rises for both sides, it is wise to stop potty training for a while, like 2 to 3 months.
When will toilet training be completed?
Each child is different, but generally boys take longer. By 36 months the majority of children present daytime continence.
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Achievement of Continence by Children (United States)
- 26% achieve daytime continence by 24 months
- 85% achieve daytime continence by 30 months
- 98% achieve daytime continence by 36 months
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Summary and Recommendations
- Toilet training is an important developmental milestone.
- Before starting toilet training, assess your child’s readiness; your doctor may help you in this.
- Do not push your child into potty training. Give positive reinforcement and rewards for each step completed in the process.
- The success of toilet training is not related with your child’s intelligence or character (do not think your child is lazy just because she/he is taking a while to learn toilet training).
- If your child is older than 7 years old and has not achieved continence, seek for medical help.
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References
- American Academy of Pediatrics.Toilet Training. Guidelines for Parents. Elk Grove Village, Il: AAP; 1998.
- Stadtler AC, Gorski PA, Brazelton TB. Toilet training methods, clinical interventions, and recommendations. American Academy of Pediatrics. Pediatrics 1999;103:1359-61.
- Brazelton TB. A child-oriented approach to toilet training. 1962;29:121–128.
- Bakker E, Wyndaele JJ. Changes in the toilet training of children during the last 60 years: the cause of an increase in lower urinary tract dysfunction? BJU Int 2000; 86:248.
- Horn IB, Brenner R, Rao M, Cheng TL. Beliefs about the appropriate age for initiating toilet training: are there racial and socioeconomic differences? J Pediatr 2006; 149:165.
- Parker, S, Sices, L. Toilet training. In: The Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics for Primary Care, 3rd ed, Augustyn, M, Zuckerman, B, Caronna, EB (Eds), Lippincott Williams & Wilkins, Philadelphia 2011. p.393.
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