Laura J. Martin, MD
Amanda Ezman, 31, of Oneida, N.Y. started potty training her daughter, Lilah, just a few months shy of her third birthday. Lilah was finally curious about the bathroom, and showing all the right signs that she was ready to start going like a “big girl.” Also, she was getting ready to move to a new day care facility, and potty training was a goal her parents wanted her to reach.
“We waited until we thought Lilah was ready,” Ezman says. “So when we did start, it went pretty smoothly -- she really wanted to learn how to use the potty like some of her friends who had already been potty trained, and after just a few tries, she started using the bathroom pretty consistently.”
Potty training is a skill all parents must help their little ones master. From timing the transition to the toilet to accidents and the occasional wet sheet at night, here are common problems moms and dads face, as well as tips and tricks from the experts that will help you and your child finally reach this major milestone.
A common question parents of preschoolers ask themselves is, Should my child be potty trained by now?
“The average age at which a child will start to show interest in learning to potty train is around 2 years, but it’s a bell shaped curve -- some will go earlier and others not until 3 or even 4,” says Mark Wolraich, MD, the CMRI/Shaun Walters professor of pediatrics at the University of Oklahoma Health Sciences Center.
While you and your child are busy preparing for preschool, her mind and body are growing and developing. Jenn Berman, PhD, family psychologist and author of SuperBaby: 12 Ways to Give Your Child a Headstart in the First 3 Years, says in order to tackle the toilet, watch for these signs that she is really ready:
Mentally. A child’s brain has to be able to receive the full bladder message, and the child has to be mature enough to know to hold his pee and poop in until he gets to a toilet, Berman says. The child also needs to understand the connection between the urge to pee and poop and the potty chair. Although this generally occurs between ages 18-22 months, it just happens later for some kids, as they get closer to approaching preschool age.
Physically. The child needs to be able to climb up onto the toilet by using a stool and with a hand from mom or dad. He needs to know to stop playing, and stay focused until he gets to the toilet. The child also must have the motor skills necessary to take off his clothes, and then relax and go.
Developmentally. A child needs to be ready for autonomy and say, “I want to do this myself,” Berman says. She needs to be independent enough to take care of her own potty needs.
Socially. A child needs to be aware that others are using the toilet and want to imitate that behavior, which can happen once they hit preschool and why sometimes, a second child may learn faster than her first-born sibling.
When a child has developed enough to reach these milestones, it's up to the parents to watch for signs that their little one is ready for the next step.
Generally, your kids will offer you subtle -- and not so subtle -- clues that they are ready and willing to start the process of potty training. Your job is to make sure you notice them.
When your privacy goes out the window. If your child is constantly asking to go to the bathroom with you -- let him. Showing him how it’s done is part of the process of learning, Wolraich says.
Verbal clues. Does your daughter tell you before she’s going pee or poop? This is an obvious clue. Use it to your advantage and let your child use the bathroom instead of a diaper, suggests Wolraich, who is also the editor of the American Academy of Pediatrics Guide to Toilet Training. If she tells you after, start talking to her about telling you before she needs to go.
Non-verbal clues. Usually when a child is getting ready to go to pee or have a bowel movement in a diaper they look for some privacy, or quiet down as they get ready to go. This is a sign parents have to watch for and anticipate.
Gender isn’t always a clue. Although many parents think girls may have a slight edge in terms of timing, that’s not always the case. Parents shouldn’t fall into the trap of waiting until their child hits a certain age to start, regardless if their child is a boy or a girl, Berman says. If your child is shows and says he’s ready, get out the toilet training seat.
Like every skill a preschooler tries to master, this one takes time. For parents, staying positive and keeping your eye on the prize -- no more diapers! -- is the trick. Here are tips from experts and a mom whose child recently conquered potty training:
Positive reinforcement. Reinforce when your child is successful each and every time she uses the bathroom, but never punish when she’s not, Berman says.
Be consistent. Create a regular schedule throughout the day when you can give your child some time on the toilet, suggests Wolraich, such as when he gets up in the morning, before preschool starts if he attends in the morning, when he gets home, before dinner, and before bath and bedtime. Also, talk to your child’s preschool teachers so they can help with the process. They’ve probably been through this before with other children, and can offer some support.
Be patient. Understand that this will be a time commitment for parents and caregivers that you need to commit to -- each trip to the bathroom could be several minutes, Wolraich says. But keep in mind that if your child says he’s done, he’s done, even if he hasn’t gone yet. You can wait and try again later when your child is ready and willing.
Stay calm. “The biggest mistake I see parents making is to worry,” Wolraich says. “They think that if their child is not trained by a certain age it’s going to be a problem or going to be a reflection on them as parents.” Almost all kids eventually learn to use the bathroom, so relax, stay calm, don’t waste time worrying, and enjoy and celebrate the achievement when it happens.
Don’t give up. Once you start, don’t stop. “It can be really frustrating,” Ezman says. “Especially when they have accidents after a period of doing well. But you have to hang in there and be positive -- don’t go back to diapers or you are just setting your child back.”
Diapers be gone. “A couple of weeks into potty training, just throw out your diapers,” Ezman says. “Otherwise you’re using them as a crutch and it will just prolong the process.”
Despite your best efforts, potty training can have its setbacks, and it’s during these pitfalls that parents panic the most. Before you reach for the diaper bag, here are the most common challenges potty training preschoolers and parents face.
Bedwetting. It’s normal. Kids, especially younger kids, are deep sleepers, and they can easily sleep through the urge to go to the bathroom. So use nighttime pull-ups until they are fully potty trained, and don't panic if it takes until they are 4 or even 5 to make it through the night.
Accidents will happen. Just anticipate that accidents are part of the process -- it’s a given. If your child has an accident, tell her it’s OK and ask her to help you clean up -- a nonpunishing way for her to understand what’s happened, Wolraich suggests.
Regression. For kids who have a major life event -- her family moves, a new baby comes into the house, or her parents separate -- potty training regression can happen, Wolraich notes. In these situations, they might have lost the attention of their parents, so regression helps put them back in the spotlight. Or, the child’s stress is too overwhelming and the skills she’s mastered in the bathroom take a back seat. So as a parent, you need to be patient and continue working with your child on potty training -- it’s that simple.
The process of potty training can take anywhere from a few days and weeks, or a few months or longer. Although the time it takes a child to master toilet training skills and the age at which it happens varies, it’s the process that is important.
“It’s going to go from a few successes to a period of accidents then more consistent success and then finally to the point of accomplishment,” Wolraich says. “Relax and enjoy your child’s success and be there to help enable their development.”
SOURCES:Jenn Berman, PhD, author, SuperBaby: 12 Ways to Give Your Child a Headstart in the First 3 Years, Beverly Hills, Calif.Amanda Ezman, Oneida, N.Y.Mark Wolraich, MD, professor of pediatrics,University of Oklahoma Health Sciences Center, Oklahoma City.
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