Most parents start thinking about potty training when their child is two-years-old. However, potty training can be a challenge at this age, especially if your child is still wetting his nappies every few hours. The best time to start is when your child is physically and emotionally ready.
The age at which your child achieves potty training success is not linked to intellect, so don’t feel pressured to start potty training just because your child has reached a certain age, or because of comments from relatives and friends.
Bowel control is usually achieved before bladder control, which is not surprising given the complexities of the developmental process. The development of bowel control is usually completed by the end of the third year, and that of bladder control by the fifth or sixth year.
Girls usually achieve bladder control before boys. However, by age three, bladder capacity and control has increased significantly, and most children will hold on and stay dry for a reasonable length of time. If your child is dry by day, there is a good chance of also being dry at night.
Some two-year-olds achieve partial bladder control during the day with relapses. By age four, most children achieve bladder control during the day and night (with relapses). By age 6, the majority of children are dry during the day and at night.
Some children achieve potty training success in days, but for most, potty training can take months and sometimes longer.
Unless there is an underlying illness, mental, physical or emotional problem, most children follow a similar path of readiness for potty training. However, changes or upsets such as moving house, the arrival of a new baby or starting pre-school, can throw them off target.
Potty training cues
The following may indicate that your child is ready for potty training:
- Becoming very still or stiffening.
- Shifting from one foot to the other.
- Telling you that his nappy is wet or soiled.
- Increasing gaps (e.g. 2 or more hours at a time) between wetting his nappy.
- Showing an interest in other people using the toilet.
- Closing the bathroom door.
- Asking to use the potty or the toilet.
- Following simple instructions, such as “Please fetch your potty.”
- Wanting to wear training pants or underwear.
Choose a time when there are few distractions or changes to your child’s routine and when you can devote your time to potty training. If your child is going through a non-cooperative stage, start potty training when his emotions and/or behaviour have settled down.
If possible, start potty training in the summer and remove his nappy during the day.
Motivators
Here are some tips to get the idea of potty training started:
- Go shopping and let your toddler chose a potty. If it’s a car, animal design or plays music, it is sure to please.
- If the potty is plain, decorate it with favourite animal or character stickers.
- Put a black sticker, which changes to a smiley face when your child has urinated, on the bottom of the potty.
- Leave the potty out so that it becomes a regular feature and can be easily spotted.
- Make the potty a fabulous place to be. Surround it with books and favourite toys.
- Read books to your child about potty training.
- Encourage your child to watch what you do, how you sit down, reach for the toilet paper, flush the toilet, and wash your hands.
- Encourage older children to use the potty and explain what they are doing.
- Use toileting words such as “Poo” and “Wee” to familiarise your child with them.
- Let your child sit on the potty with a nappy on before potty training starts.
If bowel movements are regular, leave the nappy off and encourage your child to sit on the potty. If nothing happens, praise your child for trying.
Avoid making a fuss if your child slips up. There is always another time. Getting angry or pressurising your child to use the potty will only close the door to successful potty training.
Getting started
- Ensure that your child’s clothes are easy to pull up and down.
- Place a favourite teddy on a separate potty for company. Encourage your child to reward the teddy with praise and hugs.
- Keep your child entertained on the potty with fun games, books and favourite toys.
- Keep to a regular potty training routine if possible. For example, after a nap or mealtime.
- Do not force your child to sit on the potty for long periods of time. A few minutes is usually long enough.
- If your child wants to get off the potty after a few moments, praise him for just for trying.
- Ensure that everyone who is involved with your child uses the same consistent approach to potty training.
Even if your child has only sat on the potty for a few moments, provide praise and affection or a ‘High Five’. Without doubt, they are the best motivators and rewards but do not go overboard since you could put too much pressure on your toddler, which could lead to constipation or other problems.
Rewards and incentives
Rewards and incentives will not guarantee that your child will use the potty but they can help. Ensure that rewards are given instantly when a step is achieved and not at random. Keep them instant, simple and manageable.
- Purchase special training pants or underwear together. This will help your child feel grown-up and important.
- Incentives such as stickers or coins to put in a piggy bank may provide encouragement but ensure that they are in good supply and readily available.
- Make up a fun potty training song or dance to share with your child when the potty has been used.
- Share the news with grandma or with someone special.
- Expensive treats are unnecessary and they may overwhelm your toddler.
- Avoid food rewards such as crisps or sweets because your toddler may come to rely on them.
- Avoid rewards that do not happen instantly, such as the promise of an outing or favourite book at bedtime.
All children have spontaneous bladder contractions, which are impossible to control, so your child may continue to have accidents six to twelve months after a regular potty training routine has been established. Try not to make a fuss if your child has an accident - it will only increase anxiety and stress.
Regression
If your child starts potty training enthusiastically but then refuses to sit on it, stay calm. Sooner or later, your child will want to be clean and dry but if it becomes a battle of wills, the process will be much harder. A relaxed, pressure-free attitude is more likely to bring about success than punishment.
If nothing works, then your child may not be emotionally or physically ready for potty training. Wait a month or so before trying again (false starts are very common). If you force your child to use the potty, it may become an object to be feared. Your child may then eliminate in an area that is quiet and out of sight.
If your child is engrossed in an activity or becomes excited, he may forget to use the potty. A personalised App or timer set every 45 minutes or a gentle reminder, may do the trick. If your child says “No”, then leave it a bit longer. Resist the temptation to ask your child if he needs to use the potty more frequently, since this could be irritating for both of you.
Potty (or toilet) refusal may be a symptom of constipation, which is a common problem. Constipation usually arises when stools are withheld to reduce pain on elimination. Withholding can set up a vicious cycle of faecal impaction, pain and more withholding. Ensure that your child drinks plenty of water, exercises regularly, eats high-fibre foods (fruits, vegetables, whole grains, and bran) and receives positive reinforcement.
Sitting on a potty, rather than the toilet, will also give your child leverage to push against the floor to eliminate stools. Blowing bubbles or a toy trumpet can also help to relax the bowel.
Toilet training
Some parents skip the potty and use the toilet to train their children. Providing the same techniques are used, most children will achieve success when they are physically and emotionally ready.
Top Tips from parents:
- Squirt shaving foam in the toilet bowl and encourage your child to aim towards it.
- Dye the toilet water with red or blue food colouring. Urine will change the colour to orange or green, which will become a source of fascination.
- Put your child on the toilet backwards, so that he can hold on to the seat.
- Use a toilet training seat (and footstool so he can reach the seat).
- Read a story to keep you and your child occupied while you wait.
- Encourage your child to flush the toilet when success has been achieved
- Let your child watch your usual routine, which includes handwashing. Provide a footstool so he can reach the sink and help him use soap and water. Reward handwashing behaviour with praise and a cuddle.
Staying dry at night
It can take two years or more for your child to become dry at night. Most children wet the bed up to the age of five or six, so expect frequent accidents and try to be patient.
Continued bedwetting over the age of five or six may be due to hereditary factors or to stressful events such as moving house, starting school, taking exams or a family bereavement. Treat it as a challenge that you can work on together rather than a problem.
Some children sleep very deeply, which makes it difficult for them to hold on overnight. Signals sent from the brain to urinate may not be strong enough to wake your child up during the night. Protect the bed with a waterproof sheet.
Restricting fluid before bedtime won’t speed up night time dryness, but fizzy or caffeinated drinks may stimulate the bladder into action. Encourage your child to use the toilet before going to bed, rather than picking him up when he is asleep. Dress your child in bedtime clothing that is easy to remove.
Further help
Talking to other parents experiencing the same problems or to your GP or health visitor can be helpful.
If your child has been clean and dry for some time, but has frequent accidents, a bladder infection, gastro-enteritis, constipation or threadworms may be responsible. Such problems can cause complications in potty training, and if untreated, may spiral into physical, behavioural and developmental problems that disrupt bowel and/or bladder control.
Children with encopresis (chronic faecal soiling at age 4 and older) may be unable to control their bowels. Evaluation and treatment are therefore important.
Celebrate
Celebrate potty training success! It is a fantastic achievement for your child, and also for you!
If accidents should occur, treat them as ‘one-offs’ and consider factors that might have triggered them.
Useful websites
How to potty train - NHS (www.nhs.uk) - https://www.nhs.uk/conditions/baby/babys-development/potty-training-and-bedwetting/how-to-potty-train/
Top 10 potty training tips | ERIC - https://www.eric.org.uk/top-10-potty-training-tips
