New thoughts on potty training

More and more children every year start school wearing nappies.  The advice of when and how to potty train is being debated.  Parents are getting conflicting advice: you must start potty training before two; children do it themselves when they are ready. Growing evidence, currently anecdotal but significant is suggesting two things:

1 Children need to be prepared for potty training; suddenly introducing a potty and pants at 2-3 years doesn't seem to be working

2 There is no evidence that potty training early does damage.

Children in real nappies tend to potty train earlier but it's not automatic. Some intervention as described below is necessary, especially for first-borns.

There is no set age for your child to potty/toilet train. Every child is different. The most important thing is to prepare your child. Then they can develop an interest and you can read the signs to see when they are ready for you to take away daytime nappies.

We don't delay cleaning our child's teeth until they can do it themselves. We start to clean their teeth as soon as the teeth come through, right? It's the same for toilet training. Teaching your child about pee and poo from an early age is important preparation. (This tends to be most important for the first-born who don't have older siblings as role models.) It means that when the time for potty training arrives (ie removing nappies during the day and using cotton pants - all day, every day) the process will be quicker and easier.

It's also important to note that control of bowels, control of bladder and staying dry at night are 3 different things. They tend to happen at different times. Children can be clean by one, dry by 18 months and dry at night around three. But it depends on the child - and possibly more importantly, you giving your child the stimulation and awareness to show you s/he is ready.

How do we prepare for toilet/potty training?

Always talk about poo and pee in a positive way - "Lovely poo, well done"

Talk about poo and pee. If your child wears cotton nappies talk about when the nappy is wet and when it is dry.

Get a potty. Your child can sit on a potty from an early age. Encourage your child to sit on the potty ONCE a day (if possible when you expect a poo) for a short time (a couple of minutes as a guide). It should be a relaxing time. Nothing needs to happen but if a poo or pee comes give praise to show this is what the potty is for. Warning: don't go overboard with the praise or it will be overwhelming for the child - although the prospect of you child coming out of nappies may be incredibly thrilling to you!

Open door policy: let your child see you on the toilet.

Visit the library and borrow different books about using the potty.

Create a game with your child about helping a teddy or doll to use the potty, praising teddy or dolly when they do a pee or poo on the pot and keep their pants dry. Get your child to role play being the teddy or doll and repeat the steps to you.

Visit a home where there are children of a similar age who use the loo and encourage your child to take an interest.

When to potty train ie when to help your child stop wearing nappies during the day?

If you do this preparation your child is highly likely to show an interest - letting you know a nappy is wet or poo is coming.

The act of toilet training has been found to help the bladder develop so current thinking is that we do not wait until the child can stay dry for 2 hours

Your child may already be using the potty/toilet for poos


How to start Potty/Toilet Training?

Choose a time when your child is showing an interest in the potty and you can spend some time together. Set aside a few days to spend mostly at home and devote the time to helping your child develop this skill. Prepare your child for what is going to happen - that s/he is going to stop wearing nappies during the day.

Tell your child that s/he is only going to wear pants from now on during the day and will only wear a nappy at night.

Make it exciting. Go on a special shopping trip with your child to buy some cotton pants. If your child is going to use the toilet straight away get a step and a special seat too.

For the first few days encourage her/him to sit on the potty/toilet every few hours - about half an hour after a drink. But make sure s/he knows that s/he can also tell you if s/he needs to go, and that you'll accompany her/him whenever s/he wants you to.

Some toddlers won't sit on the potty long enough to relax and let anything come out. Calmly encourage her/him to sit there for at least a minute or so. Stay with her/him and talk calmly, or read a story. It's best to start boys off with sitting too. Peeing standing up can be learned later.

When your toddler uses the potty successfully, give her/him lots of praise, though don't go too overboard, as s/he may find too much fuss overwhelming. Even if s/he continues to have accidents, s/he'll then start to grasp that getting something in the potty is an accomplishment.

When you think your child is ready stop reminding her/him to use the potty/toilet. There may be a few accidents but your child does need to get the feeling of when s/he needs to go to the toilet him/herself. 

What do we do when we go out?
Once this process has started be consistent. Stick with it and don't go back to nappies. When you go out you may need a portable toilet so s/he can use it. Choose to spend time at a park with toddler toilets (such as Coram's Fields) or a drop-in with small toilets so that your child will see 'big' boys and 'big' girls going to the loo.


What if there is no progress?
If you feel that your child is not ready after all go back to nappies and try again when your child shows an interest. This process takes co-operation. Your child should be an active participant. Be consistent in whatever seems right for your child.

What about night training?
Most children become dry at night within 6 months or so of becoming dry in the day but up to 20% will still wet at age 5 years. If so parents need to speak with their school nurse or GP re appropriate treatment to help their child become dry.

What about children with special needs?
Having special needs does not mean that your child cannot become toilet trained. Get expert advice
PromoCon
Disabled Living
Tel: 0161 607 8219
Email: promocon@disabledliving.co.uk
Website: www.promocon.co.uk
PromoCon, working as part of Disabled Living Manchester,
provides impartial advice and information regarding a whole
range of products, such as musical potties and other toilet
training equipment and swimwear and washable trainer pants
for children who have delayed toilet training.
Information is also available regarding which services and
resources are available for both children and adults with bowel
and/or bladder problems



If you're interested in your child developing bowel and bladder control from an early age have a look at this post on Elimination Communication. In particular see comments from parents who have experience of this method.


Help needed
This advice is based on listening to parents, health visitors and paediatric continence professionals over the last 15 years.  Comments on this draft welcome!







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