Toilet training tips
Potty training
Learning how to use the toilet is a big milestone in your child's life. You'll make the process easier for everyone if you wait until your child is ready before attempting to toilet train. A dose of patience and a sense of humor also help.
When to Start Training
Most children start to show signs that they are ready for toilet training between ages 18 and 30 months. Before 18 months, most children can't fully control their bladder and bowel muscles. Your child will let you know in their own way that they are ready to start toilet training. Children are ready when they:
- Show interest in the toilet or in wearing underpants
- Express through words or expressions that they need to go to the bathroom
- Hint that the diaper is wet or dirty
- Feel uncomfortable if the diaper gets dirty and try to remove it without help
- Stay dry for at least 2 hours during the day
- Can pull down their pants and pull them back up
- Can understand and follow basic instructions
It's a good idea to choose a time when you don't have other major events planned, such as a vacation, a big move, or a work project that will require extra time from you.
Don't push your child to learn too quickly. If your child feels pressure to potty train before they are ready, it may take longer for them to learn. If your child resists the training, it means they aren't ready yet. So back off and wait a few weeks before trying again.
Getting Ready
To start potty training you will need to:
- Buy a training potty seat and potty chair - you may need more than one if you have bathrooms or play areas on different levels of the house.
- Place the potty chair near your child's play area so they can see and touch it.
- Establish a routine. Once a day, have your child sit on the potty fully clothed. Never force them to sit on it, and let them get off it when they want to.
- Once they are comfortable sitting on the chair, have them sit on it without diapers and pants. Show them how to pull down their pants before getting on the potty.
- Children learn by watching others. Let your child watch you or their siblings use the toilet and let them practice flushing it.
- Help your child know how to talk about the bathroom using simple terms like "poop" and "pee."
- Children typically will have a bowel movement after a meal. Encouraging your child sit on the potty seat or toilet after a meal can sometimes increase the likelihood of having success with stool toilet training.
Teaching Your Child to Use the Toilet
Once your child is comfortable sitting on the potty chair without diapers, you can start to show them how to use it.
- Put stool from their diaper into the potty chair.
- Have them watch while you transfer the stool from the potty chair into the toilet.
- Have them flush the toilet and watch as it flushes. This will help them learn that the toilet is where poop goes.
- Be alert for when your child signals that they might need to use the toilet. Take your child to the potty quickly and praise your child for telling you.
- Teach your child to stop what they are doing and go to the potty when they feel like they need to go to the bathroom.
- Stay with your child when they are sitting on the potty. Reading a book or talking to them may help them relax.
- Teach your child to wipe themselves after passing stool. Teach girls to wipe from front to back to help prevent stool from getting near the vagina.
- Be sure your child washes their hands properly every time after using the toilet.
- Praise your child every time they go to the toilet, even if all they do is sit there. Your goal is to help them connect the feelings of needing to go to the bathroom with going to the toilet and using it.
- Once your child has learned how to use the toilet pretty regularly, you may want to try using pull-up training pants. That way your child can get in and out of them without help.
Most children take about 3 to 6 months to learn how to use the toilet. Girls usually learn to use the toilet faster than boys. Children commonly remain in diapers until about age 2 to 3 years old.
Even after staying dry during the day, most children need more time to be able to sleep through the night without wetting the bed. This is the last stage of toilet training. It's a good idea to get a water-proof mattress pad while your child learns nighttime control.
Bedwetting affects over 5 million children in the United States over the age of 5 or 6. Before the age of 5 or 6, it's total normal for kids not to be dry totally at night. But once you reach 5 or 6, we call it bedwetting or enuresis. And unless you do something to intervene, there's a good chance it will still be there next year. In fact if you're over age 6 and you're bedwetting today, there's an 85% chance you'll still be bedwetting next year on this day unless you do something. I'm Dr. Alan Greene and I what to share with you something you can do. But first, you have to understand a little bit about what causes bedwetting. Children who wet the bed have 2 things in common. One is that they make more urine at night than their bladder will automatically hold. And 2, these children don't wake up when there's a signal from the bladder saying that it's full. There's lot of kids who don't wake up, who don't wet the bed because their bladders don't get so full. Lots of kids whose bladders get pretty full but don't wet the bed because they wake up fine. Bedwetters are the ones who do both. So one of the most powerful ways to break-in and to change that cycle is to teach kids to wake up at that moment when the bladder gets full. And bedwetting alarms are a great way to do it. Here is 1 model of one. It comes in 2 pieces. There is an alarm unit. Has a cool little magnet on the back that snaps in. Kids like to play with the magnet. And you put it in the pajamas up kind of near their head. The other end is an alligator clip that clips to the bottom part of the pajamas. And it's got a moisture sensor in it. This paper towel has a little bit of water on it like simulated pajamas. (Alarm ringing) And the alarm starts going off at the first sign of moisture. I'll turn that off so you don't have to put up with that while we finish talking about this. Hopefully. There we go. So what happens then is that the first sign of moisture, the alarm goes off. You can get varying volumes of alarms. Some as loud as a smoke alarm. But often the child will not wake up. Somebody else needs to wake them up. They will instantly clench up and stop peeing at the first few drops, which helps the laundry issue right away. But they need somebody else to come in, walk them to the bathroom. And they won't recognize you. They'll be in the middle of sleep, but they'll recognize the toilet and finish going. After a couple of weeks, kids will start to wake up with the alarm. After a few more weeks, they'll start to wake up just before the alarm. That signal that the bladder is getting full gets through to them. And a few more weeks, many of them won't wake up at all. The signal will make it up to the brain. It will send a signal back down to the bladder to hold it in for the rest of the night and be completely dry. It often takes 12 weeks, though. The 2 biggest complaints that I hear from people when they've starting using the alarm is they'll say, My child doesn't wake up. And that's normal. Bedwetters are very deep sleepers. In fact it often works better for those who don't wake up themselves to the alarm. The second big complaint I hear is, I've done it for 2 weeks and they're still bedwetting. It takes longer than 2 weeks. It often takes 6 weeks and sometimes even as long as 12 weeks. But it's a very effective way to do it.
Accidents Will Happen
Expect that your child will have accidents as they learn to use the toilet. It's just part of the process. Sometimes, even after the training, accidents may occur during the daytime too.
When these events occur it's important to:
- Stay calm.
- Clean up and gently remind your child to use the toilet the next time. Never scold your child.
- Reassure your child if they get upset.
To prevent such events you can:
- Ask your child from time to time if they want to go to toilet. Most children need to go about an hour or so after a meal or after drinking a lot of fluids.
- Get absorbent underwear for your child if they have frequent accidents.
When to Call the Doctor
Contact the doctor if your child:
- Has been potty trained earlier but is having more accidents now
- Does not use the toilet even after 4 years of age
- Has pain with urination or stools
- Often has wetting issues -- this could be a sign of a urinary infection
References
American Academy of Pediatrics, healtychildren.org website. Create a potty training plan for your child.
American Academy of Pediatrics, healthychildren.org website. Toilet training and the older child.
Elder JS. Enuresis and voiding dysfunction. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 558.
Version Info
Last reviewed on: 10/22/2022
Reviewed by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
