TOILET-TRAINING BASICS
DEFINITION
Your child is toilet trained when, without any reminders, he walks to the potty, undresses, urinates or has a bowel movement, and pulls up his pants. Some
children will learn to control their bladders first; others will start with bowel control. Both kinds of control can be worked on simultaneously. Bladder control
through the night normally happens several years later than daytime control. The gradual type of toilet training discussed here can usually be completed in 2
weeks to 2 months.

TOILET-TRAINING READINESS
Don't begin training until your child is clearly ready. Readiness doesn't just happen; it involves concepts and skills you can begin teaching your child at 12 months of age. Reading some of the special toilet learning books to your child can help. Most children can be made ready for toilet training by 24 months of age and many by 18 months. By the time your child is 3 years old, he will probably have trained himself.

The following signs indicate that your child is ready.

  • Your child understands what "pee," "poop," "dry," "wet," "clean," "messy," and "potty" mean. (Teach him these words.)
  • Your child understands what the potty is for. (Teach this by having your child watch parents, older siblings, and children near his age use the toilet correctly.)
  • Your child prefers dry, clean diapers. (Change your child frequently to encourage this preference.)
  • Your child likes to be changed. (As soon as he is able to walk, teach him to come to you immediately whenever he is wet or dirty. Praise him for coming to you for a change.)
  • Your child understands the connection between dry pants and using the potty.
  • Your child can recognize the feeling of a full bladder and the urge to have a bowel movement; that is, he paces, jumps up and down, holds his genitals, pulls at his jeans, squats down, or tells you. (Clarify for him: "The poop [or pee] wants to come out. It needs your help.")
  • Your child has the ability to briefly postpone urinating or having a bowel movement. He may go off by himself and come back wet or soiled, or he may wake up from naps dry.

METHOD FOR TOILET TRAINING
The way to train your child is to offer encouragement and praise, be patient, and make the process fun. Avoid any pressure or punishment. Your child must feel in control of the process.

1. Buy supplies.

  • Potty chair (floor-level type). If your child's feet can reach the floor while he sits on the potty, he has leverage for pushing and a sense of security. He also can get on and off whenever he wants to.
  • Favorite treats (such as fruit slices, raisins, animal crackers, and cookies) for rewards.
  • Stickers or stars for rewards.

2. Make the potty chair one of your child's favorite possessions. Several weeks before you plan to begin toilet training, take your child with you to buy a potty chair. Make it clear that this is your child's own special chair. Have your child help you put his name on it. Allow your child to decorate it or even paint it a different color. Then have your child sit on it fully clothed until he is comfortable with using it as a chair. Have your child use it while watching TV, eating snacks, playing games, or looking at books. Keep it in the room in which your child usually plays. Only after your child clearly has good feelings toward the potty chair (after at least 1week), proceed to actual toilet training.

3. Encourage practice runs on the potty. Do a practice run whenever your child gives a signal that looks promising, such as a certain facial expression, grunting, holding the genital area, pulling at his pants, pacing, squatting, squirming, or passing gas. Other good times are after naps or 20 minutes after meals. Say encouragingly, "The poop [or pee] wants to come out. Let's use the potty."

Encourage your child to walk to the potty and sit there with his diapers or pants off. Your child can then be told, "Try to go pee-pee in the potty." If your child is
reluctant to cooperate, he can be encouraged to sit on the potty by doing something fun; for example, you might read a story. If your child wants to get
up after 1 minute of encouragement, let him get up. Never force your child to sit there. Never physically hold your child there or strap him in. Even if your child seems to be enjoying it, end each session after 5 minutes unless something is happening.

4. Praise or reward your child for cooperation or any success. All cooperation with these practice sessions should be praised. For example, you might say, "You are sitting on the potty just like Mommy," or "You're trying real hard to put the pee-pee in the potty." If your child urinates into the potty, he can be rewarded with treats or stickers, as well as praise and hugs. Although a sense of accomplishment
is enough for some children, others need treats to stay focused. Big rewards (such as going to the ice cream store) should be reserved for when your child walks over to the potty on his own and uses it or asks to go there with you and then uses
it. Once your child uses the potty by himself two or more times, you can stop the practice runs. For the following week, continue to praise your child frequently for dryness and using the potty. (Note: Practice runs and reminders should not be necessary for more than 1 or 2 months.)

Instructions for Pediatric Patients, 2nd Edition, ©1999 by WB Saunders Company.
Written by Barton D. Schmitt, MD, pediatrician and author of Your Child's Health, Bantam Books, a book for parents.
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