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Toilet
Training
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In
former times washing diapers was a tremendous chore so 9-12 months was
considered an appropriate age to start toilet training. At this age a
child does not understand what is expected and why. As a result, it was
the adult who learned to “read” the child and put the child
on the toilet at appropriate intervals in order to catch bowel movements
or urine. This required time and effort on the adult’s part. The
child’s role was fairly passive. With today’s disposable diapers,
diaper services, and automatic washers, it is easier to wait until the
child is physically capable of controlling sphincter muscles, intellectually
capable of understanding, and emotionally and psychologically ready to
master a new socially approved skill. This usually happens between 18
months (1 ½) and 30 months (2 ½). T. Berry Brazelton, M.D.,
the well-known pediatrician states that the average age for daytime control
is 28.5 months and the average age for nighttime control is 33.3 months.
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Signs
of Readiness
Physical
Readiness
- The
child has fully mastered walking and running, is able to sit down and
get up with ease, can easily get to the toilet, and has the dexterity
to get pants off and on.
- There
are clear signs of bladder control — the child is able to stay
dry for several hours, anticipate urination, and urinate a significant
amount at one time.
Emotional/Psychological
Readiness
- The
child is able to sit and play quietly for a period of time.
- Wants
to imitate adult behavior like brushing teeth and eating neatly.
- A
child is in a relatively cooperative period. Children around two alternate
between periods of negativism and cooperation. If the child is in an
oppositional period it is often best to wait for a more cooperative
time.
- Shows
interest in the toilet.
Instructional
Readiness
- The
child had displayed the ability to understand instructions and communicate
needs.
- The
child has mastered enough language to assign a word to the products
designated for the toilet. And understand what the potty is for.
- The
child seems to be aware of wetting or soiling diapers and perhaps even
be telling you that a diaper needs changing.
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Preparing
the Child
- Assign
words for urination and bowel movements. Use these words along with
“wet,” “dry,” “clean” and “messy.”
- Toilet
training is easier if your child prefers clean, dry diapers. This can
be encouraged by changing your child as soon as you notice it is needed.
- Buy
a potty chair (floor-level type) and place it in the bathroom. Let the
child know that it is his/her chair. If you use an inset for the adult
toilet, be sure to have a footstool the child’s feet can reach.
This gives the child leverage for pushing and a sense of security
- If
you are comfortable, have an “open door” policy where your
child observes adults using the toilet. Children who observe same sex
children close to their age using the toilet usually want to copy this
behavior. You can also allow the child to flush the toilet for you
- Buy
cotton training pants and plastic outer pants.
- For
older children introduce the concept of “being the boss.”
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How
to Proceed
- Select
a time to begin. If both parents work outside the home, a weekend when
nothing is planned is best.
- Tell
the child in a friendly way how proud you are of how he/she is growing
into such a big boy/girl. Then say something such as, “You’re
old enough now to how to put your pee in the toilet like big people
do. We’ll start today by having you wear training pants instead
of diapers.” It’s important to make toilet training the child’s
responsibility and for the parent to adopt a very casual attitude about
it.
- Switch
to training pants as they allow the child to know when he/she is wet
or messy. They are also uncomfortable when wet or dirty. This helps
the child to recognize when he/she has to go if this is something that
is not yet clear. Don’t forget the plastic outer pants!
- Once
you start using training pants, use diapers only for naps and nighttime.
Nighttime bladder control usually takes longer than daytime.
- Begin
making practice runs to the toilet about 20 minutes after the child
drinks or eats. Use the phrase, “Let’s try to use the toilet.”
If nothing happens after a few minutes, casually go on to other activities.
If the child is successful, say encouraging things such as, “Wow,
you’re using the toilet just like mommy and daddy. You’re
really becoming the boss of your pee/poop.” If the child has an
accident, respond nonchalantly with something such as, “Oh, oh.
Looks like the pee was boss. That’s O.K. I know you’ll learn
how to be the boss of it soon.”
- Some
authors suggest giving your child extra drinks to promote more opportunities
“to try.”
- Do
not yell, criticize or punish the child for accidents.
- Sometimes
running water while the child is sitting on the potty helps to promote
urination. Some parents buy special training pants with animals, flowers,
super-heros or something else that the child enjoys. The child is told
that these can be worn when he/she is able to use the toilet.
- If
you begin toilet training and do have positive results or if the child
is resistant, put the child back in diapers and wait few weeks to a
few months. Then repeat the above steps. You may simply have tried to
soon.
- Keep
in mind that toilet training done in the above manner is a natural process.
The parent’s role is to be an encourager.
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After
Toilet Training
After
successful toilet training, young children often have accidents. These
can be caused because the child becomes excited or frightened or because
the child was involved in some activity he/she did not want to stop. Until
the first grade, you will need to remind the child to try to go before
getting into the car or whenever you see him/her doing the “pee dance.”
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Bedwetting
- Bedwetting
(nocturnal enuresis) is common. By age 3, 50% wet their beds. By age
6, 10% wet their beds. By the age of 16 1-2% wet their beds. One study
found that 3% of U.S. soldiers wet their bed.
- Common
causes cited include: small bladder size, ‘irritable bladder’
(one which feels full and contracts before actual fullness has been
reached), deep sleeper, lack of hormone that restricts urine production
during the night.
- Common
treatment options: wetness alarm, delaying urination during the day
to increase bladder capacity, practicing stopping urine flow, urine
restriction drug (for older children and adults only).
- Good
resource: Dry All Night by Allison Mack
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