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Ask Dr. Sue
POTTY TRAINING
Dr. Sue,
My friend just dropped off her child's old potty chair
for my 18 month old son. I took it out of the box
and set it up, and then suddenly realized I really don't
have a clue about what to do next. How do you get
this potty training business started?
Dear Mom,
The first thing you need to be certain of is whether
your son is physically and emotionally ready to start
the process of toilet training. Some children are
ready at 18 months, and some aren't ready until much
later. You also want to start the process at a time
where there aren't a lot of external stresses in his
life; don't begin if you are moving or have just moved,
if you have or will soon have a new baby, or if there
has been a recent major illness or death in the family.
Next, look for signs of readiness:
-
Your child can sit down and play
quietly for at least 5 minutes.
-
He can help to dress and undress
himself, and can easily walk to and from the
bathroom.
-
He can follow simple instructions.
-
His bowel movements are fairly
predictable, and he lets you know he is having one,
(either in words or by posture or facial
expression).
-
He stays dry about two hours at a
time and/or wakes up dry from his naps.
-
He can hold his bowel movements for a
little while (for example, if he finds a corner or
hides behind the couch before he grunts, he must be
holding it long enough to get there).
-
It also helps if your child has a
name for urine and bowel movements and that he is
willing to admit when his diaper is dirty (he may
not be able to feel that it is wet if you are using
disposable diapers).
-
He wants to please you and is happy
when praised.
-
He acts like he is bothered by dirty
diapers.
If your son displays most of these
readiness signs you are ready to start toilet training.
Remember that acquiring this skill will be a gradual
process, and there is no way that you can control your
son's urination or bowel movements! Do not let it
become a power struggle, since it is not one that you
will win. Do not have any preconceived ideas about
how long it should take your son to achieve dryness.
He'll get there when he is ready, and not before.
The first step in toilet training is letting your son
become familiar with his new chair. Let him keep
it in a central area, like the living room or family
room, and let him sit on it fully clothed as often as he
wants. Once he is very comfortable with the chair,
you can let him sit on it once a day unclothed; before
or after his bath is logical. This is a convenient
time to move the chair to the bathroom. If he
accidentally has a bowel movement or urinates in the
potty, praise him! Gradually increase the number
of times per day he is on the potty with his pants down.
You could have him sit on it before and after naps,
after each meal or snack, and before bed, as well as at
bath time. At the same time, allow him to watch
others in the bathroom, using the toilet.
Teach him words to use for urine and bowel movements,
and begin to help him recognize when he is soiling his
diaper, using the words you prefer. Be sure to use
words that you won't mind having shouted at the grocery
store. Never use words like yucky or nasty to
describe his productions; treat waste products in a
matter-of-fact way. When you see him grunting,
with a red face, you could say "Are you pooping?
We'll get you a new diaper and flush that poop in the
toilet."
If weeks go by and he has still not had a bowel movement
in his potty chair, it helps for him to watch you dump
the bowel movement from the diaper into the potty chair,
saying "look, the poop is in the potty chair! Good
job! That's where it goes!" He can then help
you dump it from the potty chair into the toilet and
help flush it away, as long as flushing the toilet is
rewarding and not frightening for him.
Next you can begin to ask him to tell you when he is "poopy"
and if he does tell you, praise him for being such a big
boy. Once he has done this several times, tell him
that you want to know BEFORE he goes poop, and keep
reminding him of that. This step may take quite
awhile, so be patient. When he does begin telling
you that he is about to go, help him get to the
bathroom, but don't rush him there in a panic-stricken
way (remember, this is to be a pleasant process)!
Reward him for every positive action, even if its not
the one you wanted; if he remembers to tell you but is
soiled when you get to the bathroom, praise him for
telling you and say something positive, like "I'll bet
next time you get the poopoo into the potty chair
yourself."
If he has an accident, treat it lightly and don't scold
or complain. Any time he wants to sit on the potty, take
him there, even though most times will be unproductive.
Praise him for sitting there each time.
Once he has had a number of successes in the potty
chair, you can start using training pants. I
recommend the old-fashioned cotton training pants, since
I feel it is difficult for children to tell the
difference between disposable training pants and
diapers, and since it can be hard for them to tell when
they are wet in the disposables. Whichever you
choose, continue to have your child sit on the potty
frequently during the day, and praise him even if he
just sits there. Praise him more if he
successfully goes!
Continue to be very matter-of-fact about accidents,
which may occur for many
weeks yet. Control of urine usually comes after
control of bowel movements. Keep talking about how
big boys go pee in the toilet, and reward him when he
does. Nighttime control often comes many months
after daytime control, so use a nighttime diaper or
training pants until he is nearly always dry when he
wakes up.
The final chore is to teach him to take over the rest of
toileting, including getting his pants back up, wiping
(though most children need help with this until they are
at least three), and washing his hands. Remember, if you
face major resistance at any step in this process, is it
best to drop the whole program for awhile and resume
later. You will not win a power struggle, so don't
even let one begin.
 
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