A Pediatrician’s Guide to Potty Training

The Problem:

One of the most frustrating and exasperating experiences of parenthood is the socialization process of potty training their children. This is a function unique to human beings and distinguishes the very first level of independence for both the child and the parent who now is no longer tied to the ever present diaper bag. Somewhere along the way, the thought of having a child not yet potty trained by the age of eighteen months or even younger has been viewed as being an “abnormal” developmental milestone and poor parenting performance. I’m not sure exactly how this occurred, but conversely, a child potty trained at an early age demands respect for potty-training success :)him/her and his/her parents. Of course the non-need for diapers is a well deserved and less expensive rest for parents who have been struggling through the “diaper game” for at least the past year. But, just as children acquire speech at different ages, walk at different times, get their teeth in different order, so it is that not all children are emotionally or physically able to be toilet trained at the same age. There is a wide range of “normal variability” and parents need to understand that, contrary to what they are told by “friends” whose children were toilet trained at a young age, their child may not be ready yet.

As usual, there are a lot of brain neurons and cells that need to make the correct connections in order to coordinate “complicated” functions. This takes time and may be the deciding factor in determining when to begin the process of toilet training. We have all heard stories from well meaning and bragging parents who claim to have toilet trained their children by the age of one year old; and this may very well have been the case in one particular circumstance- perhaps by chance- but it certainly does not represent the norm. More parents who attempt to toilet train their young toddlers find it to be a very frustrating experience, fraught with feelings of guilt over their inability to complete their mission at this time.

The Fix:

There are many formulae for both rapid and slow methods of potty training a child. I have found through the years that a relatively simple and guilt free approach is the best. This is what works for me:

  1. Do not attempt much of an effort prior to the age of two years old. It could even wait longer depending on the societal pressure a parent feels.
  2. When your child is “ready”, sit him/her on the potty seat for about 1 minute per day with his/her clothes on, hopefully at the time of day your child has a bowel movement.
  3. Be sure that the child’s feet are not dangling in the air but are given a platform from which to “push off”. Use of the correct muscles for defecation requires a solid base.
  4. If your child is fearful of just sitting on the potty, back off and try again a month later.
  5. Once your child is comfortable sitting fully clothed on the potty seat for a minute a day over a 2 week period of time , take his/her clothes off and begin again one minute a day (around the time of bowel movements) until he/she is comfortable.
  6. At this point take all his/her clothes off and do the process all over again.
  7. Reward your child with something of “value” just for the process of getting on the potty, not for only a productive visit.
  8. At this point let him/her follow you (and other cooperative family members) around to the bathroom and observe the “correct method”.
  9. If he/she is wearing a diaper at this time, and has a bowel movement in the diaper, quietly take him/her to the bathroom, empty the products of defecation into the toilet and show him/her graphically where such a deposit is supposed to go. Calmly put the diaper back on, pick him/her up and hug.
  10. Time to raise the stakes and increase the value of the “reward” if your child should do everything you have been teaching for the past 2 months.
  11. Don’t forget that washing one’s hands is also part of the process.

Be patient, remain calm, no punishments but reward, reward, reward for appropriate behavior and stop getting on the internet or speaking to your friends and family about the topic. There is no relationship to the time of potty training done correctly and any disruption of normal behavior or activity in otherwise healthy children. This too will pass.

About the Author

Dr. Joseph Skoloff received his undergraduate degree from the University of Pennsylvania and his medical degree from The Jefferson Medical College in Philadelphia. He is a past Vice Chairman of the Department of Pediatrics, a past Chairman of the Infection Control Committee at the Loudoun Hospital Center and a Fellow of the American Academy of Pediatrics. In his 41 years as a practicing pediatrician he has kept hundreds of kids and families healthy and safe and plans to continue to do so for years to come. Dr. Joe believes strongly in the combined power of parent and physician working together for the health of their children. He is an advocate for children everywhere and and adheres strongly to the principles of the American Academy of Pediatrics. Dr Joe is a member of the PedSafe Expert team


3 Responses to “A Pediatrician’s Guide to Potty Training”

  1. Peryl says:

    Thanks for this – I needed it – my second boy, almost three, is showing very little interest in potty training…!

  2. 38traci says:

    This is GREAT advice. I am in the final throws of toilet training. It is so hard. I have to keep remnding myef that she will get it — just be patient and give her the space she needs to learn but it is not easy!!!
    .-= 38traci´s last blog ..Day 231 or To Be or Not to Be… =-.


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