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toilet training Alternative Names
potty training, toilet teaching
Definition
Toilet training is the process of helping a child learn to urinate or have bowel movements in the toilet. Being "potty trained" is a learned experience. The process that takes time and patience on the part of both the caregiver and the child. Toilet training can take anywhere from a few weeks to several months. It may take even longer to achieve nighttime dryness. Being prepared for the toilet training process can help the caregiver and child have success with this goal.
What is the information for this topic?
There is no specific age when a child is read to start toilet training. Children vary greatly in their development. On average, a child is ready to start toilet training when he or she is between 18 and 24 months old. It is not uncommon, however, for children not to be ready until they are a little older. Girls are often ready to be toilet trained at a younger age than boys. Children under 1 year old have little bladder or bowel control. Most children achieve bowel control and daytime urine control by 3 to 4 years of age. Even after a child is able to stay dry during the day, it may take months or years before to achieve nighttime dryness. Most girls and approximately 75% or more of boys will stay dry at night after age 5.
The following general guidelines suggest a child may be ready for toilet training: - The child prefers a dry nappy to a soiled one. The child should be able to understand the connection between staying dry and using the potty.
- The child understands the words used to describe bladder and bowel functions. Some parents use the words "pee," "poop," clean, and dry while others prefer to use the terms urine, bowel movement and BM. Caregivers should avoid words that sound negative such as stinky or dirty. This may make the child may feel self-conscious.
- The child understands the purpose of the toilet. The child may become aware of this by observing other family members use the toilet.
- The child appears to understand a when he or she has a full bladder or needs to have a bowel movement and can communicate this fact. The child appears to understand that his or her muscles are pushing out the urine or bowel movement. The child may go to a certain place to urinate or have a BM in the nappy. If the caregiver notices this behaviour, it is a good time to explain to the child that the muscles are trying to push the urine or BM out of the body.
- The child stays dry for at least 2 hours at a time and is dry after naptime.
- The child can follow simple directions, can get to and from the bathroom independently, and pull his or her own pants down.
- The child shows interest in wearing underwear.
When preparing for toilet training, a caregiver will need to decide what type of toilet chair to use. Some people prefer a seat that attaches to the regular toilet. Other people prefer having the child use a toddler chair. A toddler chair lets the feet touch the floor and allows the child to get on and off the seat independently. This may make the child feel more secure.
A caregiver may have the child sit on the toilet to get comfortable with the seat. If using a toddler chair, it is sometimes helpful to put the chair in the room the child spends the most time. The child may want to sit on the seat fully clothed at first to get a feel for the chair. After the child appears comfortable with the seat, actual potty training can proceed.
The caregiver should encourage a child to make practice runs to the potty. Often children will a give some sort of signal indicating that they need to urinate or have a BM. It may be a facial expression, a grunt, wiggling the body, holding the genital area, pulling at clothing, or squatting. Having the child sit on the potty seat first thing in the morning, after naps, and about 20 minutes after a meal will help him or her acquire a pattern for toilet training.
The caregiver should try to explain to a child what needs to happen. For example, "The pee or poop needs to come out. Let's try to use the potty." If a child is reluctant to sit on the toilet, a fun activity to do while sitting may help. This may include reading books, listening to music or watching a movie.
A child should never be forced to stay seated on the potty. The child should sit for a few minutes while the caregiver offers reminders about what should happen, such as "the pee or poop needs to come out." If the child wants to get up, he or she should be allowed to. If the child still has not successfully urinated or had a BM after 5 minutes on the potty, he or she should get up and try again at another time.
Another key element in the process is the use of praise or rewards for the child for cooperating with the toilet training. Even if the child is not able to urinate or have a BM in the potty, he or she should be praised for trying. When the child does have success, stickers or treats as well as praise and hugs help to reinforce the idea of a job well done. Some children are more than happy with praise. Others may need treats to stay focused on the toilet training process. Caregivers sometimes place stickers on a chart for every time the child sits on the potty. Stickers are also given when the child successfully urinates or has a BM. In this system, the child may receive a reward for a certain number of stickers.
Once the child uses the potty spontaneously on several occasions, the practice runs may not be necessary. The child should continue to receive praise for success using the potty.
It is very important to not use any negative words or punishments for accidents or refusal to sit on the potty. If a caregiver gets upset or frustrated with accidents, toilet training may turn into a power struggle. For this reason, it is not a good idea for toilet training to start when a child is in a negative phase. Also, a child who is resistant to potty training may not be ready for the challenge. Toilet training may be more successful if postponed for a few weeks.
Some caregivers find it easier to potty train during the summer months when the child has fewer clothes to take off. As potty training progresses the child can be moved from nappies into training pants. Taking a child to the store to buy underwear may be seen as a reward for success. Once a child is put into training pants, nappies should be used only for naps and overnight. Some people like to use disposable pull up pants during potty training. These are purchased near the nappy area of a store. Some doctors discourage use of the disposable pants since they keep moisture away from the child's skin in the same way as nappies do. This may prevent the child from being aware of accidents. Many children achieve bowel control before bladder control. Boys sometimes prefer to sit down when they are first learning to urinate in the toilet. They will learn to stand up later.
It is also good to teach good hygiene when toilet training. Children should be encouraged to wash their hands after using the toilet. Also, children should be taught to clean themselves properly after a BM. Girls should be taught to wipe from front to back to avoid urinary infections.
If a caregiver is concerned over how the toilet training is progressing, he or she should consult with the child's doctor. Stress is a common cause for a child's reluctance to be potty trained. Events in a child's life such as a new house, new baby or a family illness may cause the child to have more accidents even if he or she has already been successfully toilet trained. It is not uncommon for a child to become constipated while being bowel trained. Constipation causes hard stools that are difficult to pass. The child should be encouraged to eat plenty of fruits, vegetables and fibre to help keep stools soft. Children may become fearful when urine or stool is flushed down the toilet. They may be afraid that they will be flushed down the toilet as well. To avoid these fears, a caregiver should reassure the child and discuss how the toilet works. If a child shows the signs of being ready for toilet training but success does not occur, the doctor should be consulted. It is also a good idea to see a doctor if a child who has already been trained starts to have accidents and shows symptoms of illness. Symptoms such as pain with urination and flank pain, with or without a fever, may indicate a urinary tract infection.
Author: Eileen McLaughlin, RN, BSN
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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