Definition

Your goal is to toilet train your child. Your child will be toilet trained when without reminders he can:

• Walk to the potty
• Pull down his pants
• Pass urine or a bowel movement (BM) into the potty
• Pull up his pants.
• This handout discusses a gradual type of toilet training.

Health Information

Bladder and Bowel Control

• Some children will learn to control their bladder first. Others will start with bowel control. Both kinds of control can be worked on at the same time.
• Bedwetting is different. Bladder control through the night normally happens several years later than daytime control.
• Most toilet training can be completed in 1 to 2 months. However, your child needs to be ready before you start.

Toilet ReadinessTraining

• Don’t begin training until your child is clearly ready. Readiness doesn’t just happen.
• Toilet readiness training involves concepts and skills you teach your child. This can start at 18 months of age or earlier.
• All children can be made ready for toilet training by 3 years. Most are ready by 2½ years. Some can be ready by 2 years and occasionally even younger. Ways to help children become ready are found in the handout, "Toilet Readiness Training".

How to Know if Your Child is Ready to Start Real Toilet Training

• Your child can recognize the sensation of a full bladder and full rectum
• Your child knows what the potty is for
• Your child likes to sit on his potty chair
• Your child is cooperative with verbal requests

Care Advice

1. Encourage Practice Runs to the Potty:
   • A practice run (potty sit) is encouraging your child to walk to the potty. Then, have your child sit on it with his diapers or pants off. Your child can then be told, "Try to go pee-pee in the potty".
   • Only do practice runs when your child gives a signal that looks promising. Such signals are a certain facial expression, grunting or holding the genital area. He may also pull at his pants. You may notice pacing, squatting, or grimacing.
   • Other good times for practice runs are after naps or 2 hours without passin urine. You can also try about 20 minutes after meals or a big drink. Say, "The poop or pee wants to come out. Let’s use the potty".
   • If your child doesn’t want to sit on the potty, read him a story there.
   • 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. Even if your child seems to be enjoying it, end each session after 5 minutes.
2. Keep a Potty Chair Close By:
   • Initially, keep the potty chair in the room your child usually plays in.
   • This easy access increases the chances that he’ll use it without you asking.
   • Consider owning 2 potty chairs.
3. Wear Clothing That is Easy to Remove:
   • During toilet training, children need to wear one layer of clothing. That usually means training pants or regular underwear.
   • Avoid shoes and pants.
   • In the wintertime, turn up the heat or wear loose sweatpants.
   • Avoid any pants with zippers, buttons, snaps, or a belt.
4. Praise Your Child for Cooperation and Reward 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 go pee-pee in the potty".
   • If your child urinates into the potty, he can be rewarded with treats. For example, you can use animal cookies or stickers. Also, give lots of praise and hugs.
   • A sense of accomplishment is enough for some children. However, many need treats to stay focused.
   • Big rewards like going to the toy store should be reserved for big steps. For instance, 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.
5. Practice Runs - When to Stop:
   • Once your child uses the potty by himself 2 or more times, you can stop the practice runs.
   • For the following week, continue to praise your child frequently for using the potty.
   • Practice runs and reminders should not be necessary for more than 1 or 2 months.
6. Change Your Child Calmly After Accidents:
   • Change your child as soon as it’s convenient. Respond with kindness. Say, "You wanted to go pee in the potty, but you went in your pants. I know that makes you sad. You like to be dry. You’ll get better at this."
   • If you feel a need to be critical, keep it to mild verbal disapproval. Use it rarely. For example, "Big boys don’t go poop in their pants." Or mention the name of another child whom he likes and who is trained.
   • Change your child into a dry diaper or training pants in a pleasant manner.
   • Don’t show anger. Avoid physical punishment, yelling, or scolding.
   • Pressure or force will start a power struggle. Your child may become completely uncooperative.
7. Regular Underwear - When to Start:
   • Introduce regular underwear after your child starts using the potty.
   • Regular underwear can spark motivation.
   • Switch training pants to regular underwear after your child passes urine into the potty a few times.
   • Buy loose-fitting underwear that he can easily lower and pull up by himself.
   • Once in underwear, use diapers only for sleep and travel outside the home.

Call Your Doctor If

• Your child is over 2½ years old and has a negative attitude about toilet training
• Your child is over 3 years old and not daytime toilet trained
• Your child won’t sit on the potty or toilet
• Your child holds back bowel movements
• The approach described here isn’t working after 6 months
• Note: See Toilet Training Resistance handout

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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