Potty Training Pointers

The Great Training Debate

In the wake of the recent polarized debate between child development specialists, parents are more confused than ever about when and how to potty train their child. Most parents who look to authorities for advice on how to best approach toilet learning have heard the prevailing “don’t pressure your child” message of T. Berry Brazleton, M.D., a prominent pediatrician and an internationally known authority on child development. Brazleton and the majority of his peers urge parents to hold off on potty training until the child shows clues to his readiness, and to allow the child to set the pace for training.

Recently, however, many parents have also heard the highly publicized message of John Rosemond, PH.D., a family psychologist who has made waves with his syndicated column “Naked and $75” strategy for toilet learning. In direct contradiction to Brazleton, Rosemond recommends that parents choose a three-day period in which to accomplish potty training. During this time, the child is kept naked so that she will figure out that using the potty is preferable to having urine and feces run down her leg; the $75 is to get the carpets cleaned afterwards.

To many parents, the Brazleton approach is appealing for its compassionate view of the child’s experience, while Rosemond’s method is appealing for its no-nonsense efficiency. The principles of the disparate training approaches, however, suggest that parents must make a strategic choice. If parents opt for Brazleton’s approach and wait for their child to train at his own pace, then they will likely miss the relatively early training age recommended by Rosemond. With Brazleton’s approach, the family may be in for a prolonged training period and their child may still be in diapers as his fourth birthday approaches. But what if parents take Rosemond’s advice, abruptly taking the diapers away, and their child still refuses to use the potty so the three-day bare-bottom training period stretches on for three months? According to Brazleton’s philosophy, the child will have developed a negative attitude towards using the toilet, which will create conflict and will likely prolong the training process even further.

When to Begin

No matter what approach they take, parents will need to give careful consideration to the timing of potty training. According to Rosemond, the timing of training is determined primarily by your child’s age: he considers it a “slap to the human intelligence” for a two year old to wear diapers. Many of our own mothers would probably agree with him on this point. In 1957, 92% of children were potty trained by 18 months; today, less than 25% of 18 month-olds are trained, and by age three, 30% are still in diapers. Recent studies indicate that many children today who begin training at 18 months are not fully trained until age four. Many parents argue that the advent of comfortable, highly absorbent disposable diapers lessen their child’s motivation to be diaper free. Others feel that parents today are far too casual in their approach to potty training, and that the longer parents wait, the more resistant the child will be to using the potty.

The majority of child development specialists, including Brazleton, advocate beginning the potty training process only after the child has mastered some basic skills and has demonstrated an interest in learning to use the potty. “Only a child can decide when the time for toilet training has come”, Brazleton says in his book Touchpoints, “Any pressure parents may feel from grandparents, nursery schools, or helpful friends had better be disregarded. It’s got to be his achievement, not theirs.”

For many parents, however, waiting may not be realistic: preschools often do not accept children in diapers. This can pose a huge dilemma for parents who have had their child wait-listed for their desired preschool, and who may have already paid a hefty deposit for their child to enroll when he is two. This is also the period when many mothers make commitments to return to work.

Indicators of Readiness

According to the development-oriented approach to training, basic skills must be achieved before training process should begin, regardless of your child’s age. Some indicators of readiness are:

The child demonstrates bladder control by staying dry in diapers for two to three hour periods.
Timing of bowel movements is somewhat predictable. The child may seek a private spot to have a bowel movement.
The child asks for his diaper to be changed or lets you know when he is wet or soiled.
The child can follow simple instructions and has the ability to learn the sequence of steps required in using the potty.
The child has the dexterity to pull pants up and down.
The child demonstrates an interest in the toilet or in wearing underpants.

Major changes in the child’s life, such as the birth of a younger sibling, a move to a new home, or a change in child care should be factored into the training equation. If parents know such changes are on the horizon, they may want to hold off or begin potty training well in advance, and anticipate the possibility of regression when other major changes in his life occur. It is preferable to avoid introducing the potty when the child is in a particularly negative stage in his emotional development. The catch here is that parents never know how long such a stage may last.

The How-To of Potty Training

The how-to of training is controversial as well. Rosemond recommends an all-or-nothing approach: put the diapers away, keep the child naked from the waist down, and let the messes fall where they may until she learns to use the potty. Some parents claim tremendous training success after only a few days with this method. For other children, it results in problems ranging from constipation to unsanitary living conditions. When accidents continue to happen over a period of months, parents find it challenging to maintain the encouraging attitude their children need.

Brazleton recommends that the child “must be allowed to refuse if she wants to.” Many child development authorities recommend that parents follow a sequence of steps over several weeks:

Buy a comfortable child sized potty and let the child know it is hers. Place it in her play space and encourage (but don’t pressure) her to sit on it while still clothed.
Change the child’s diaper often so that she becomes accustomed to dry diapers and is less tolerant of being soiled or wet.
Try to establish a daily routine of sitting on the potty for a short period of time, first with her diaper on, then bare-bottomed. It may help to have the child observe you using the toilet regularly or to watch an older child use the potty. Do not force her to sit on the potty.
Teach the words associated with the process and demonstrate how the toilet works.
Keep an encouraging attitude about accidents, letting the child know that it always takes practice to learn how to do new things. Never punish or humiliate her.
Give the child plenty of high fiber foods and fluids to help avoid the constipation which often occurs with potty training. Avoiding constipation in the first place will spare parent and child a lot of grief in the long run.
Let the child go bare-bottomed for short periods of time, working up to longer periods. Remind her, without nagging, that her poop and pee need to go in the potty, and to sit on the potty when she feels that the poop or pee is ready to come out.
Teach boys to sit on the potty to pee, with his penis held down, so that he will be more likely to stay there long enough to have a bowel movement.
Remind the child to use the potty before each outing. Assure him that most places you go have restrooms he could use.
Give the child the option of wearing special new underpants after she has had her first successes with the potty.
Dress the child in loose fitting, elastic-waist pants that she can pull up and down herself. Begin to teach her how dress herself.
Keep your sense of humor.

At first, parents might want to consider putting diapers back on their child for naps and at bedtime, especially if he resists using the potty for bowel movements, to help avoid constipation. This will also spare him from the discouragement bed-wetting early in the training process.

Whether or not parents put the child back in a diaper at other times requires some strategic planning. If the child is permitted to wear diapers again whenever she wants, she may feel that she never needs to learn to use the toilet. Brazleton insists, though, that she should be able to wear diapers if she wants to; the child must stay in control of the training process and parents should not at any time pressure her.

Tried and True Motivating Tips from Parents

When facing the challenges of potty training, it will help to consider your child’s temperament and what extra incentives might motivate him. In learning about other’s experiences, parents will know that they are not alone in the setbacks and frustrations they and their child may face along the way. Here are some of the challenges that other parents have faced, and the solutions they found.

Chip Trick
Cheryl M., Ann Arbor, Michigan
Brandon refused to use the potty, and we had several frustrating attempts to get him started training. Desperate, I had my husband demonstrate how he could try to sink a potato chip by peeing on it. Brandon had to try it for himself. When he got pretty good with chips as a target, he moved on to Cheerios. But getting him to poop in the potty has been another challenge. I’m curbing my impulse to refer to his poop as bombs.

Summertime Strategy
Scott J., Arvada, Colorado
Our pediatrician recommended that we try potty training Joseph in the summertime, when he could spend a lot of time in the yard naked. We put a little potty in the backyard, and dressed him in long t-shirts so he wouldn’t feel too exposed. He enjoyed having a bare bottom and accidents weren’t such a big deal when they happened outside. Not fiddling with clothes also helped him to get to the potty on time.

Story Time on the Stool
Jennifer S., Boca Raton, Florida
It was hard for Emily to get the timing right, and she often had accidents on her way to the potty. But if she got there too early, she did not have the patience to sit on the toilet long enough to have a bowel movement. Emily loves for me read to her, so I kept her favorite books next to the potty. I’d sit on the edge of the tub and read any story she chose. It helped make the associations with the potty more positive, even if she wasn’t always successful.

Sticker Rewards
Suzanne C., Reno, Nevada
When Chelsea was two, she enjoyed playing with stickers, so we used them as rewards for potty training, and put her usual stickers and sticker books away. We went out and bought special stickers that she could have only after she used the potty. Every time she did, she put a sticker on that date on the calendar. She liked to show visitors how many “potty stickers” she had on the calendar. After a while we phased out the stickers used for peeing, but kept doing the stickers for pooping, since she needed extra motivation for that. Finally, when she didn’t need reminders to use the potty, we stopped using stickers as rewards.

The Voice of Authority
Jill R., Evanston, Illinois
We may have gotten off to a bad start in training Jacob by using “pull-ups”; it took us awhile to figure out that these were just like diapers to him. He refused to use the potty at all. When I took him for his three-year check up, the Pediatrician told him that she was very proud of how big and strong he was growing up to be, and to show everyone what a big boy he is it was now time to use the potty instead of diapers or pull-ups. I think that he needed to hear it from someone other than his parents, someone who clearly has authority and whom he wanted to impress. He started using the potty that afternoon. He’s had plenty of accidents, but I’ve managed to keep my composure through it all.

The Big Reward
Rick A., Boulder, Colorado
The first time our son sat on the potty to pee, I wasn’t quite prepared, and didn’t think to show Michael how to hold his penis down. Of course, the pee went all over the floor and, in spite of our reassurances and encouragement, he wouldn’t have anything to do with the potty for a long time after that. We finally had a breakthrough when we told Michael that we would take our first family camping trip after he learned to use the potty. We knew this was a bribe, but it seemed a little more politically correct than buying something for him. It was just the motivation he needed.

Watch it Flush
Marilyn G., Oakland, California
My son wasn’t willing to use the potty when he had bowel movements and he had become constipated, so we put him back in diapers. I had heard that some children consider whatever comes out of their body to be a part of themselves, and so they have issues with letting it go into the potty. We let Sam watch us use the toilet, and let him flush the toilet for us. Then we started dumping bowel movements from his diaper into the toilet for him to flush. I think it helped him to watch and participate in that part of the process. (Note: Brazleton recommends having your child watch his bowel movements being put in the toilet, but not to let him watch you flush them, as children may worry about where it all flushes to.)

Helpful Products

PiddlePad
Waterproof Seat Liner by Kiddopotamus
So now you have taken the diapers away, but do you dare venture away from home while your toddler is in training? It may be months before your child has enough control to make it to grandma’s house- or even to the corner market-without making a mess of the car seat or stroller. Reverting to back to diapers for outings is very confusing to toddlers. The PiddlePad is an indispensable potty training tool that prevents wet and soiled seats. To learn more about the PiddlePad click here.

Waterproof bed pad.
This investment is worthwhile, considering that 25% of four year olds and 20% of five year olds continue to wet their bed occasionally.

Flushable wet wipes.
These feel more comfortable and more familiar to children than dry toilet paper. Make sure the wipes are the flushable kind, not the standard ones used for diaper changes. Most children will continue to need help wiping their bottoms clean until they are four.

Sturdy, simple child sized potty seat.
Consider having two, so that your child is more likely to use it no matter what part of the house she is in. (The Consumer Reports Guide to Baby Products, by Sandy Jones, makes recommendations on what to look for when shopping for a potty seat.)