How will I notice when my child is ready to start using the potty or toilet?

When children already stay dry for several hours and notice when they “need to go,” they may be old enough to use the potty. That means they're probably aware of their bladder and bowel movements, and can already control them somewhat.

There are also other signs that a child is ready for toilet training. For instance, if they:

• can sit and walk,
• already understand basic instructions,
• start wanting to do some things on their own,
• want to be praised, and
• copy other family members’ behavior.

There are different ways to start potty training. Besides stand-alone potties, special potty seats are commonly used to make the toilet seat smaller for children. Some toddlers even want to use the toilet just like big people right from the start, and sit on the toilet without using a special toilet training seat. Simply see what works best for you and your child.

How can I help my child to get out of diapers?

It's generally a good idea to consider the child's needs and see whether they are ready. Active encouragement is also important. It can be distressing for the child if you force them or even punish them for still needing diapers.

Unfortunately, there's hardly any research on which methods are best suited to help a child learn to stay dry. One commonly used method involves encouraging the child to use the potty or toilet once they can already exercise some control over their bladder and bowel. The following suggestions may help:

• Start by getting your child to explore the potty or toilet training seat, and explaining what it's used for.
• At first, whenever you use the toilet yourself or are in the bathroom, have your child sit down on the potty or toilet with their diaper still on, and then later on without. But don't pressure them to use the potty.
• When your child “goes” in their diaper, you can walk to the bathroom together and explain how the toilet (or potty) works. Once your child has understood this, you can start putting them on the potty several times a day.
• As your child becomes more interested in the potty, you can take off their trousers and diaper for short amounts of time and encourage them to use the potty. Make sure the potty is within easy reach when you start potty training. Regularly remind your child to sit on the potty or the toilet.
• If your child is making progress, teach them to put on and take off their trousers so they can use the potty on their own. It's easier to do this with clothes that can be taken off quickly, like trousers with an elastic waistband and slip-on diapers. Bodysuits and overalls tend to get in the way when they need to go urgently.
• Praise your child whenever they successfully use the potty, but don't show any disappointment if they're not yet successful or if they have an accident.
• Moving to a new home, for example, can make children feel less secure and may have an effect on their development. Patience is important here too: Things will return to normal again after a while.
• Should you find that your daughter or your son isn't ready for toilet training yet, take a break for a few weeks and then try again.

If you're concerned that there may be a medical or psychological issue, a doctor should be able to help. If a child is having developmental problems in other areas, then toilet training might be harder too. Extra help may be needed then.

When will my child manage without diapers?

Sometimes children say themselves that they want to start wearing underpants rather than diapers. If you have the feeling that your child is ready, you could simply stop using diapers at home. It's not a problem if they sometimes wet their pants at home because it's easier to change their clothes. If your child manages without diapers at home and seems to feel comfortable not wearing a diaper for a longer period of time, you can see whether this is the same when you leave the house.

At first, your child will sometimes notice too late that they have to go to the toilet, or go in their pants on the way there. That's a normal part of toilet training, and is no cause for concern. Even when your child is already toilet-trained, accidents may still happen from time to time. When they are playing or excited, children can easily forget to go to the toilet in time.

Will my child also manage to stay dry at night?

Nighttime bladder and bowel control develops somewhat more slowly. So even once your child is dry during the daytime, it can take a while before they notice in their sleep that they need to go to the toilet. Then it can make sense to keep on using diapers at night for a while.

If your child manages to stay dry a few nights in a row, you could see what happens when they don't wear a diaper. By the age of five years, about 8 out of every 10 children can also control their bladder and bowel at night.

If older children still wet their beds at night or start doing so again, it is known as bedwetting. With a little patience, that usually goes away on its own over time too.

Why doesn't my child want to use the potty or toilet?

Some children refuse to use the potty because they don't understand why they should. It may seem a lot of hassle to use the potty or the toilet because it means they have to think of it and then stop playing or whatever they are doing. But most children are proud of themselves when they can finally go to the toilet like grown-ups. Seeing other children managing without diapers can be motivating.

If children feel pressured into using the toilet, they might start avoiding it. This may lead to constipation and intensify their dislike of the toilet and potty. A child is considered to be constipated if he or she has had hard and small “dropping-like” bowel movements for more than two weeks, or has bowel movements fewer than three times a week. Typical symptoms of constipation include a bloated belly, flatulence (gas) and belly ache. If your child is constipated, talking with a doctor can help.

Some children use the potty when they need to pee, but not when they have a bowel movement. Then it can help to keep on praising your child whenever they use the potty anyway. It's important not to react negatively when they go in their diaper or clothes, and to take care not to use any negative words for bowel movements. There is usually no cause for concern: Almost all children eventually start to use the potty or toilet for bowel movements too.

What do other parents do?

Some parents put pressure on themselves or their child if other children they know have already stopped wearing diapers. This reaction is understandable because all parents want their children to develop well and make progress. Perhaps they're also worried because they want to protect their child and prevent them from being teased for wetting their pants. Then it can help the child to know that they're in no way "still a baby" just because it's taking them a little longer to develop bladder control.

It's sometimes easier to start toilet training in the summer because it's warm and children wear fewer clothes. This means that it's less of a problem if the child doesn't make it in time.

Experience shows that it's helpful to approach going to the potty in a playful way so children associate it with having fun. For example, you could read to your child while they're on the potty so that they feel comfortable there. Or you could let your child pick out a potty when you buy one. Parents can encourage their child by emptying the potty into the toilet together and letting him or her flush. Involving the children gives you a lot of opportunities to praise them, making them feel more confident and less anxious about doing something wrong.

Sources

• Jansson UB, Danielson E, Hellström AL. Parents' experiences of their children achieving bladder control. J Pediatr Nurs 2008; 23(6): 471-478. [PubMed: 19026916]
• Joinson C, Heron J, Von Gontard A, Butler U, Emond A, Golding J. A prospective study of age at initiation of toilet training and subsequent daytime bladder control in school-age children. J Dev Behav Pediatr 2009; 30(5): 385-393. [PubMed: 19827219]
• Kaerts N, Van Hal G, Vermandel A, Wyndaele JJ. Readiness signs used to define the proper moment to start toilet training: a review of the literature. Neurourol Urodyn 2012; 31(4): 437-440. [PubMed: 22396334]
• Klassen TP, Kiddoo D, Lang ME, Friesen C, Russell K, Spooner C et al. The effectiveness of different methods of toilet training for bowel and bladder control. Evid Rep Technol Assess (Full Rep) 2006; (147): 1-57. [PMC free article: PMC4781561] [PubMed: 17764212]
• Vermandel A, Van Kampen M, Van Gorp C, Wyndaele JJ. How to toilet train healthy children? A review of the literature. Neurourol Urodyn 2008; 27(3): 162-166. [PubMed: 17661380]

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