Toilet Training
Any parent will tell you that toilet or "potty" training is one of the most stressful times in a young child's life. It is also stressful for the adults. Frequently kiddos cannot start preschool until they are potty trained. Everyone else is an expert, yet no one knows your child like you do. That being said, when is your child ready? What is normal vs not normal? What should I do/avoid? What happens if we try too early and fail? The hope of this blog is to provide some unbiased facts and be a resource for all out there.
How do I know when my child is ready?
Can dress and undress without help.
Shows interest in using the toilet.
Notices when his/her diaper is wet or dirty.
Tells you when he/she needs to pee or poop.
Is willing to interrupt activities to use the toilet.
Child is dry for 2 hours at a time (typically wakes up from naps dry).
This most commonly occurs between 2-4 years old.
What is normal?
Delay/regression with new life events is common. This can include a new baby sibling, moving, death in the family, or a divorce.
Daytime continence (staying dry) comes first. It is common for it to take up to a year before your kiddo is dry through the night. If nighttime dryness happens right away, awesome! If not, don't sweat it.
Don't worry about bedwetting/enuresis until the child is 6 or older. If your child is 6 or older and still wetting the bed, it might be a good idea to mention it to your pediatrician/healthcare provider. They can order a work up (checking hormone levels), urology referral, and/or pelvic floor physical therapy.
Girls usually potty train earlier than boys.
By age 3, only 50% or so are fully potty trained.
It is normal to have difficulty holding back diarrhea.
Normal peeing frequency is 4-7 times per day and pooping is 3-21 times per week (once 5 years old). Pay more attention to the color of the urine and consistency of stool.
Pee: shoot for light yellow or a straw colored. Dehydration typically shows up as dark urine.
Poop: Shoot for type 3 or 4 on the Bristol Stool Scale (see below)
What should I avoid?
Avoid using the word "accident". This can cause the child to correlate bladder or bowel incontinence with a word that triggers fear or shame. Try placing the blame on the organ that was involved instead of the child. For example, "Did your bladder let you down?" instead of "Did you have an accident?"
Avoid shaming. Do you like to be ridiculed for mistakes when learning a new skill? All these kiddos want to do is please mommy or daddy. Do not tie their self worth up in the success of their potty training.
Avoid wiping back to front, especially in girls. This can increase your risk for a bladder or kidney infection. Don't assume that your child is wiping correctly. Have them show you and teach them to keep wiping their bottom until the toilet paper is "clean".
Avoid constipation and straining/pushing to empty bowels or bladder. If you need a refresher on proper body mechanics and tips on how to avoid straining, read my blog on pooping. It is NEVER ok to strain on the toilet.
Remember to keep your kiddo's feet well supported. There are many products out there for this. Squatty Potty makes a specific product for kids
Avoid bladder stimulants from dinner/supper time until bedtime if your child is having a hard time transitioning to nighttime dryness.
Tomato based products
Tea
Citrus fruits & juices (especially oranges)
Spicy foods
Caffeinated or carbonated beverages
Soda
Milk (cow’s milk)
Artificial sweeteners
Chocolate
Food or drink with red or blue dye
Avoid constipating foods if your child’s poop is hard (type 1 or 2- see above) or painful to pass.
Bananas
Applesauce
Marshmallows
Peanut butter
Cheese
What happens if we try too early and fail?
Chronic holding of urine or feces/poop can lead to incomplete bladder emptying or constipation. Incomplete bladder emptying can lead to urine backing up into the kidneys are creating kidney damage. It can also stretch out the bladder muscle. Constipation can stretch out the colon making it hard to sense when it is "full". If either of these go on too long, they can lead to irreversible damage to the bladder or colon.
It can frequently lead to a power struggle between parent and child creating increased stress and anxiety.
"Failed toilet training" is one of the leading triggers of child abuse. Typically the training is "failed" because it was attempted before the child was ready.
As for how to specifically potty/toilet train your child... that's entirely up to you. There are A TON of books/blogs/videos on different techniques. Choose one that lines up with your parenting style and don't be afraid to abandon ship and try something else, or even wait it out a little longer. Just because you (mom or dad) are ready for your child to be potty trained, does not mean that they are. I get it, diapers and pull ups are expensive. But the possible physical and emotional damage of pushing too early are just not worth it.
If your child is struggling with chronic constipation and/or leakage of pee or poop (day or night), say something to your healthcare provider. There is help available! Pelvic floor physical therapy can be a very useful tool to help your child become the master of his/her bowel and bladder.
