Routine Checkups

Your child should have regular checkups, sometimes called well-child appointments, with a pediatrician, family medicine doctor, or other health professional. These visits allow the health professional to evaluate your child's development and ensure that he or she is healthy.

At the 2-year visit, the health professional will ask you about your child's progress in toilet training. This is a good opportunity to discuss any concerns you have about your child's readiness.

When to Call a Doctor

Call your doctor if you have concerns about your child's readiness for or progress with toilet training.

Most children use the toilet during the day consistently and successfully around age 3. Call your doctor if your child:

• Does not use the toilet during the day by age 4.
• Continues to soil his or her pants after age 5.

How to Help Your Child

There are many different strategies and approaches to toilet training. The methods that work best use positive reinforcement and begin intensive training only when a child is physically and emotionally ready. Introduce the basic concepts of toilet use gradually and repetitively to your child. As your child gains the necessary skills, he or she will show a sincere interest in using the toilet.

Get ready

Before you decide to start toilet training, make sure the household environment is stable and that all family members are prepared to help in the process. Trying to start potty training soon after having another child, while remodeling your home, while having a succession of household guests, right before going on vacation, or during a time of relationship problems will likely not be as successful as during a calm period when the family can focus on helping your young child reach this significant developmental milestone.

Talk with your child about having a bowel movement and about urinating. Your child may be more comfortable saying "poop" and "pee." It is fine to use these words, but use the proper terms as well so the child learns what they mean.

Start to talk with your child about how to use the toilet. Explain how the toilet works and how your child will be able to use it when he or she is ready. Be enthusiastic and always speak positively about your child's using the potty. Talk about how he or she will no longer need to wear diapers, will get to wear underpants that are more comfortable, and can go just like a big boy or girl.

You can also use books and DVDs to help prepare your child. Ask your doctor or a librarian for more information.

Get set

Take your child with you to select a potty that is sturdy and comfortable. Be patient and give your child time to get used to and comfortable with it. Some ways to do this are by:

• Letting your child move a portable potty into his or her room or other play area to get used to having it around.
• Helping make the potty special by personalizing it, such as painting it or writing your child's name on it.
• Letting your child sit on it and read a book or sit on it with his or her diaper on while having a stool or urinating. You can say, "This is your special chair for you to go pee-pee and poop in. Soon you will use it just like grownups use the toilet."

Your child may want to join you when you use the toilet. If you feel comfortable with an audience, allow him or her to join you. Talk with your child about what you are doing.

Toilet training is usually more successful if you are relaxed and patient with your child.

• Do not try to begin toilet training before your child is physically and emotionally ready. Trying to toilet train your child before this time creates frustration for both of you.
• Avoid power struggles, which will only make toilet training more stressful and last longer. All experiences and associations with toilet training should be positive. Do not scold, punish, or embarrass your child for failing to use the toilet.
• Do not verbally or physically force your child to sit on a potty. Allow your child to sit on the potty only for 5 minutes at a time unless he or she is beginning to pass stool or urine.
• Tell your child that it is up to him or her to decide when to use the toilet.

Go!

Eventually, your child will show an interest in using the toilet. When this happens, follow your child's lead and start the process. General suggestions that can make this process go more smoothly are to:

• Dress your child in clothing that is easy for him or her to remove. Clothes that have elastic waistbands or easy-to-open fasteners (such as Velcro) work best. Pull-on diapers also work well during toilet training. Bib overalls and one-piece outfits are hard for a child to take off.
• Help your child feel comfortable and safe on the toilet. Assure your child that he or she will not fall in. Some children feel more comfortable sitting backward, facing the toilet tank.
• Teach your boy how to urinate as he sits on the toilet. (Some boys may need to push down on their penis so that the urine stream goes into the bowl and not over the front of the toilet seat.) As he grows taller, he can learn to urinate from a standing position. A small step stool may help him reach the toilet bowl and improve his accuracy. A step stool also supports the feet and allows your child to push his or her feet against the stool during a bowel movement.
• Teach your child to wipe properly. Show him or her how to remove toilet paper from the roll, wipe, and throw the used toilet paper in the toilet. Instruct girls to wipe from front to back, which helps avoid infection caused by getting stool near the urethra or the vagina. Many children need help to wipe effectively, especially after a bowel movement, until about age 4 or 5. You may want to keep diaper wipes near the toilet to help remove residue without chafing your child's skin.
• Help your child flush the toilet. Some children are afraid of the sucking mechanism of the toilet. If your child has this fear, it is fine for you to flush the toilet after he or she leaves the room. Eventually, your child will be able to flush the toilet without a problem.
• Teach your child how to wash his or her hands after using the toilet.

What to think about

Praise and encourage your child for success. You can say, "You are sitting on your potty just like mommy (or daddy, or big sister)" or "You are trying really hard to poop (or pee) in your potty." Reward your child for trying to use the toilet. You can use verbal praise and fun activities, such as stickers or special playtime with you.

Accidents happen. Do not scold or punish your child for accidentally wetting or soiling his or her pants. Be matter-of-fact and reassure your child that it's okay and that he or she will get better with practice. Also, remind your child to use the toilet when he or she wakes up in the morning.

If you and your child are not making progress with toilet training, it's okay. It's probably not the right time. Put the potty chair away until your child shows that he or she wants to try again.

The most important things to remember for toilet training are to wait until your child and family are ready and to make it a positive experience. Be patient, and look forward to the days ahead of freedom from diapers.