Potty Training 101

Safe, stress-free and scientific tips from a pediatrician

“I can’t wait to potty train my toddler,” said no one ever. As parents face various challenges while preparing toddlers to become functioning little humans, helping them pee and poop on the toilet can truly be a pain in the butt. While there are almost always stressors associated with the process, the angst is unnecessary. The biggest challenges around toilet training are often the product of a society that makes the basics of parenting overcomplicated. Here’s how to approach potty training with confidence and minimal worry.

1. Formal toilet training is optional.

This might be hard to believe, but there is no evidence to support the need for an official method or schedule to help children learn how to use the toilet. I was surprised to discover this through my personal journey. Initially eager to potty train my eldest daughter, instead I had little motivation. It was a perfect storm of circumstance, personality and privilege. I had no daycare deadlines, could afford diapers and was dealing with a happy, growing toddler who started to explore using the toilet on her own.

In my situation, the effort of formal training was more headache than it was worth. I followed my daughter’s lead, encouraging her interest to sit on the toilet, and creating awareness when she started (or finished) urination and bowel movements. I used potty training strategies, including verbal praise, matter-of-fact bodily discussions, timed “toilet sits” and even some rewards.

The best training method is the one that’s right for your family.

2. Consider your child’s readiness milestones.

There are a host of interconnected factors that determine when to start the toilet-teaching adventure. While it can be a complicated decision, start with your child’s readiness. To gauge readiness, consider these physical and cognitive milestones that will make potty training easier for children.

Physical milestones:

• Awareness of the urge to void

• Ability to hold in urine (and usually later, stool)

• Relaxation of appropriate muscle groups when on the toilet

• Awareness of when bowel and bladder are empty

• Ability to take pants off and on

• Ability to perform developmentally appropriate hygiene

Cognitive milestones:

• Ability to communicate that they have to go potty or need help

• Goal-oriented motivation or behavior

• Memory and attention (helps keep them on track)

• Social and emotional development

From ages 1–3 years, there’s a huge shift in psychology. Toddlers seek increasing autonomy, take pride in “mastery” of skills and enjoy social praise. It’s the scientific reason that, even without formal training, most kids could (and want to) learn to use the bathroom on their own timeline and in their own way.

3. Get a bigger picture of “readiness.”

In general, most typical children achieve readiness milestones between 2–3 years. This is when childcare centers either start potty training (or observe children eagerly dive in as they witness already trained peers), or require that kids are potty trained before enrolling. Sometimes deadlines are too early, defying statistical physiologic norms.

Some parents may need to choose a childcare option that requires potty training before their child is ready. That’s our society and it’s nothing to feel guilty about. Even the most realistic age-based expectations will be too soon for some kids’ physical readiness, and too soon for many kids’ emotional development.

On the flip side, you may, like me, find yourself ditching formal training even if your child is technically fully “ready.” That’s because your readiness matters too! You may need to wait until a calmer time in your life, even if your child seems eager to learn. Your strategy has the best chance of working when you feel empowered and have the bandwidth.

4. Red flags to avoid.

There are countless potty training methods to choose from. If you take the formal route, keep the following important caveats in mind when deciding which ones to try.

• Training techniques that ignore readiness. Training before you’ve seen all signs of readiness is an understandable choice, as long as it’s deliberate. Training guides should always acknowledge how readiness plays into the equation, including emotional readiness. Anything that’s black-and-white ignores a child’s individuality. A method that boasts toilet training in a certain number of days will either fail some children by definition, or push some families to the brink with extremism in order to achieve results.

• Punishment. Discipline is never advised during potty training. Reinforcements such as praise, sticker charts—even tablet use— are a much better idea, and won’t take away from all the gentle, mindful parenting you do daily. I’m not a fan of food reinforcement. It’s hard enough to teach good eating habits and model a healthy relationship with food as it is. I’ll take an iPad reward over an M&M’S reward any day.

• Techniques that interfere with bodily functions. Messing with a child’s physiology is much worse than ignoring it. Some guides suggest it’s a good idea to overhydrate your child, increasing urination frequency and speeding up the training process. In the best-case scenario, this is just mean—overfilling a child’s bladder when learning how to control it and causing discomfort. More importantly, there could be very serious health implications. Water toxicity is a rare but life-threatening complication of overhydration. In addition, repeated bladder overdistension can lead to long-term incontinence.

5. Remain flexible. Accidents such as soiled pants, wet floors and car seats (and beyond) happen. As do unexpected hiccups and learning opportunities on your potty training journey. The approach you thought would work best for your family might turn out to be an absolute disaster. Maybe you encounter behavioral, medical or developmental challenges that make strict toilet training impossible, or cause a delay. Or perhaps the heavens will smile down upon you and your child will ditch diapers before the glitter glue dries on your sticker chart. Whatever the case, remain flexible. You can stop, modify and restart your approach as much as needed. v

Dr. Rebekah Diamond is a boardcertified pediatrician and the author of “Parent Like a Pediatrician” and “Eat Sleep Tantrum Repeat.” Follow her on IG at @parentlikeapediatrician.