Toilet Training
When Can Toilet Training Start & How Long Does It Take?
Typically, toddlers first show readiness signs from 18 to 24 months. They won’t show all the signs at the same time, so this age range is more to inform about when to start thinking more seriously about your toilet training approach and foster skills needed for success.
Cues & Interest: Your toddler should differentiate a “wet” vs. “dry” diaper, have a dry diaper for at least 2 hours, interpret signals about when they need to relieve themselves, and make the connection that this means using the toilet.
Language & Comprehension: Your child should follow simple instructions, understand simple toileting vocabulary, and express when they need to go.
Motor Skills: Walking to the toilet, sitting on it, and getting off are important steps in toilet training and require mastering certain gross motor milestones. It’s also helpful for your toddler to be able to lower and raise their pants and underwear.
It’s important to note the the above ages are averages for starting to think about toilet training. It often takes 3-6 months to complete, though can take longer for some children, including those with developmental delays (like in autism) . It’s more helpful to rely on your child’s developmental stage than a firm age cutoff. Over time, the toilet training age has gone up, and the average for successful daytime toilet training is 30 months. It’s worth mentioning that girls tend to learn faster than boys, and that successful nighttime training can sometimes take months to years longer (especially if there is a family history of nighttime bedwetting, since this has a genetic component).
Is There A Time We Shouldn’t Start?
Avoid starting during times of transition. This can mean either the arrival of a new sibling, moving homes, or family stress (e.g., divorce or a death). The stress or trauma associated with these events can lead to unintended accidents as a coping mechanism, and makes it harder for children to master new skills. I also advise avoiding starting if your child is ill (like with a diarrheal illness), since it’ll be messier and they’ll have less interest.
How Should We Prep?
Set The Scene: When your child is shows readiness, have a transition where you explain the concept of toileting over a few days to weeks. Introduce words you’ll use in training, like “pee,” “poop,” and “potty,” until they’re integrated into their vocabulary. Ask throughout the day if their diaper is wet, so that they get attuned to these signals. Allow them to sit on the toilet with their clothes or diaper on a few times a week, so that they can familiar with the toilet seat or chair. After they soil a diaper, empty it into the toilet so that they can understand that this is were urine and stool should go.
Get Them Excited: Try framing this process as reaching a new “big kid” stage. Have them help you select their preferred “big kid” underwear (focus on their favorite superheroes, animals, or TV characters). Use books designed around toilet training to help visually illustrate the process, and you can create songs to make it more fun.
What Toilet Should We Use?
It’s up to you! There are two options available.
Potty Chair: This is an individual, toddler-sized chair with a vessel that is emptied into your home’s toilet. Their smaller size makes them more approachable, and your toddler can help pick it out as part of the toilet training process (e.g., if they love Spiderman, they can add decals of him on it, which helps build excitement). It’s also portable, which means you can take it on road trips. The downsides are regular cleaning and a transition period in switching from the potty chair to the toilet seat.
Potty Seat: This is a toddler-sized toilet seat that attaches to a regular toilet, to help with proper positioning and reassuring your child that they won’t fall in. Using this eliminates a transition period from a potty chair, requires no cleaning, and helps your child feel more comfortable using the toilet in settings outside the home (e.g., when traveling). However, it can feel more overwhelming to due to its size and height, and requires a step stool so the child can reach the seat.
There’s no “right” answer. Some children will do better with one option over the other, so it’s best to go off of their preferences. You can start with the one that fits your needs, and if it doesn’t work out, it’s easy enough to switch to the other.
Toilet training is a marathon, not a sprint. Think about how much exposure to new skills we need as adults before mastering them. Support your child as they tackle this milestone.
Give Me The Nitty Gritty - My Child Is Ready, What Do I Do?
Demonstration & Slow Exposure :
After you’ve decided to formally embark on toilet training, start with a demonstration. If there’s older siblings, have them help out. If not, you can take lead. Narrate what you do when you use the restroom in simple-to-understand steps with the toileting words you’ve taught them, and do those actions in real time.
Once they’ve seen the steps in action, have them sit on the potty chair or seat for 5-10 minutes each day with their diaper off. Choose consistent times (I recommend after mealtimes, to take advantage of our natural reflex to stool after eating, as well as before bedtime). It’s OK if they don’t end up urinating / stooling, as we’re just trying to familiarize them with the process. If they already stooled, empty it into the toilet so that they can see where it goes, and try again at the next opportunity. Never force your child onto the toilet, and let them leave if they get up. We want to ensure toilet training is a positive experience and avoid forming any negative associations that come with punishment.
Rewards:
All learning is motivation-based, and this is easier with a rewards system. Whether it’s a sticker chart, a small collection of toys that they’re able to pick from, or extra story-time before bed, choose something they’re excited about as their reward for a successful toilet experience. Make a huge deal if they’re successful, with cheering, lots of praise, and verbalize everything they did well. This will help solidify the correct behaviors so that they’re repeated in the future. After a few days of consistency with the new routine, you can slowly start phasing out rewards, and stick to just encouragement (otherwise, you’ll get stuck in a never-ending cycle of giving your child something every time they use the restroom). If they aren’t successful, don’t take away privileges.
Intentional Trips & Larger Routine:
Once your child has gotten more comfortable with the toilet, transition to more intentional trips outside of the scheduled times, and focus more on completion of the additional steps (e.g., removing pants, flushing toilet). If you notice cues during the day like crossing of legs, go to the restroom with them and do the routine. Ask if they need to go prior to leaving the home and listen when they volunteer that they have to void / stool. You can switch to “big kid” underwear around this time if you’d like, since it’s a good “halfway marker” towards daytime continence where there will be some accidents, yet it won’t be every single time.
Focus On Nighttime Training:
Nighttime continence takes the longest. You can trial Pull-Ups if you’d like (there’s unsettled debate on if this causes slight regression since it’s similar to diapers, but if it works for your family and cleanliness needs, go for it), or “big kid” underwear. Schedule “potty time” prior to bedtime so that they go to bed with an empty bladder and avoid fluids in the 2 hours prior to going to sleep to minimize risk of accidents. Start small with goals (1-2 hours of “dry” time overnight, then 3-4 hours, etc.) and give positive reinforcement when they’re successful. If they have an accident, clean it up without making a fuss, tell them that it’s OK that they wet the bed, and that there’s another chance for stickers (or whatever reward you’re using) the next night.
Additional Tips:
Make sure your toddler has easy-to-remove clothing (no jumpsuits, overalls, etc.), so as not to confuse the learning process more.
Try Crocs during toilet training, since these are easy to clean up if soiled.
It’s helpful to have boys start with mastering peeing while sitting down, then transition to standing up.
If you have caregiver support, make sure everyone is on the same wavelength with the approach and vocabulary you’re using.
You’ll be helping to wipe until around Kinder, during which you can help them transition into wiping on their own, with emphasis on front-to-back technique.
Troubleshooting:
Constipation: This is one of the largest barriers to toilet training, since it causes pain and makes children scared of using the restroom (they’re often not able to discern that the pain is due to the stool, rather than the toilet). At first signs of constipation, talk to your doctor about natural solutions (“P” fruits such as pears, peaches, papaya, prunes, etc. have lots of fiber and water content and are super helpful) or Miralax (usually 1/4 capful daily mixed into 4 ounces of a clear liquid) to prevent withholding behaviors, which can cause setbacks in training. Make sure to have a step stool if using a toilet seat, to help the muscles expel stool easier. You can also try blowing bubbles, since this activates muscles involved in stooling.
Fear: Some children will get scared of their stool disappearing. To counter this, make sure you empty diapers with stool into the toilet, so they’re aware of where it goes. Some will try cutting a hole in the diaper for poop to exit from while on the toilet to give a layer of extra security, though this can be tough to wean away from. If your toddler has issues with the loud flushing noises or has fear of water / air from the toilet touching their bottom, constant reassurance that they are safe is key. If this isn’t resolving, talk to your doctor about sensory concerns, which an occupational therapist may be able to help with.
