AAP PARENTING CORNER Q & A: TOILET TRAINING

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Toilet Training

When is the right time to start toilet training?

There is no set age at which toilet training should begin. The right time depends on your child's physical and psychological development. Children younger than 12 months have no control over bladder or bowel movements and little control for 6 months or so after that. Between 18 and 24 months, children often start to show signs of being ready, but some children may not be ready until 30 months or older.

Your child must also be emotionally ready. He needs to be willing, not fighting you or showing signs of fear. If your child resists strongly, it is best to wait for a while.

It is best to be relaxed about toilet training and avoid becoming upset. Remember that no one can control when and where a child urinates or has a bowel movement except the child. Try to avoid a power struggle. Children at the toilet-training age are becoming aware of their individuality. They look for ways to test their limits. Some children may do this by holding back bowel movements.

Look for any of the following signs that your child is ready:

Your child stays dry at least 2 hours at a time during the day or is dry after naps.
Bowel movements become regular and predictable.
Facial expressions, posture, or words reveal that your child is about to urinate or have a bowel movement.
Your child can follow simple instructions.
Your child can walk to and from the bathroom and help undress.
Your child seems uncomfortable with soiled diapers and wants to be changed.
Your child asks to use the toilet or potty chair.
Your child asks to wear grown-up underwear.

Stress in the home may make learning this important new skill more difficult. Sometimes it is a good idea to delay toilet training in the following situations:

Your family has just moved or will move in the near future.
You are expecting a baby or you have recently had a new baby.
There is a major illness, a recent death, or some other family crisis.

However, if your child is learning how to use the toilet without problems, there is no need to stop because of these situations.

How to teach your child to use the toilet

Decide what words to use. You should decide carefully what words you use to describe body parts, urine, and bowel movements. It is best to use proper terms that will not offend, confuse, or embarrass your child or others.
Pick a potty chair. A potty chair is easier for a small child to use, because there is no problem getting on to it and a child's feet can reach the floor.
Help your child recognize signs of needing to use the potty. Your child will often tell you about a wet diaper or a bowel movement after the fact. This is a sign that your child is beginning to recognize these bodily functions. Praise your child for telling you, and suggest that "next time" he let you know in advance.
Make trips to the potty routine. When your child seems to need to urinate or have a bowel movement, go to the potty. Explain what you want to happen. Encourage your child with lots of hugs and praise when success occurs.
Encourage the use of training pants. This moment will be special. Your child will feel proud of this sign of trust and growing up. However, be prepared for "accidents." It may take weeks, even months, before toilet training is completed.

If any concerns come up before, during, or after toilet training, talk with your pediatrician. Keep in mind, most children achieve bowel control and daytime urine control by 3 to 4 years of age. Even after your child is able to stay dry during the day, it may take months or years before he achieves the same success at night. Most girls and more than 75% of boys will be able to stay dry at night after 5 years of age.

Healthcare professionals may order this publication in multi-copy packs.
Parents can find more information on this topic in Caring for Your Baby and Young Child: Birth to Age 5. To order a copy of this book visit the AAP Bookstore.

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The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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