Toilet training: time to take a seat

Are you planning on toilet training this summer?
Are you planning on toilet training this summer? 

Your next-door neighbours' two-year-old was toilet trained in three days, so how come your three-year-old is still showing no interest in even sitting on their potty?

Toilet training can be frustrating for many parents, particularly those with little boys, says Illawarra GP Dr Margaret Perrott. Boys make up 90 per cent of the clients at her Figtree clinic where she assists parents with their children's toilet training, bedwetting and soiling control.

Firstly, Dr Perrott says it's important to take the stress out of the situation. When it comes to toilet training, parents should not expect too much of their toddlers too soon. And they should never compare their child's progress to that of another. "For starters, most children are not ready to learn to control their bladder and bowel until they are two years old," she says. "Their neurological system has to be to the stage where they are able to be forewarned. At 18 months, a child's nervous system is not capable of translating the fact that the feeling they're getting is a signal that something is about to happen, whether it's a wee or a poo."

Toilet training is a particularly hard concept to explain to young kids, as it's not a process they can initially see, Dr Perrott says. "If they're doing something with their hands or feet, they can see that so they have a reference point," she says. "But the control of the bladder or bowel is internal so they can't see it which makes it hard for them to readily understand."

However, parents can start preparing their children for toilet training before actually starting the process. "Parents can actually prepare kids for successful potty training from birth by making sure their inside environment is right - for instance ensuring they have plenty of fluid and their diet is good," Dr Perrott explains. "This will ensure they are doing plenty of wees and their poos are soft and regular, which makes it easier to toilet train them.

It's important to praise them for doing the right thing, and equally important not to make a fuss out of accidents.

"Many times, kids have trouble with toilet training because they are not drinking enough and they are constipated. When they try to use the potty it hurts, and they don't want to try again." Another way to prepare children early is to talk to them from day one while you are changing their nappies. Tell them why you are changing them, eg "You've done a big wee/poo". And, if you're comfortable, let them watch you go to the toilet too.

Your child will generally let you know when they are ready to start toilet training, Dr Perrott says. They may know the words "wee" and "poo" and may start to tell you when they are about to go. Some children with older siblings will show an early interest in doing what their big brother or sister is doing. Parents can then buy a potty or a step and small seat adaption for the main toilet. They should choose a time when everything is on an even keel - not when any major change is occurring like the arrival of a new baby, moving house or mum is returning to work.

It may also be easier to toilet train during the warmer months, says Dr Perrott. "You don't want to do it in the middle of winter unless your child is demanding to do it. It's obviously more convenient for everyone in summer as your child can wear less clothing and will be less uncomfortable if they do have an accident."

When embarking on toilet training, Dr Perrott urges parents not to see it as an "all or nothing" situation. Some kids may be successfully trained in three days, but many will take their time and there will be the inevitable accidents. Also, it can be a gradual process - start by aiming for daytime dryness and use nappies or pull-ups at night or during the afternoon sleep. Similarly, start with either wees or poos and once kids have that figured out, get them to work on the other one. Parents should let their child get comfortable with the potty or toilet. Then watch for signs that your child is doing something, ask them regularly if they need to go or let them tell you, and then guide them to the potty. Eventually they will go there by themselves.

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"Regular toileting is useful, for instance half an hour after a meal, sit them on the potty for a few minutes and if something happens that's great," Dr Perrott says. "However if they get off the potty and then wee on the floor, do not make a fuss. When a child is learning how to walk, they will walk for a few steps and then fall down - similarly when a child is learning to use the potty or toilet they will may sit there for a few minutes and then have an accident. The main thing is they're tried.

"It's important to praise them for doing the right thing, and equally important not to make a fuss out of accidents." When an accident happens, clean up as quickly and quietly as possible, avoiding eye contact. When a child does a wee or poo on the potty, then get down on their level, have good eye contact and praise them. And while treats and bribes are not necessary, small rewards can be a positive part of the process.

"When a child is trying really hard there's nothing wrong with putting a stamp on their hand they can show daddy or mummy later, or placing a sticker on a chart - it reinforces their success," Dr Perrott says. Toilet training is also a great time to start or continue teaching children about hygiene. Get a small step for the sink and get them to wash their hands after using the potty. And while mum or dad will probably have to assist with wiping their bottom after a poo until they are about four or five, it's good to teach girls to wipe themselves after a wee from front to back to avoid infection, and to show boys to shake themselves. If toilet training is proving impossible, parents should contact their GP or a paediatrician.

Magazine articles can be a good source of information, as can looking up credible websites - Dr Perrott suggests the Continence Foundation of Australia. "While the age of starting toilet training can vary, every child should be toilet trained by the time they start school," she says. "It's important to seek help if needed as some kids may have developmental delays or a medical problem that may impinge on toilet training, such as extreme constipation."

Getting help is important as bedwetting and soiling in older children can be emotionally and physically draining on a child and their family. Again, more boys than girls are bedwetters. Dr Perrott says the fact that parents let little boys wee behind trees, and don't make them hold on to get to a toilet like they would for a girl, can cause problems here. "When treating bedwetting, you have to teach children how to hold on. Once they have control of that during the day, that control passes into sleep," she says.

Getting bedwetters out of bed late at night to go to the toilet also causes problems, as it programs their bladders to empty at that time. Also parents who get kids to go "just in case" again are teaching the child to empty the bladder early rather than wait until it is filled to capacity. Poor drinking and eating habits can fuel bedwetting. Getting kids to drink more ensures they pass more urine which gives them more practise in bladder control.

Related links
Fuss-free toilet training tips
Toilet training: is your child ready?
Night-time toilet training
Toilet training tips

Information sourced from Families NSW.

Do you have questions? Ask Essential Baby members in our Toilet Training forum.