Potty Training

How do you recommend potty training a toddler?

Our Daddy MD Guide’s reply:  As both a father and a pediatrician, I’ve spent the last 30 years helping thousands of children get through life issues, including potty training.

The most important part of potty training is that the child actually tells you that they need their diaper changed. The neurologic function kicks in at about 18 to 21 months. Any attempt to train before this time is useless, and only trains the parent, not the child. It also gives the child a tool to use against you when they are upset.

You put the child in regular underwear, not pull-ups. This encourages the child to hold their urine so as not to be uncomfortable. You then take the child to the toilet every 30 minutes by the clock. They sit on the toilet for two minutes (a minute per year of age). There are no books, games, or singing. The child is there to go to the bathroom. After two minutes if the child goes, give a small reward like a sticker, M&M’s, etc. If the child doesn’t go, take him or her off and go about their business. Then 30 minutes later, they return to the toilet. In one to two days, as they hold it for the opportunity to go, stretch the waiting time to one hour, then one and a half hours, then two hours, and you are done. A pull-up should be used at night until they are dry and any accidents should be changed without any discussions or scolding. This will take about three to four days.

Jan Widerman, DO, a dad of 37-, 34-, 27-, and 25-year-old children and an AOA board-certified pediatrician in private practice in Philadelphia

* * *

Our Daddy MD Guide’s reply: Most parents find potty training to be a very difficult task. I am often approached by parents who feel exasperated by their older child’s (usually age three or four years old) inability or refusal to toilet train despite all the parents’ efforts. Parents usually come into my office with lists of everything they have tried. Most have attempted various forms of positive reinforcement, such as sticker charts, toy rewards, food rewards (which, by the way, I strongly discourage using food rewards since that can lead to food “relationship” issues down the road in a child’s life). Most have also tried negative reinforcement, such as scolding, expressing disappointment in the child, reasoning with the child, spanking, and even making the child sit in a dirty diaper for prolonged periods of time.

My solution to these parents is simple: Give back control to your child. Allow him or her to do their “business” in diapers for a month or two without getting frustrated or even mentioning using the potty. Understand that your three- or four-year-old has very little control over anything in his or her life and yet is developing a desire for control. Aside from what goes in their bodies and what comes out of their bodies, three- and four-year-olds have everything in their lives dictated for them. So by giving them back control for awhile, you effectively break that cycle of power struggle. Hopefully that will lead to them being open-minded when you resume potty training.

Mark J. Pyle, DO, is a dad of eight-year-old, three-year-old, and one-year-old daughters and a pediatrician in private practice at Banner Health Center Verrado in Buckeye, Arizona.

Q&A by Wyatt Myers