Potty training has been up and down for my family. My first son was an ideal trainer. I started familiarizing him with the potty around 16 months and he loved the potty since. He asked to use the potty from early on and would often sit on the toilet to read his books. By the age of two, he was fully trained except for nights. At 2.5 he was completely trained. I thought I had toilet training down. In my mind, I would have all my boys trained in the same manner. Now, I am at total acceptance with a nearly 4 year old who regularly has accidents. Toileting is something that develops slowly, with paitence, guidance and perhaps even a bag of M&Ms. With 4 little ones, under the age of 5, I’m a toilet training champ. It takes up large portions of my day! With a gentle approach, a few books to help potty training and encouragement, I know that some day they’ll all be trained!
As an Occupational Therapist, I address toileting with nearly everyone. Getting to the toilet, pulling down clothing, wiping and getting on and off safely are typical treatment goals. For children, these are developing skills. For adults, these skills may be lessened or weakened by illness, injury or a change in physical or mental abilities and need to be re-developed or adapted. There are so many factors involved with toileting, including muscle strength and control, cognition and even time of day…it’s important for everyone. Toileting is just one of the activities of daily living OTs address and everyone poops. It’s just a matter of how and where.
Every child learns to potty differently, in different time frames and methods. I often hear parents state that “Today is the Day so and so potty trains” “No more diapers from today on” and other definitive and ultimatum laced methods. I have news for you. If your child potty trains, from diapers to underwear…no accidents in a few days, then your child was already ‘trained’ and you are very late to the potty party! Your child already developed the skills required for this complicated processes needed and you were unaware until boot camp day. How complicated?
The toileting system is a complex process that is made up of cognition, sensory systems and the physical ability to stop and start the flow of urine and bowels. The body must tell the brain that it needs to empty, the brain must tell the body to head for the potty and the body must hold in the urine/bowel until the appropriate time to release waste. This means holding in pee/poop until clothing is removed and the child is seated on the potty! For example. I’m training my 2 year old to use the potty, gently that is. Two days in a row I found him standing by the toilet, with a poop in his trainer. His body told his brain he needed to poop, his brain send him to the bathroom…but he is not to the point where he removes clothes and sits on the potty…yet. However, it’s developing and these are amazing and fantastic steps towards using the toilet.
When I think of potty training, or I discuss it with parents, I often compare it to walking. Imagine that tomorrow you decide your baby is going to walk. Today your baby is just crawling but tomorrow is the day it will happen! You would think that it’s absurd. What child can go to crawling to walking in a few days?! Before walking, crawling happens, sitting up independently and typically standing on furniture and walking holding onto objects, known as furniture surfing. Just like walking, toileting requires coordination of the muscle system, brain, balance, knowledge and desire to potty. So, why the rush with potty training? If your child can’t train in a few days, have you failed?
The answer is No. Just like walking, learning to potty is something that develops and occurs over time. Just like the other systems and development of the body, learning to use the potty develops over a long period of time and does not magically happen in a few days. If your child can sit on the potty and purposely release pee and poop in one day, chances are they already were able to do it and were just releasing in the diaper. In addition to the developing systems required to release pee and poop on the potty, the level of independence is a developing factor.
Along with pottying, comes independence with this activity. Say, for example, my 4 month old is pretty much dependent for pottying. He is incontinent and uses a diaper, changed by me, and all of his wiping and hygeine is done by me. My 4-year old is totally independent. He going by himself (most of the time I don’t even know he had to go until he’s in there) and does all of his cleaning and pulling up/down of his clothes independently. Going from the stage my baby is in, to the stage my 4 year old is in requires patience, teaching, learning and persistence too. Yelling, demanding or insisting that it’s time to ditch the diaper today is not only ignorant, but can damage relationships.
Achieving toileting independence is completed over time. Gentle words, encouragement and I’ve even used food treats, stickers and rewards to help us over a rough patch. How can you gently encourage toileting?
- Watch for patterns. Most humans eliminate after waking up, after drinking or eating and at regular intervals. When my 2 year old wakes from a nap we head for a “potty party.”
- Make toileting fun! Read on the potty, break out the tablet, sing songs and cheer for any progress including sitting even if peeing doesn’t happen.
- Let go of preconceived notions and deadlines. Determined to get your little one trained by two? What’s the Frozen song….Let it go, let it go! Children progress at their own paces and abilities. Of course you don’t want to put putting diapers on your 6 year old, but if development is occurring normally then there’s no need to force training.
- Cloth diaper! Worried about continued cost of disposable diapers, or more then one child in diapers? Cloth means no new purchases, no weekly disposable diaper costs and can ease the need to ‘rush’ toileting to save money.
As always, if you’re concerned talk with your pediatrician and/or Occupational Therapist. Taking a gentle approach to toileting helps my entire family have more peaceful days. This article is by no means meant to replace medical advice, but instead to give some insight into my adventures as parent and OT. If you’re starting to potty train, good luck! Remember that being gentle and taking it step by step will help keep everyone in the household happy, including you!