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Toilet Training: Trials and Triumphs

My husband and I joke that if our youngest daughter, Natasha, had been the first child we'd potty trained, we'd have thought there was something seriously wrong with our other kids. One day we said to her, "Natasha, it's time to stop wearing diapers." "Okay," she said, and that was that. Really.

It makes for a good story (one that my other children don't always appreciate), but the truth is that it was easy precisely because Natasha wasn't the first we'd trained -- she was the fourth. And by then, I had well over a decade of experience as a pediatrician. (I should be able to train my 7-month-old, Liam, in my sleep when the time comes!)

When my eldest, Michaela, was a toddler, I was new to parenting and doctoring. But I'd been taught about potty training during my residency in pediatrics, I'd read books and magazines, and it all seemed straightforward enough  -- until I actually tried it. I discovered quickly that potty training isn't one-diaper-fits-all.

Not that it's impossible -- it's certainly challenging, more so with some children than others, but potty training does happen eventually (as a look around the average preschool classroom will prove). It's just a far more individual process than people realize, one that depends on your child's personality, and even on what's happening in your own life at the time. Learning to tailor your potty-training strategy to your child's temperament  -- and your family's  -- will save you a lot of stress in the long run.

Claire McCarthy, M.D., is a Parenting contributing editor.

Is he ready?

Before you give potty training a try, I was taught, your child must show signs of readiness. He should, for example:

• Have words for "urine," "stool," and "potty" or "toilet." ("Pee-pee," "poop," or other slang is fine.)

• Be at least somewhat bothered by being (or have some sense that he is) wet or soiled.

• Have an interest in using the potty -- he should be open to sitting on it, and might follow people into the bathroom to see what they're doing in there.

• Have some awareness of when he is about to urinate or have a bowel movement.

Pretty clear, right? The first two are, and they're crucial, because if your child is happy to live in a poopy diaper, or has no way of telling you otherwise, you're not going to get very far.

But the other signs can be murkier. Zack, our second child, had the right words, showed some desire to be changed, and was enchanted by the potty, but he never produced anything there. When we took his diaper off, he blithely made puddles everywhere. (He wound up using one of those seats you put on your toilet so your kid won't fall into it.)

To figure out when your child is ready, you'll ultimately have to guess. Most pediatricians suggest starting to look for the signs around age 2, but some kids are ready even earlier  -- and many won't be for a year or more after that. The best you can do is give it a shot when you notice some of the signals. If it turns out that your child wasn't so ready after all, you can simply try again later.

Are you ready?

Potty training takes energy and patience. It requires countless bathroom visits, not to mention the laundry and puddle cleaning. All of which you're expected to do with an encouraging smile. I don't know about you, but there have definitely been periods in my life when I couldn't have pulled that off, certainly not with a smile. A new job, a new baby, marital stress  -- some things simply don't mix with potty training. You shouldn't feel bad about postponing; it will be far easier if you wait until the time's right for you.

It's important that everyone who looks after your child be on the same page, so talk with your caregiver to be sure she's ready, too. If your child goes to a daycare center, check to see whether it has any toilet-training routines or policies. You may be able to coordinate your efforts and find a solution that's convenient for them, you, and your toddler.

What's he like?

Okay. Everybody's ready and you want to get started. When I began to train Michaela, the process seemed so simple:

  • Buy a potty.
  • Introduce the potty to your child and let her sit on it clothed.
  • Have her sit on it unclothed at times when kids usually wet or soil their diapers (like first thing in the morning or after meals), and give her lots of applause and praise.
  • Buy her fun underwear that she likes.
  • Be patient and upbeat.

Except that with Michaela, this took nearly a year. In retrospect, it was a personality thing. Michaela, now 15, has never liked to be rushed into anything -- not walking, not talking, and definitely not potty training. And because she took her time, I assumed it wasn't working and stopped several times to try again later.

I realize now that she would likely have been trained much sooner if I hadn't kept quitting! Michaela was simply going at her own pace, as she always does.

Though it never occurred to me to consider personality in toilet training, it's the key to making it work. Think about how your child has approached milestones like walking, trying new foods, and socializing. The way he approaches giving up diapers is likely to be the same. Is he bold and adventurous, or more tentative? If he's brave, presenting potty training as something new and exciting may work well, and he may have no problem going cold turkey and ditching diapers completely. If you have a cautious kid, like Michaela, "new and exciting" might be plain scary. Read potty-training stories together and talk up the subject before buying a potty. Proceed gradually: You can have your child wear underwear while at home, even just for an hour or two at a time, and then go back to diapers. Many kids are somewhere in between bold and tentative and may need an approach that's in between.

If your child is clearly upset by what's going on  -- he's tearfully refusing to sit on the potty or clingy all of a sudden -- or if accidents are far outnumbering successes, you really should stop and try again later. (Keep in mind that most children will need diapers at night for a while after they are trained during the day. Wait until your child's diapers are dry in the morning before having him wear underwear to bed, and make sure you've got a plastic cover on the mattress: Nighttime accidents are common through age 6.)

But sometimes struggles are part of the process. Elsa, who's 8 now, has always hated change -- all change. By 3, she didn't like being in dirty diapers but refused even to discuss wearing panties. And she hates to be the center of attention. When she once used the potty by accident (she had agreed to sit on it in the living room clearly just to humor me and ended up pooping while distracted by a TV show), my husband and I applauded and cheered. She was furious. "Don't be happy at me!" she yelled, and refused to sit on the potty again for weeks.

Finally, when months went by with no progress, I took her diapers away. She'd glare at me when she couldn't hold it in any longer and had to go sit on the potty. We did this for about four days, and just when I was about to give in because I felt like the Evilest Mommy (and was beginning to worry about medical trouble  -- click on Problems to Watch For

Standoffs should be a last resort, and stopped if your child is upset. But if your child is a standoff kind of kid -- Elsa certainly is -- toilet training may not be much different.

What's it worth?

Most kids, unlike Elsa, do like praise, and that's where all that smiling and encouraging come in. Try not to scold your child for accidents -- they're totally normal, and you don't want your child to feel pressured or shamed.

Clapping and cheering, though, may motivate a child only so much. Incentives are an important part of potty training. I'm not advocating that you buy your child something every time she sits on the potty, but hey, we're all more interested in doing something if it's worth our while. You can use small rewards, like stickers or an extra bedtime story, for little successes, or bigger ones -- like a much-wanted toy or a special outing -- when the diapers are gone (or when the end is in sight).

Sometimes the best motivation won't come from you. We enrolled Zack in a summer program just before his third birthday. The program had a pool -- but you couldn't go into it if you were still in diapers. Zack took one look at that pool and was trained within days.

Peer pressure can work for you, too. Preschoolers want to do what their pals are doing, and that includes being potty trained. The cool underwear or wanting to be like older siblings has helped others.

Back to Natasha (now 5). She seemed ready by 2½, but I saw two problems. First, she always needs to be in charge. Second, we weren't ready. It was September, and with three kids starting school, we were way too busy to take on potty training.

So we put it off. We talked about doing it, and she characteristically said no. Of course not now, we told her. When you're 3. We took her to see the preschool she was going to attend the following year, which absolutely fascinated her, and we pointed out that the children there weren't wearing diapers. "But I don't want to use the potty," she said. Of course not now, we told her. When you're 3. We went to the store and she picked out pretty panties. You can't wear them now, we told her. You have to wait until you're 3. She looked at the panties a bit wistfully and, little by little, began to talk about using the potty when she turned 3.

Finally, her third birthday arrived. We got the potty out of the attic, took the panties out of the package, and told her it was time. "Okay," she said. After my years of frustrating moments, cleaning up puddles, and trying idea upon idea, she was toilet trained.

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