Is your child ready? That’s the first question you have to ask yourself when it comes to toilet training, according to paediatric occupational therapist and mother of two, Dr Áine O’Dea.
“Your child should be showing signs that they are ready to begin,” she says.
“Toilet training is a developmental skill, the same as learning to walk. Sometimes we forget that. Some kids will walk early, some much later, so I say don’t get too caught up on age in months but instead focus on watching for the signs.”
These signs are easy to spot and include the child wanting to sit on the toilet like others do and wanting to do things like flush the toilet.
“These are all signals,” she says. “Recognising and mentioning that they have a wet or dirty nappy is another indicator. They might say ‘whiffy nappy, Mammy’. You may also notice physical signs, like them going behind the couch to do a poo in their nappy in a quiet place or you may see them fidgeting, jumping up and down when they need to wee,” she continues.
“Another sign is when they can stay dry in their nappy for an hour, because if they are not doing that then they don’t have bladder control. These changes are all indications that they are getting ready physically, cognitively and emotionally to toilet train.”
Don’t force it
If these signals are not there, Áine (right) suggests postponing toilet training until they are, as starting when the child is not ready can cause problems.
“There can be a lot of social pressure, as in, ‘Is that child not toilet trained yet?’ or, ‘Z child is dry ages ago’, but if a child is not displaying the signs mentioned above I would recommend waiting,” she says.
“If you rush, it won’t be successful and if it isn’t successful that will impact on their emotional wellbeing and their learning. I often feel for mothers in this situation. Usually a mother will know and say to me, ‘I actually knew he wasn’t ready but everyone was telling me...’
“If a child isn’t ready they don’t have any awareness about whether they are wet or dry and you could very easily end up in a battle for control.”
Battle for control
You don’t want to end up being in a situation where you are forcing them onto the toilet, getting them to sit there for ages trying to do it when they are just not ready.
“They may dig their heels in very quickly and this may lead to a lot of negative behaviours around them wanting to control,” Áine says. “Once you get into control issues – especially around bowel movements – that’s when kids will start to hold onto it, and you don’t want to go there. If they are ready for toilet training they will ‘get it’ after three to five days. If they are not ready, they will literally pee and poo on the floor because they are just not aware enough.”
The age question
But at what age, generally, do children start showing signs of readiness?
“This can happen any time from 18 months on, depending on the child, but it does vary a lot,” Áine says. “Most children would be over two, some two and a half. It can be a tight line sometimes for parents to get their child trained before they are two years and 10 months old, so that they can start early childhood care and education (ECCE) pre-school.”
How to help
Explain the activity in stages
Using the toilet is an activity like anything else that we do, Áine believes, and new skills have to be learned.
“For a child to learn, you have to teach it the same way as you teach any other activity,” she says. “You break it down into the tasks and skills that are involved. By talking about what’s involved, you are priming the brain to learn. “You name the skills and the tasks within the activity like cleaning themselves and washing hands and so on, while also making it fun because if it’s not fun it’s not going to catch their interest or engage them.”
She also recommends going slowly and being patient. “Go at your pace and your child’s pace. Being patient with them will help them get it right, even if you sometimes feel frustrated. Remember all that hard work will be worth it in the end!”
1 Routine is very important
Encourage the child to sit on the potty when they get up and at regular intervals during the day, especially after meals and snacks so that they get used to it. Make it fun eg “Look, dolly/spiderman is sitting on the potty/toilet seat.”
2 Keep a potty in the bathroom
Keep another one in a room you spend time in – and a clean one in the boot of the car.
Make sure your child has a substantial diet, high in fibre with lots of water and fruit. This helps to stimulate frequent passing motions.
4 Environment is important
It needs to be stress-free and easily accessible for the child, whether you use a potty or toilet insert. A stool may be necessary. Give them a book or toy when on the toilet. Be really encouraging – praise, clap, make it fun and interesting. It is an exciting time for them as they reach another milestone.
5 Positioning is also important
Children should feel grounded with their feet firmly on the floor or on a stable surface. In order for a child’s sphincter muscle to relax they have to feel physically secure and that they can ‘let go’.
No mixed messages
Once you start, take off the nappies and leave them off during the day.
“Otherwise there’s inconsistency,” Áine says. “If you start putting the nappy on, sometimes you may get a bit of regression and you have to start all over again. Most parents use pull-up nappies at night for a while, however, until they are dry at night.”
When to start?
While summer may be an easier time for toilet training it’s more about having the right clothes on your child.
“Once they start you want it to be easy for them. So tights wouldn’t be the best thing, for example, as they are difficult to get down,” Áine explains. “Forget zips and buttons. Tracksuit bottoms or leggings are ideal. There’s no reason why you can’t toilet train in winter and when they will be ready to toilet train also depends on their age and the time of year that their birthday falls on.”
If your child has a history of any medical conditions or concerns that may affect bowel or bladder functioning it might be helpful to organise a consultation with a paediatric occupational therapist to get tailored advice with sensory strategies and toilet training equipment.
“I would give a lot of recommendations about washing hands, going to the toilet, making it fun,” Áine says.
Mary Burke is acting content and community editor of the parenting website rollercoaster.ie She has this advice:
Take your time and be patient
Potty training is a challenge, but stick with it and remember your child is very perceptive and will pick up that you can be stressed out or fed up.
Give it your full attention
Put your phone down and dedicate this time entirely to your child. No distractions, it may be easier said than done, but keep it in mind.
Make it fun
For boys, one of the easiest ways to potty train is to make it fun. Throw a few pieces of cereal into the toilet and tell him he should try to aim for it. Learning those aiming skills quickly speeds the process of toilet training along.
Show them how it’s done
This might seem a little embarrassing, but once they see you doing it, they’ll understand their own bodies more. Don’t worry, most children forget everything from that age anyway!
Cheer them on every time they finish using the bathroom. It will encourage them to keep doing it.
Let them be naked
This might sound crazy, but it’s worth a try. For a day or two, have them walk around the house bare bottomed. They will be more likely to hold in their pee and poop, and then you can take them to the bathroom every 30 minutes or so to see if they need to go.
Pull ups are your best friend
Accidents are bound to happen and having pull-ups on hand is a must. It will help them get used to underwear and using the toilet.
Stick to a regular routine with your child. Start by having them go first thing in the morning and just before bed. Check with them regularly throughout the day. Once they get the hint they may start asking you!
Dr Áine O’Dea’s website is otforlife.ie
Also see HSE tips for toilet training at hse.ie