Toilet training tips

Most children start to show signs that they are ready for toilet training between ages 18 and 30 months. Before 18 months, most children can't fully control their bladder and bowel muscles. Your child will let you know in their own way that they are ready to start toilet training. Children are ready when they:

• Show interest in the toilet or in wearing underpants
• Express through words or expressions that they need to go to the bathroom
• Hint that the diaper is wet or dirty
• Feel uncomfortable if the diaper gets dirty and try to remove it without help
• Stay dry for at least 2 hours during the day
• Can pull down their pants and pull them back up
• Can understand and follow basic instructions

It's a good idea to choose a time when you don't have other major events planned, such as a vacation, a big move, or a work project that will require extra time from you.

Don't push your child to learn too quickly. If your child feels pressure to potty train before they are ready, it may take longer for them to learn. If your child resists the training, it means they aren't ready yet. So back off and wait a few weeks before trying again.

To start potty training you will need to:

• Buy a training potty seat and potty chair - you may need more than one if you have bathrooms or play areas on different levels of the house.
• Place the potty chair near your child's play area so they can see and touch it.
• Establish a routine. Once a day, have your child sit on the potty fully clothed. Never force them to sit on it, and let them get off it when they want to.
• Once they are comfortable sitting on the chair, have them sit on it without diapers and pants. Show them how to pull down their pants before getting on the potty.
• Children learn by watching others. Let your child watch you or their siblings use the toilet and let them practice flushing it.
• Help your child know how to talk about the bathroom using simple terms like "poop" and "pee."
• Children typically will have a bowel movement after a meal. Encouraging your child sit on the potty seat or toilet after a meal can sometimes increase the likelihood of having success with stool toilet training.

Once your child is comfortable sitting on the potty chair without diapers, you can start to show them how to use it.

• Put stool from their diaper into the potty chair.
• Have them watch while you transfer the stool from the potty chair into the toilet.
• Have them flush the toilet and watch as it flushes. This will help them learn that the toilet is where poop goes.
• Be alert for when your child signals that they might need to use the toilet. Take your child to the potty quickly and praise your child for telling you.
• Teach your child to stop what they are doing and go to the potty when they feel like they need to go to the bathroom.
• Stay with your child when they are sitting on the potty. Reading a book or talking to them may help them relax.
• Teach your child to wipe themselves after passing stool. Teach girls to wipe from front to back to help prevent stool from getting near the vagina.
• Be sure your child washes their hands properly every time after using the toilet.
• Praise your child every time they go to the toilet, even if all they do is sit there. Your goal is to help them connect the feelings of needing to go to the bathroom with going to the toilet and using it.
• Once your child has learned how to use the toilet pretty regularly, you may want to try using pull-up training pants. That way your child can get in and out of them without help.

Most children take about 3 to 6 months to learn how to use the toilet. Girls usually learn to use the toilet faster than boys. Children commonly remain in diapers until about age 2 to 3 years old.

Even after staying dry during the day, most children need more time to be able to sleep through the night without wetting the bed. This is the last stage of toilet training. It's a good idea to get a water-proof mattress pad while your child learns nighttime control.

Expect that your child will have accidents as they learn to use the toilet. It's just part of the process. Sometimes, even after the training, accidents may occur during the daytime too.

When these events occur it's important to:

• Stay calm.
• Clean up and gently remind your child to use the toilet the next time. Never scold your child.
• Reassure your child if they get upset.

To prevent such events you can:

• Ask your child from time to time if they want to go to toilet. Most children need to go about an hour or so after a meal or after drinking a lot of fluids.
• Get absorbent underwear for your child if they have frequent accidents.

Contact the doctor if your child:

• Has been potty trained earlier but is having more accidents now
• Does not use the toilet even after 4 years of age
• Has pain with urination or stools
• Often has wetting issues -- this could be a sign of a urinary infection

Potty training

American Academy of Pediatrics, healtychildren.org website. Create a potty training plan for your child. www.healthychildren.org/English/ages-stages/toddler/toilet-training/pages/Creating-a-Toilet-Training-Plan.aspx. Updated May 25, 2022. Accessed December 14, 2022.

American Academy of Pediatrics, healthychildren.org website. Toilet training and the older child. www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Toilet-Training-and-the-Older-Child.aspx. Updated November 2, 2009. Accessed December 14, 2022.

Elder JS. Enuresis and voiding dysfunction. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 558.

Updated by: Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.