Month 18 Worry: How Do I Start Potty Training?
The most common medical concern for parents of children this age
Consider the Numbers
Potty training is an interesting developmental and behavioral milestone. The average age of controlling voiding and stooling habits varies by culture, race, socioeconomic status, and whether your child is male or female, just to name a few. Potty training theories abound by the so-called experts. So let’s break it down. What are the fundamentals in beginning potty training for your child?
In the United States, the average boy urine trains at 39 months of age, according to a Medical College of Wisconsin study. The average girl trains at 36 months.
In other cultures (Africa, Eastern Europe, China, the Arctic), babies learn to potty train about the same time that they learn to walk (about one year of age). This process, termed “elimination communication,” begins between birth and 6 months of age and consists of very attentive parents reading subtle infant cues. Keep in mind that the average young infant pees five to six times per day. Those are a lot of cues!
What Parents Can Do
Start the potty training process in your child’s second year of life and start gently. Put the potty in or near the bathroom and allow your toddler to see it as part of the environment. Allow her to sit on it with her diaper on.
Know that potty training is usually a two steps forward, one step back kind of process. Initial excitement may lead to general indifference or even anger … and then there are the toddler’s feelings to deal with! Try putting your toddler on the potty without a diaper. Read a book on the potty while the bathtub is filling. If the process becomes stressful for you or your toddler, back off.
You might also wait until the weather is warmer and let your child out in the yard without clothes or wearing underwear. Have the potty available if she feels the urge, and gently guide her to sit every so often. Downplay the failures and cheer the successes. After a number of trials of bare-bottomed frolicking, many toddlers will find it hard to go back to a bulky diaper. If your child is not developmentally ready, don’t feel bad about tabling the issue and coming back to it in a few weeks.
If your child has a set back, make pooping and peeing in the diaper as inconvenient as possible for her. Have her get the new diaper and wipes, have her throw away the soiled diaper in the garbage. And while changing the diaper, non-judgmental statements such as, “Some day you are going to use the potty like a big girl and Mommy will be so proud,” go a long way to motivate.
What the Docs May Do
Your pediatrician should take a detailed elimination history (“peeing” and “pooping” in pediatric language) with every well-child visit. The focus should be on age-appropriate behaviors and watching for early signs of withholding and constipation. A chronic and severe issue with constipation can begin to develop at this delicate time. Hard, painful, and bulky bowel movements can easily trip toddlers into a cycle of withholding and more severe constipation which might not be noticed until years down the road.
Most doctors will tell you that the most physiologic way to pee or poop is to have your feet planted firmly. Imagine trying to poop on a super-sized toilet with your legs dangling in mid air! Toddlers also feel more secure with their feet planted. So if your toddler is going to use the adult toilet, have a sturdy bench or stool in front of the toilet so she can rest her feet.
Although a bit unorthodox, our practice discourages the use of pull-on diapers, though most pediatricians do recommend Pull-Ups. They give a toddler all the benefits of big girl underwear (comfort and easy on and off), but lack the potty motivation factor that a bulky diaper automatically supplies because of the relative discomfort.
And remember, no amount of training slowness is considered abnormal (according to the Yale Child Study Center Guide to Understanding Your Child) unless your child is not potty trained by age five. So if you are stressed out by the process or your toddler is frustrated, don’t hesitate to take a step back to diapers. You have plenty of time.
More 18th Month Help
Even the most confident parent has concerns about her child’s health and wellness from time to time. Learn more about which medical issues are most common at each age, here. (If you have any pressing concerns or questions about your child’s health, please check with her healthcare provider.)
- What was last month’s most popular health worry?
- Learn which medical question you might have next month.
- Here’s what else is happening with your child’s health and development this month.
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