PAMF Health Blog

Be Well, Be Well Informed

Bye Bye Diapers – Potty Training Q & A

Posted on May 15, 2012

Iris Kaddis Hanna, M.D., PAMF Pediatrics

The economic crisis, strife around the world, natural disasters and the latest celebrity scandal may feature big in the daily news but eavesdrop on any group of parents of preschoolers and one of the top topics under discussion will probably be – potty training! Questions abound from when you should start training to the best way to go about it. The most important thing for parents to know is that much like crawling or walking, potty training readiness is a developmental milestone. According to Iris Kaddis Hanna, M.D., a pediatrician at the Palo Alto Medical Foundation, every child will reach this step at a different age, when they are physically and emotionally ready to ditch the diapers and take the trip to the toilet. In this blog post, Dr. Hanna answers some commonly asked questions.

How can I tell if my daughter is ready to start potty training?

Most children will be ready for potty training sometime between two and four years of age but there are factors that are much more important than age.

Diapers may be on the way out if your child:

  • Stays dry for at least two hours at a time
  • Can follow simple instructions
  • Is becoming uncomfortable with dirty diapers and wants them changed
  • Goes and hides to urinate or have a bowel movement
  • Asks to use a potty or the toilet
  • Asks to use regular underwear

My three-year-old son is asking to use the potty. What’s the best way to start potty training?

Start by swapping the diapers with some thick cotton underwear that has several layers. Diapers are amazingly absorbent and your son needs to experience what it’s like to be wet to encourage him that getting to the toilet or potty will help him feel a lot more comfortable. Avoid pull ups as well, as they have the same absorbency as diapers and children can get very attached to them – especially if they picture a favorite princess or superhero!

If your son is showing signs of readiness, it’s an opportune time to prepare him by letting him see others using the toilet, introducing books or DVDs on the subject and talking to him about using the potty. Be encouraging and praise successes!

If your son resists, don’t insist. You don’t want toilet training to be a stressful time by pushing him too fast or punishing mistakes. Accidents and mistakes are bound to happen. Essentially, potty training should take one day, if you pick the right day. If it’s taking weeks, months or years, it’s likely that you are trying to make it happen before your child it ready.

My three-year-old daughter has been potty trained for a while but since her little baby brother came along she has been having accidents again. What should I do?

Any change, especially such an important one as a new sibling coming into the family, can make your child regress. These accidents can also occur because your child is seeking your attention. Remain matter-of-fact and give the accident as little attention as possible – otherwise she’ll learn this is the best way to get your full attention. Ask her to help you clean up the mess, then move on to something else. Praise her next time she uses the toilet in time.

My daughter is showing signs of being ready to use the toilet but is very attached to her diapers. What’s the best way to wean her from them?

Try the following four-week plan to ease her into toilet training:

  1. Week one: let her wear a diaper but make sure she goes into the bathroom to get down to business.
  2. Week two: allow her to keep the diaper on but encourage her to sit on the toilet or potty when she needs to go.
  3. Week three: cut a hole in the diaper so that when she sits on the toilet to urinate or have a bowl movement this goes into the toilet.
  4. Week four: graduate to underwear and using the toilet or potty.

Remember that although it might feel like your daughter will never let go of her beloved diapers, this is just a stage and she will soon much prefer regular underwear and using the toilet.

My five-year-old son never has an accident during the day but often still wets his bed at night. What should I do?

Night time dryness is a completely separate developmental milestone from daytime potty training that may take a lot longer to reach. Many children under seven still wet the bed at night and this is considered very much within the normal range. Simply continue to use a diaper at night to keep him dry. Children older than seven can use a bedwetting alarm that is triggered by moisture and wakes the child up, so he or she can get up and use the bathroom. Speak to your doctor if you are at all concerned about your son’s bedwetting but know that he will most likely outgrow this issue.

Iris Kaddis Hanna, M.D., a pediatrician at the Palo Alto Medical Foundation’s Mountain View Center, contributed to this blog post.