Friday, February 3, 2023

Potty training considerations

 

Potty training tidbits



If you look at parenting as a journey, consider that every single one of us has to pass through the ‘toilet training’ station. Some kids do it very easily, but they are the minority.


There are tons of differing opinions on how best to tackle this.

Regardless of which method appeals to you, the key is recognizing that kids all will present their own unique way of achieving the ‘big kid/no more diapers’ status. Watch your child's cues. If you start too soon, more often than not, you can expect several months of aggravation.


My kids were no exception to this and I learned some valuable lessons along the way.


My first daughter, Lauren, mastered most of the milestones on the early side. Seriously, she was singing show tunes at 18 months. She was interested in the potty and was mostly trained well before she was 2. But it wasn’t completely smooth sailing. She went through a period of horrible constipation. 


Constipation is very common during this phase. I am defining constipation as when they have hard or pellet-like stools. I see this happen ALL the time. Toddlers are now physiologically able to hold their poop. If they hold it too long, it will be uncomfortable coming out; this will make them want to hold it even more. Even one painful poop is going to make them more reluctant to go. This is the proverbial vicious cycle.


Keep track

I don’t think it is necessary to track every pee and poop (sneeze, yawn, ounces of milk etc) when you have an infant. However, once you have a child who is on the brink of leaving diapers behind, it is very important to pay attention to their poops. This is especially critical if there are multiple caregivers. It is easy to lose track. Kids might skip several days before anyone notices. If they miss a few days and the stools are still mushy, that is just fine. However, more often than not, the infrequent stools are harder than we want them to be.


I would suggest starting a shared document or using a tracking app such as Huckleberry. This is to make sure that whoever is on duty when the poops make an appearance, marks it down. Make note of the consistency as well. This would include daycare providers, grandparents and anyone who is part of the team.

All the caregivers should not only help keep track, but it is really important that everyone is on the same page and giving consistent messages during this process. 


Pay attention to diet

Be proactive. Make sure they are getting lots of fluids and fiber. Make some healthy muffins with ingredients like oats, flax seeds and molasses. Kids tend to eat things that they have helped with.


Or make smoothies with lots of veggies. Let them add things to the blender, be in charge of turning it on and have a special cup that they drink it out of.


All the kids will manage to get out of diapers sooner or later. 

If you wait until they seem ready, they can have success within a week. My younger daughter, Alana took her time with all of the milestones. Having Lauren do everything so quickly made it feel even slower. She was slow to walk, slow to talk and not in the least bit interested in getting rid of the diaper. 


Be careful how you ask the questions!

Me: " Hey Lani, don't you want to be a big girl? Do you want to wear these wonderful big girl undies?"

Alana: " Nope. I like being a baby. I like my diapers."

Hmmm, for some reason, that wasn't the response that I was expecting and I didn't have a follow up.


Just when I was figuring that this 'big for her age' almost 3 year old would need to start wearing "depends" all of a sudden she was magically ready. She asked for underwear and barely had an accident after that. As with everything, Alana waited until she was good 'n ready before doing anything and then simply mastered it.

(her first poop in the potty was 5/31/93 How can I possibly know this???? Check out the "keep a journal post!" )

For anyone who is worried, Alana is a local therapist who has given her blessings to me sharing this.


Books, songs and Potties

As soon as they show the slightest signs of being interested, I suggest getting a selection of the children's books and videos about potty training. Let them get familiar with the concept that some day, big kids pee and poop in the potty or toilet.  Regardless of which method you choose, books can be a fun part of the learning process. A simple search on Amazon will show you that there are tons of cute ones out there.


My grandson, Elliot likes the Elmo book P is for Potty, and he also likes the song “Go Potty Go” by Daniel Tiger.


My old friend and ex-boss Dr. Schwanke’s favorite is an old book called Toilet Learning, by Allison Mack. This one is especially good for boys. He likes that the title helps parents recognize that it is learning, not training. 


Everyone poops is another classic



So many options

There are also all sorts of potty seats. Some have steps and fit over the toilet. Others play music. Talk to your child about the choices that exist. Which one would they like to try?  Lauren and Adam inherited an Elmo potty that makes noise and Elmo laughter, which they have quickly come to resent. 


Monkey see. Monkey do

Let them watch you do your business. Although most kids start out by sitting down, little boys and dads...go play the ‘sink the cheerio game’

(I don't really need to spell that one out, do I?)


If they are in daycare, exposure to some little friends who have made the transition makes a difference. Elliot has a bunch of little friends that occasionally do some facetime from the potty to show off a successful pee or poop. If you have siblings, cousins or friends who are willing to demonstrate, kids can be motivated by watching their peers.


It is okay if they master Pee before the ‘daunting poop’

You may opt to allow this to happen in stages. For some reason most kids are way more comfortable tackling the pee issue but are much more reluctant to poop out of the comfort of their diapers. 


Go ahead and work on peeing in the potty first. Some parents have their kids wear undies but tell them when they need to poop and then put a diaper or pull-up on for that.


Potty training is the second (hunger cues are the first) big developmental transition where our children learn to listen to their bodies. And as you well know, some are better at listening than others. Having them recognize that they need to pee or poop is such an important first step and a big win.


Rewards may or may not be helpful

Sometimes a simple star chart is all you need. Other parents have success offering limited use of the ipad or phone for potty sitting. 


Some kids are motivated by the lure of ‘big kids’ undies. There are so many fun choices. Princess, dinosaur, super hero, let your little one decide what they would want to wear.


Watch out for reward backfires. With Lauren we were offering some little M&M for each poop in the toilet. She proudly squeezed out a pea size piece of poop, pointed to the ‘no longer clean’ potty. She received her treat and a round of applause...."but wait Mom and Dad...look there's more!" Like a gumball machine, she had figured out how to dispense a small piece of poop at a time. After washing out the potty multiple times, we had to do a recalculation (much to her displeasure).


And suddenly they are over 3

Aside from reading a few books, unless a deadline is forced on you, such as acceptance to a preschool that only accepts kids who are potty trained. I usually leave the more recalcitrant kids alone until they are 3-ish. Once that birthday is on the horizon, I think it is now time to take some action. There are popular methods available that some folks swear by. The premise is that disposable diapers are very absorbent and make it very comfortable for kids to hang out with a dirty one. Most kids are not inclined to just pee anywhere when the diaper is off.


Drawing a firm line in the sand and just getting rid of the diapers is the fastest way to do this. Here are some of the more popular ones


Oh Crap potty training guide This is probably the best known


Three Day Potty Training This is the one that Lauren’s friend Arielle used with her son Makai and it worked really well.


Potty training made simple. This one was created by Big Little Feelings


These systems typically help you make a step by step plan. Most involve finding a several day stretch of being home with no diaper.


Make sure that you pick a convenient time where you can carve out several days at home where you don't need to be anywhere and can focus a good bit of attention on this.

Kids may cry for their diapers, but these method usually works pretty well.


I share these because using a program or formal method is great for people who crave firm guidelines and handholding. The costs are variable. For everyone else, remember that generations of parents successfully potty trained their children without fancy apps or prescribed ‘methods’ . It is fine to just wing it!!


Here is a consideration/incentive for your older kids. Take them to the store with you when you buy the diapers. (Amazon will survive). Use cash. Singles if you have them. (Remember what actual currency looks like?) Show them the money that you give to the store every time you buy some diapers. Then, look at some toys and see how much they cost. Plant the seed, so that when they are ready, instead of a box of diapers, you can perhaps use some of the money to buy that toy instead. Obviously this tactic works better when the kids are old enough to understand the concept.


Recipe for success

  • Give some nice positive attention for any attempt at sitting on the potty and making a real effort. 


Ariell shared that the sustained and also specific enthusiastic praise was SO key to their success. Now Makai gives her a hip hip hooray every time she goes to the bathroom and she has never felt so celebrated for such a routine part of the day!



  • Set a timer and have them sit on the potty or toilet for five minutes when they are working on a poop. 


  • Just like squatty potties are great for adults, helping your child be in the right position can facilitate easier pooping.


Give them a little place for their feet so that the knees are bent a little. 


  • Make sure that they are wearing outfits that they can pull up and down easily so that when they do remember on their own they are not hampered by difficult buttons.


  • Kids get involved in playing and often don't pay much attention to their body's cues. Get in the habit of taking them to the potty every hour or so. The adults who are watching them need to be consistent.


Oops/accidents happen

There should be no shame or punishment, but once they are three, they can have a little ‘skin in the game’

They need to help clean up and know where the dirty clothes get deposited. As you are cleaning it is fine to mention how nice it would be if the poop went right into the toilet.


Have them be part of the problem solving team 

Pay attention to your language

“What can we do to keep your new undies dry”

Consider having a ‘poop agreement’ so that everyone is clear on any rewards and /or consequences that have been discussed


Leaving the diaper phase has its challenges

Being out and about with a newly potty trained child is an adventure. You will quickly learn which friendly merchants have clean and accessible toilets that you can run in and use.


You will learn to watch out for the telltale signals. The hand down at the crotch and the jiggling up and down usually mean you have a minute or less to find a bathroom. 

An inner tube and a large kitchen garbage bag make for an excellent makeshift potty.

I used to have those in my trunk and this came in handy on many occasions when my kids were little.


Some toilets are scarier than others

You actually never know what is going on inside their little heads. When my nephew was 5, he started having some accidents because he refused to pee in his upstairs toilet. I asked him what that was all about? He showed me that there was a towel rack that was crooked. His mom fixed it and he no longer had an issue with that bathroom.

Sometimes it is indeed a simple fix


I have had some little patients absolutely terrorized when a public toilet automatically flushed while they were still sitting on it. Perhaps you go first and show them how it works.


Arielle did the very wise move of getting her guy comfortable with public bathrooms well before they started the toilet training process. They explored the automatic faucets, noisy hand dryers, different toilet flushes and it made him much more comfortable. In fact recently they went to a show and he wanted to spend more time in the bathroom flushing the toilet instead of seeing the show because he was so intrigued by the sounds.


If the toilet happens to go rogue and flush while someone is still on it, make it funny. “Silly toilet, I wasn’t finished yet”


Or you can use this brilliant post it note’ hack

If you put a post it note over the sensor, it should eliminate the toilet from flushing until you are ready! 


I have other patients who are really struggling with their aversion to the toilets at school or daycare. It is worth meeting and problem solving with the staff to see if you can come up with a workable solution.


Blink and they are 3 ½

Do not shame or yell at a child who isn't quite ready. If your child is over 3 ½ and you don't feel that you are making progress, it might be time to talk to the pediatrician to see if they can help you move forward.


Night time is a whole different issue. 

I suggest working on the toilet training during the day and using pull ups at night. Don’t even think about tackling night time peeing until your child is waking up dry or asking to get rid of the night time pull ups 


Extra Pearls of Wisdom from some experts

Julie King, parent educator and coauthor of How To Talk So LITTLE Kids Will Listen shares:


I learned from my own child not to ask certain questions. "Do you have to use the toilet?" always got me a "No!" My toddler was probably thinking, "No, I don't have to go. I'm sure I can hold it for at least another ten seconds. I'll keep playing." (Ten seconds later, of course....)


I know a mom who asks her little one to "check in with your bladder and your colon. Do you have any pee or poop in there?" Her daughter will stop and try to feel what's going on in her body. 


You can also model for your potty learner by checking in with your own body, and reporting out, to help them make the connection. "My bladder is getting full. I better go empty it."


When I wanted my little one to empty his bladder before we went out, it worked better for me to say, "Let's see if you can get three drops of pee in the potty." Turns out that once you open the spigot, the pee flows freely!


I'm also in favor of being playful. When my daughter was learning to use the potty, she was resistant to "trying" on command. But she was delighted when I used the toilet, and then told her, "My pee wants to say hi to your pee!" 


(If you come up with other playful ideas, please share them with me julie@julieking.org! We might as well have some fun while we're spending so much time thinking about pee and poop!)


It's not unusual for kids to resist using the potty, especially when it means they have to interrupt their play. (Raise your hand if you have ever sat somewhere for a tad longer than you probably should have, so you could finish an email or a video ... and then had to race to the bathroom? My hand is raised.) Our kids have less experience -- and smaller bladders -- than we do, so the problem is not uncommon. It can help to sit down and problem solve with your child -- come up with a plan for reminders or potty breaks. We have a pretty hilarious example of using problem solving to address this issue with a child, which is on page 110 of our book How To Talk So Little Kids Will Listen. It's called Miss Liberty Pitches In, and it's a true story from my co-author Joanna's family.


 And just a reminder that kids with sensory processing differences or developmental delays can take longer to figure out all the steps of potty learning. One of my kids didn't have a good sense of what was going on in his own body, and he didn't feel it when his pants were soaking wet. It took him longer than what is considered typical, but he did eventually figure it all out. If you think you might have one of these kids, it can help to adjust your expectations so you don't get frustrated and impatient with the process, which can affect their ability to make progress. I know, easier said than done! It may help to remember that, for most kids, it will happen. 



Mona Singhal of Sparks wonder, and Oath’s behavioral specialist adds:


What to Wear:

This is always a hot topic. Some experts say wear nothing, go commando! I am not a fan of that. Firstly, that isn’t always the best option depending on where you live. Secondly, we are a society that does wear clothes (most of the time) so that is what we should be teaching our children. 



My preference is to have your little ones in underwear and loose sweatpants. You want them to feel wet because that will make them want to change and eventually not want to wet themselves. If they are naked it may not be that bothersome to pee everywhere.


Remember to be casual when they have accidents. “Let’s go clean up! You can always tell us when you have to use the bathroom. What color pants do you want now? Can you put your pants in the laundry please?” Drop in the reminder to tell you but don’t focus on it.  



Thanks to Julie, Mona, Lauren and Arielle for their valuable time,wisdom and feedback.


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