Potty training can be one of the most emotionally filled challenges of parenthood. What a relief to have a child out of diapers but how do we get there without too many accidents and tears along the way.

1. When to Begin
One of the most common questions we get about toilet training is when should I start? Sometimes this is in the context of an older sibling or family member who was toilet trained at a certain age. But as with many things, one size does not fit all.

It is important to realize that children will be ready for toilet training at different ages. The average age for achieving daytime toilet training is between ages 2-3 years old but the range is much wider (and yes, in general boys achieve toilet training a bit later than girls).

In order not to pressure your child to begin toilet training when they are not yet ready, try not to feel pressured yourself. Here are some cues that may indicate that a child is developmentally ready to begin toilet training:

• Can your child tell you (through words, facial expressions or actions) when they need to go to the bathroom?
• Can your child stay dry for several hours in a row?
• Can your child follow simple routines and understand simple directions?
• Can your child remove their clothing and diaper/pullup and put clothing back on?

Consider other things that may be going on in a child’s life causing stress or change in routine (birth of a sibling, moving homes, travel). If there are major transitions, this may not be the best time to start toilet training.

2. Keep it simple
Have your child go with you while you go to the bathroom. Talk through the process so they know what is happening and what to expect.

Have your child get used to the potty chair or toilet seat. Have them sit on it with their diaper on and then with their diaper off. Having a stool that they can put their feet on can take away some of the fear that some children have when sitting on the toilet.

Have simple words that you use (and help your child learn to use) to indicate when they need to go to the bathroom and when it is time to sit on the toilet.

3. Be consistent
When you are ready to start, begin by making frequent visits to the bathroom with your child.

Especially when starting out, do not ask your child if they need to go to the bathroom, tell them it is time to go to the bathroom every 1-2 hours. Be matter of fact.

Have your child sit on the toilet for 1 minute each time. When done help them with wiping and flushing the toilet even if nothing comes out. This reinforces the steps in the routine.

4. Be Positive
Staying positive is crucial. Give praise for even small steps (sitting on the potty even if nothing comes out). Positive reinforcement for behaviors you want to see repeated works for many areas in a toddler’s life including toilet training.

Positive reinforcement charts/sticker charts and “prizes” such as an extra bedtime story or trip to the park when certain goals are achieved can be helpful.

Do not give negative feedback if nothing comes out or if your child has an accident. Let them know you are excited that they are working hard and talk about the steps to use next time they need to use the toilet.

Most importantly, do not make toilet training a battle. We cannot force a child to use the toilet and we do not want to make the bathroom a negative experience so if your child starts to rebel, back off for a few weeks and then try again.

5. Expect ups and downs
It is not unusual after some successful weeks of toilet training for the novelty to wear off and a child to express interest in using diapers again. Continue to be positive and praise their hard work and success.

Reinstitute positive reinforcement charts if they were helpful before to re-energize your child’s commitment to toilet training.

Remember to continue to take your child to the bathroom frequently (I generally recommend every 2 hours and before leaving the house).

If your child has any difficulties with using the bathroom (if they have constipation or seem to be holding in their bowel movement), if they complain of pain or things do not seem to be progressing as you would expect, check in with your pediatrician.

What are your tips for potty training?

Alice Rothman is a general pediatrician with the University Pediatrics practice at Vanderbilt One Hundred Oaks. She also works with families in the International Adoption Clinic at Vanderbilt. She enjoys travel and all activities with her 2 children.

Editor’s note: For information on toilet training children with developmental delays, click here and for children with autism, click here.