How to Potty Train Your Kid

How to Potty Train Your Kid

How to Potty Train Your Kid

harvey karp

A child’s journey out of diapers and onto the toilet is, for better or for worse, up to the kid. Maybe they’re eager and willing and a fast learner. (Congratulations.) Or maybe they would rather be doing just about anything else.

Pediatrician, professor, and child development expert Harvey Karp, MD, helps parents guide their babies and toddlers through major milestones, like sleeping through the night and getting on the toilet. He’s one of the people we trust most when childhood transitions like toilet training get difficult: His techniques and solutions are based on science—and they work.

A Q&A with Harvey Karp, MD

What makes toilet training difficult for a child?

When you feel like you have to go to the bathroom, it’s because the muscles of your intestine are starting to contract a bit. They know they’re overstretched and need to empty themselves out. When you go to the toilet voluntarily, you squeeze your stomach muscles to create a force to help push that poop out, like squeezing a tube of toothpaste. But you also have to relax the anus at the same time. It’s like taking the top off the toothpaste: If you don’t open the door, nothing’s going to come out. That’s not the easiest thing in the world for children to learn. It’s like patting your head and rubbing your belly at the same time.

That’s why children don’t necessarily get it the first time. It takes a little bit of sitting there before they start to sense what it is that you want them to do, and even once they do get it, it takes some practice to do it.

How do you know when your child is ready for toilet training?

Just as there is with any other milestone, there’s a window of opportunity when a child is going to learn this skill more easily. What seems to be most healthy for the child is this idea of readiness: You go at their pace.

For most kids, that window of opportunity for toilet training is between eighteen months and two and a half years old. But it varies from kid to kid. Here are some signs to watch for:

Verbal abilities. Your child needs to be able to communicate to you that they have to go to the bathroom.

Cooperation. There’s this period around eighteen months when kids can be so negative—“no” is their favorite word. This oppositional phase is not a great time to try to get their cooperation with potty training.

Willingness to sit still. In order to potty train, a kid needs to be able to sit down for a minute or two or three. If your kid hates to sit down, it’s going to be too stressful to try to hold them in place to poop.

Interest in neatness. If your child goes through a period when they’re interested in putting things in their place—you’ll see them putting all their toys in a bin, organizing soft toys with soft toys and hard toys with hard toys, or imitating cleaning when they watch you cleaning—they might be in a good place to learn to put poop in the toilet.

Where do you start?

You don’t start with “Let’s sit on the potty and poop.” You’re going to end there, but that’s not where you start. A good place to start is with a potty chair, not the adult potty. The reason for that is twofold: Number one, sometimes kids get intimidated by being up there on the adult toilet. It’s like you sitting on a ten-foot platform. And two, it’s very hard to poop when your feet are dangling. If you do use a little thing you put on the toilet seat, you need to have a little platform or step stool that they can put their feet on.

The first thing you do with a potty chair is you get them sitting there comfortably like it’s no big deal. You do that by making it more a party chair than a potty chair. The child will sit there, fully clothed, just to read a book or to sing a fun song. Then, “Come on, honey, let’s sit on your magic chair and look at a book. Which book do you want to look at?” When they’re sitting, set a timer for a minute or two. When the timer goes off, you say, “Yay, that was fun! Bye-bye, special chair. We’ll see you later.” The child is going to go, “Wait, I’m not finished. We were reading a book.” And you go, “Okay. Yeah. We’ll finish this page, but then we’ll come back and read some more later.” Get them wanting it more than you want it.

Once a child will do that, the next step is to do the same thing but without pants on. The next thing is to do the same thing but without a diaper on. Then, oftentimes, whether by coincidence or through their figuring it out, they pee or they poop.

I’ll note that it’s a good thing for boys to learn to pee sitting down. Because once they can pee standing up, they don’t want to sit. Standing is more fun. So getting them to learn to sit down is helpful, because that will help them figure out how to poop sitting down faster.

Does a reward system help?

The goal is not to reward the peeing or pooping; the goal is to reward sitting. And the reason for that is important: For anxious kids, the more you focus on performance and the more challenging a task is for them, the more they don’t even want to try. They’re just afraid of failing. You can undermine their confidence by making too big a deal of it. “Oh my god! This is so important to my mom. I don’t want to screw this up!” On the other hand, kids who are resistant and stubborn and tenacious might figure out that pooping is important to you and may use it against you as leverage for rewards. “You know that thing you like so much, Mommy? You didn’t give me cookies, and now I’m not going to do the thing you like.” So when they do pee or poop, you do not applaud. You do not jump up and down. You do not give a big gift. Instead, you want to be positive about it without emphasizing the accomplishment: “Hey, good job, you just pooped. Okay, let’s wipe up, and we’ll finish the book.”

If your child is motivated by rewards, you might give them a something small—but again, this is just for sitting there. One of the rewards I like a lot is a check on the hand: Just take a pen and just put a little check on the back of his hand. “Good job! Here’s a check on your hand.” Kids like that the way they like temporary tattoos. But what’s most fun about a check on the hand is that at the end of the day, when you’re putting them to bed, you can count the checks on their hand as a part of their bedtime routine. “What was that one for? What was that one for?” And they go to bed remembering all the good things they did.

There can be setbacks. Kids get sick, you travel, they had an illness and diarrhea, and then they got scared to poop. It’s not always a straight line. Sometimes it’s two steps forward, one step back. But this process is a less stressful way of doing toilet training. If your child is ready for it, you can expect it’ll take anywhere from a couple of weeks to a couple of months. Just as with anything else, it’s about consistency. That’s how we all learn: repetition and familiarity.

How do you deal with accidents and bed-wetting?

Accidents are inevitable. These things usually happen for some reason, whether you understand that reason or not. Maybe the child is sick or stressed, or maybe you’ve been out and about all day and they just haven’t had the chance to go potty at home. When accidents happen, you want to take the feeling of failure away from your child and stay positive. “Oh, yucky! Well, no big deal. Next time you’ll do it on the potty, right, bud?”

If you’re seeing frequent skid marks or poop accidents, make sure that your child is not severely constipated: Things can leak out when you’re carrying a load down there. Reconsider what you’re feeding your child. Pasta, bread, and cheese tend to be more constipating, while foods with lots of insoluble fiber can help. It’s important to fix this issue quickly because constipation can interfere with toilet training as a whole. When a child passes a hard poop, it can be painful, which can scare them into holding back the next time.

For bed-wetting, it’s important to know that some people can be dry during the day, but they don’t have good bladder control at night. Wetting the bed can go on until five years of age up until about nine. You want to be thoughtful about how you handle that: This is usually an issue that runs in families; it’s not the child’s fault. Talk to your doctor about it.

Why can toilet training feel like such a psychological battle?

Studies have shown that about 50 percent or so of personality is inherent—it’s there from birth. As I say in Happiest Baby, two Dobermans don’t give birth to a cocker spaniel. Parents see their own personalities in their baby all the time: “Oh my god. He’s got your intensity,” or “She has your sensitivity,” or “He has your crankiness in the morning,” or things like that. As parents, we can make the best out of these personality traits, or we can push against them, which usually creates more stress for our kids and for ourselves.

Here’s what I mean by that: If you have a child who is very laissez-faire and you’re always trying to whip them into shape, they’re going to feel that they’re not accepted for who they are. Or maybe you have a fearful or timid child and you’re constantly pushing them to be brave, be brave, be brave—that’s a child you’re going to end up breaking.

When it comes to parenting, you have to play the cards you’re dealt. Some kids are much more sensitive to pressure, other kids take it in stride, and other kids become totally resistant and tenacious about holding on to their point of view. Do you have a very obedient child who’s going to do everything you say, including getting on the potty, or do you have a little lawyer which who’s going to constantly rework the deal? If you can recognize what your child’s personality type is, you can work with that personality instead of pressing against it.

Harvey Karp, MD, is a pediatrician, child development specialist, and assistant professor of pediatrics at the USC Keck School of Medicine. He completed medical school training at Albert Einstein College of Medicine in New York, pediatric residency at Children’s Hospital of Los Angeles, and fellowships in ambulatory pediatrics and child development at UCLA. In pediatric practice for twenty-five years, Karp taught thousands of parents his approaches for soothing colic, encouraging infant sleep, reducing tantrums, and promoting patience. He is now the founder and CEO of Happiest Baby, a tech company focused on supporting babies’ health and empowering parents.

This article is for informational purposes only, even if and regardless of whether it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.

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