{ THE A B Cs OF POTTY TRAINING }

Reviewed by Sarah Pearson, M.D., September 2006

Most parents eagerly anticipate toilet training as a milestone in their child's development, if for no other reason than that it means an end to changing diapers. But few moms and dads are prepared for how long toilet training can take. Sure, some children master it within a few days, but others can take several months. In fact, it's generally true that the earlier you start, the longer it takes.

You and your child have a better chance of success if you understand the elements of training and approach the process in a clear fashion. Here are the basic steps:

A. Assess your child's readiness — and your own
Some children are ready to start potty training by 18 months or so, but others aren't interested in the process until they're closer to 3 years old. Many parents begin potty training when their children are about 2 and a half.

Watch for signs that your toddler is ready to start (can she follow simple instructions? can she walk and sit down?) but try not to put on the pressure. Rushing her when she's not ready will be counterproductive. And remember that what worked for your older child might not work for this one — boys tend to train a bit more slowly than girls, while second (and subsequent) children may learn more quickly than firstborns.

Look beyond your toddler's developmental readiness, too. If she's experiencing any turmoil or major change in her life, like a new school, caregiver, or sibling, the potty-training process is likely to hit some snags and should probably be put off until things have settled down.

There's also no sense in beginning potty training when you — or your child's primary caregivers — won't be able to devote time, patience, and a dash of humor to the process. If you're in the middle of remodeling your house, have just taken a challenging new job, or are suffering from morning sickness with your next pregnancy, it's probably not a good time to try to potty-train your toddler. Wait a couple of weeks — or months — for other pressures to ease.

B. Buy the right equipment
First and foremost, invest in a child-sized potty chair or a special adapter seat that attaches to your regular toilet. This eases the anxiety some children feel about the grown-up toilet — some fear falling into it, others dislike the loud noise of the flush. Figure out what equipment is best for your toddler before you go shopping.

If you have a boy and are buying a potty chair, look for one without a urine guard or with a removable one. You may have to wipe up a little more stray pee, but the guards tend to bump into and scrape a boy's penis when he sits on the potty, which can discourage him from training.

If you're using an adapter seat, make sure it's comfy and secure, and buy a stool to go with it. Your toddler will need the stool in order to get up and down from the toilet quickly and easily, as well as to brace her feet while sitting, which helps her push when she's having a bowel movement.

C. Create a routine
Set your toddler on the potty seat, fully clothed, once a day — after breakfast, before her bath, or whenever else she's likely to have a bowel movement. This will help her get used to the potty and accept it as part of her routine. If there's not an easily accessible bathroom around, bring your child's portable potty outside, to the playroom, or wherever your toddler may be.

Once she's fine with this routine, have her sit on the potty bare-bottomed. Again, let her get used to how this feels. At this point, let her know that this is what Mommy and Daddy (and any older siblings) do every day. That is, taking off your pants before you use the bathroom is a grown-up thing to do.

If sitting on the potty with or without clothes is upsetting to your toddler, don't push it. Never restrain her or physically force her to sit there, especially if she seems scared. It's better to put the potty aside for a few weeks before trying again. Then, if she's willing to sit there, you know she's comfortable enough to proceed.

D. Demonstrate for your child
Children learn by imitation, and watching you use the bathroom is a natural way to understand what using the toilet is all about. If you have a son, it's simpler to teach him to pee sitting down at this young age. Later, when he's mastered that, he can watch his dad, older brother, or friend pee standing up — he's bound to pick it up quickly with just a little encouragement.

When you demonstrate for your toddler, it's helpful to explain what's going on as you're using the bathroom and let her see afterward what you "made." Then show her how you wipe with toilet paper, pull up your underwear, flush the toilet, and wash your hands.

Even though you'll be helping your toddler with these activities for some time, especially wiping after a bowel movement, seeing you do it and hearing you talk through it will help her get used to the whole process. (When you wipe your toddler, make sure to go from front to back, especially after a bowel movement, to minimize the risk of urinary tract infections.)

If your toddler has older siblings or friends who are potty-trained, consider having them demonstrate, too. It can be helpful for your child to see others close to her age exhibiting the skills she's trying to learn.

E. Explain the process
Show your toddler the connection between pooping and the toilet. The next time she poops in her diaper, take her to the potty, sit her down, and empty the diaper beneath her into the bowl. Afterward, let her flush if she wants to (but don't force her if she's scared) so she can watch her diaper contents disappear.

You also may want to pick up a few potty-training picture books or videos for your toddler, which can assist her in taking in all this new information. Everyone Poops, by Taro Gomi, is a perennial favorite, as well as Uh Oh! Gotta Go! and Once Upon a Potty, which even comes in a version with a doll and miniature potty.

Keeping a book like this in the bathroom, or a poster or flipbook that illustrates the steps in using the potty, can help your toddler get familiar with the process and relate it to what she does in the bathroom.

F. Foster the habit
Encourage your toddler to sit on the potty whenever she feels the urge to go. If she needs help getting there and taking off her diaper, make sure she knows it's okay to ask you for help any time.

If you can, let her run around bare-bottomed sometimes with the potty nearby. The more time she spends out of diapers, the faster she's likely to learn, although you'll have to steel yourself to clean up a few more puddles. Tell her she can use the potty whenever she wants to, and remind her occasionally that it's there if she needs it.

Sometimes toddlers won't sit on the potty long enough to relax and let anything come out. Calmly encourage your toddler to sit there for at least a minute or so. You'll have the best luck getting her to stay put if you keep her company and talk to her or read her a book.

When your toddler uses the potty successfully, shower her with praise. Chances are that she'll continue to have accidents, but she'll start to grasp that getting something in the potty is an accomplishment. Still, try not to make a big deal out of every trip to the potty, or your toddler may start to feel nervous and self-conscious under the glare of all that attention.

G. Grab some training pants
Once training is under way, consider adding training pants — extra-thick cloth or disposables that pull on like underwear — to your routine. They'll allow your toddler to undress for the potty on her own, which is a critical step toward becoming completely potty-trained.

While cloth training pants are less convenient than disposable pull-ups, many parents say they work better because your toddler can really feel when she pees or poops in them. Whichever option you choose, introduce them gradually — probably for a few hours at a time — and stick with diapers at night for the time being.

When your child consistently seeks out the potty whenever she has to go, it's time to move on to "big-kid" underwear. Many moms and dads have found that undies with a favorite character on them give kids a dandy incentive to stay dry.

H. Handle setbacks gracefully
Virtually every child will have several accidents before being able to stay dry all day long. When this happens, don't get angry or punish your child. After all, it's only recently that her muscle development has allowed her to hold her bladder and rectum closed at all, and she's still learning why it's important to use the potty. Mastering the process will take time.

What can you do? Reduce the chance of accidents by dressing your toddler in clothes that are easy to remove quickly. When she has an accident anyway, calmly clean it up and suggest (sweetly) that next time she try using her potty instead.

I. Introduce night training
Don't give away that stash of diapers just yet. Even when your child is consistently clean and dry all day, it may take several more months, or even years, for her to stay dry all night. At this age, her body is still too immature to wake her up in the middle of the night reliably just to go to the bathroom.

When you're ready to embark on night training, your toddler should continue to wear a diaper or pull-up to bed, but encourage her to use the potty if she has to pee or poop during the night. Tell her that if she wakes up in the middle of the night needing to go, she can call you for help. You can also try putting her potty near her bed so she can use it right there.

If she manages to stay dry for five nights in a row, it's a good time to start nighttime training in earnest. Put a plastic sheet under the cloth one to protect the mattress, and put your toddler to bed in underwear (or nothing) and see how it goes.

There's not much you can do to help things along, short of limiting liquids before bedtime, so if your toddler doesn't seem to get the hang of it, put her back in nighttime diapers and try again in a few months.

J. Jump for joy — you're done!
Believe it or not, when your child is mentally and physically ready to learn this new skill, she will. And if you wait until she's really ready to start, the process shouldn't be too painful for either of you.

When it's over, reinforce her pride in her achievement by letting her give away leftover diapers to a family with younger kids, or by packing up the cloth diapers and sending them away with the diaper delivery service one last time.

And don't forget to pat yourself on the back. Now you won't have to think about diapers ever again — at least, not until the next baby.