F woke up with a wet bed. First time since the amazing transformation this past month where he decided to wear underwear. It felt like a miracle. New Year’s hopes and dreams come true. Wait until you hear how it happened.
I just couldn’t bring myself to write about toilet training until now. Didn’t want to jinx it. Now with the wet bed this morning, I’m safe. Can’t blame the blog for any future wetting-messiness. You’re off the hook, SeattleMamaDoc.
There is some new data suggesting there is an ideal time for initiation of toilet training. A recent study suggests half way between age 2 and 3 years is the golden age. Ditch the diapers between 27-32 months, the urologists say.
Finally, a data-driven answer to the question of “When should I toilet train little Jane?”
So F wet the bed this morning. Not a big surprise. And pretty typical for the beginnings of toilet training. But a first for us since the miracle of toilet training graced our home.
This all started after F’s 3 year-old check up. Yup, it just took seeing the doctor. Who would have known? At the visit, F’s pediatrician turned to him and said, “Did you hear what Mommy and I were talking about? It’s time for you to use the potty. When you get home, no more diapers. Just use the potty.”
Believe it.
I’m not kidding. My son lives with two doctors, also known as his parents, who have most certainly offered up this kind of “permission” for a year. If someone had told me that F’s pediatrician was the one with magic word candy, we would have been to the office much earlier.
Previously, most pediatricians, baby sites, and books have said something like, “There is no set age when toilet training should begin.” This is what I’ve been saying to patients for years. This study disagrees.
The Data
The study published in the Journal of Pediatric Urology in December got lots of attention because it was one of the first studies to discuss when to toilet train as opposed to how. The study looked at over 200 kids who were either potty trained on their own timeline (child-oriented approach) or when their parents decided it was time to dump the diapers (parent-oriented approach). To avoid daytime drips, little pee squirts, and those accidents kids have on their way to the potty, research found the best time to toilet train was between 27-32 months of age.
Researchers said, “Initiating training later than 32 months was associated with urge incontinence (peeing on the way to the potty) in our study; however, training prior to 27 months may not be beneficial and has been shown to only lengthen the overall training process.”
The reason to avoid these little accidents is not just the inconvenience of washing 4 loads of laundry and changing 2 sets of sheets each day. This matters because urge incontinence is associated with dysfunctional voiding (when children are unable to coordinate peeing at the “right” time and have difficulties advancing with toilet training). Dysfunctional voiding can put children at higher risk for bladder infections, scaring of the kidneys and long-term kidney damage. So, urologists feel there is compelling rationale to protect all those pee parts by avoiding the risks. Toilet training earlier than 32 months may help.
So there it is, the time to start potty training is about 2 ½ years of age.
Justifying my mistakes: this study wasn’t even published when F was 32 months of age! Even if it had been, I don’t know if he would have agreed. When I read this study about a month ago, it felt like another “whoops” of parenting. F was bout 36 months at the time and he’d blown past 32 months without even considering using the toilet. Since I had bought in to the child-oriented approach (waiting for F to be “ready” to train) I’d been tapping my watch for about a year. Waiting. And then the dreaded “zoiks” once I saw the study.
Researchers suggest that once children show signs of toilet-training readiness, then it’s time to initiate. Apparently, you just have to cross your toes readiness happens by about 32 months.
We live, we learn. When O turns 27 months, I’ll be the one in the bathroom all day waiting for success and science to ring true. But maybe I’ll swing by his pediatrician’s office first. I’m counting on the magic word candy working next time, too.
Tips For The New Timeline Of Potty Training
- Consider buying a small potty and keep in an accessible area once your child is 18 months of age
- Watch for signs of toilet training readiness
- Talk, talk, and talk potty. When you or any one in the house goes pee, talk about it.
- After 27 months, if your child is showing signs of readiness, consider getting some underwear or training pants for your child to use.
- Celebrate successes. Ignore failures.
- Never punish your child for wetting or having an accident.
- Talk to your pediatrician if you’re worried. You never know if they have magic word candy, too.
Erin says
Your blog is fantastic! So, M is just over 2 and, being the youngest of 3, wants to use the potty and ‘be naked’. This, of course, means 1/2 the time, he’s peeing on the floor before he lets me know he needs to go potty and 1/2 the time…success! I plan on paying you a visit shortly (prior to his 3 year check up) just so he can hear the ‘magic words’ from you and I can be out of diapers forever! 🙂
Stacey says
At Kelsey’s 3 year appt I’ll be needing those magic words from you 🙂 She is in theory interested in the potty but once its time for her to use it she says she’s scared and wants nothing to do with it. She even held it for over 5 hours one day! I know we just need to quit giving in with diapers but I’m so worried she’s going to give herself a bladder infection or something by not going. Looking forward to discussing this at her appt! Loving the blog!
celia says
With my daughter one day she was just ready and was toilet trained pretty much overnight, of course with a few accidents here and there. We had had the potty for a long time, but she did not want to go on it until then. I really think that it was a question of waiting for her to be ready. She was 2.5. Also, pull-ups are a waste and a gimmick in my opinion, and straight to underwear works. I find pull-ups were just like diapers, and gave her permission to pee in them.
molly says
I began “training” Aidan around 18 months, then hit it again shortly after he turned 2. He did really well and was soon out of daytime diapers. He is now 3.5 and only wears a diaper at night still (naptimes are underwear and he stays dry). He wakes up with poop EVERY MORNING. This started about 2 months ago. It went from just pee and occasional poop to poop AND pee every single day. We’ve tried bribery, prizes, rewards, encouragement, praise and admittedly, a few exasperated words (but no punishment). At first, with a newborn coming, I thought it was for attention, but now I’m convinced it’s just his body clock. Any suggestions for turning this around? Sister is now 26 months and I have started with her. Just wasn’t planning on wiping 3 dirty bottoms at this point!
Wendy Sue Swanson, MD says
I don’t have any magic words. I wish I did! Just the same old, “pass the responsibility” to Aidan, have him be a part of the clean up (with no punishment or “words” if you can help it :-)), part of the responsibility of changing into underwear, knowing that he is in charge and the one to take this on. Tell him it’s time to wear underwear and get out of bed when he has to go potty, especially in the morning. Go back to underwear. Really and truly, I think this will help in the LONG run, just not in the short one. Although you may have a bad few nights & lots of sheets, it may encourage him to get out of bed if he wets or stools in his underwear. He can certainly do this; he’s proved it to you! Give it a try. Be consistent and positive. Let him know he can do this, too. He needs to know it. Good Luck!
molly says
thanks, mamadoc. i will try the underwear thing. off to find me some plastic sheets! hooray! your blog is a godsend. that’s all. happy monday (we’ll see you tomorrow!), mollly
Susi says
Our oldest (3.5) is still wearing pull-ups at night but daytime potty-trained at 27 months really easily. We had heard advice to wait until several consecutive nights of dry diapers. We even heard from a friend’s doctor that it can be common to not expect overnight success until they are 8! eeks! Sounds like you recommend off with the pull-ups. Think we’ll give it a go!
molly says
3 NIGHTS WITH NO POOP. just pee. which i can totally handle. 3 WHOLE NIGHTS!!! IN A ROW!! thanks for the advice, doc. you’re the best. i’m just sayin’…
AnaLee says
I am desperate for advice! I am so frustrated! My 2nd son is now 4.5 and still is not potty trained. He pees in the toilet on his own about 85% of the time IF he is in underwear. If he is in diapers he will just pee &/or poop in them.He denies pooping in his pants 100% of the time, and when you ask him if he needs to use the bathroom he always says no. When I make him sit on the toilet he cries. It’s so sad! He does not want to have a BM in the toilet. Instead he holds it in and he becomes very constipated. We have been on and off with Miralax for about 1.5 years. I am constantly cleaning the sludge out of his undies serveral times a day. He has been in preschool for 2 years, and it still has not clicked, and he is a very bright boy. Intellectually he is ahead of everyone, but emotionally behind. (Text book middle child! ) My oldest struggled with potty training until he was in preschool. I have a 2 year old daughter I am trying to potty train now too, and she is resisting. I really need help. I tried sticker charts, m&m’s, lollipops, reward toys, reward Toy R Us trip, taking things away, Everybody Poops Book, talking calmly with him, having him ask his brother questions, telling him all of his friends use the toilet….I’m just stumped and beginning to lose my temper! Not OK! Please help!
Wendy Sue Swanson, MD says
AnaLee, I really think your concerns warrant a visit with your pediatrician. You are in a tough spot and could use some support that I feel I can’t provide well in the blog! Your son likely has toilet training resistance leading to some other issues which is fairly common — together with your pediatrician you may be able to chart out a plan that will help you calm down, transfer responsibility to your son, and find a way out of the messiness you’re in. Book an appointment; it will help.
Tamara says
OK! Now I’m stressed. So, we have 31 month old twins and we just had a new baby…well actually she is 4 months old now. Our plan was to wait until E (the new addition) was 6-9 months old to start potty training the twins. There has just been so much change in R & A’s life. They have been moved to a new room, welcoming a new baby sister into their life (which they have done ever so gracefully), and my husband has been traveling more frequently. My thoughts were, that’s a lot for little ones to take in, heck, that’s a lot for mama to take in! Now before I get of track, this would make R & A 33-36 months old. SO, my question is am I going to mess them up? Help! It’s just with all the change going on right now…I just can’t imagine starting the journey to the potty.
Wendy Sue Swanson, MD says
No–you will not mess them up! Do what you can. If your twins show interest before your plan/schedule, then I’d suggest running with it. But your schedule will likely work. Follow your instincts (and your twin’s) and you’ll do great. This is only one study and the first of its kind to suggest 27-32 mo is “ideal.”
Viki says
So what do you think of this study, having waited till after the “magic” start age for toileting with F and succeeded; and started during the magic time with O and sustained a setback? A bunch of kids in our playgroup resisted training during the magic age range and went on to essentially self-train after their 3rd birthday.
Wendy Sue Swanson, MD says
Well, Viki, you bring up a good point. But my boys aren’t the same. What F did and what O is entirely entirely different (of course), but they are also entirely different spirits/souls/boys….
That’s the benefit of studies like the one I wrote about, they incorporate all sorts of children, all sorts of temperaments, and they help provide guidance applicable to all.
F “self-trained” essentially, too.
I don’t think O will ever do that, but I’ve also totally backed off and am letting him lead the way. Trying to take my own advice. When he wants to do this, he will. Like I say to many of my patients, I trust I won’t be sending him to college in diapers…
L says
I started to potty train our boy/girl twins at late 13th months. They are now 27 months, soon to be 28 months. We’re spinning in wild circles. Some days/weeks they’re down to 0-2 misses a day, and a couple times they’ve even had perfect days! Most of the time, it’s a mistake to get all pleased about this because it’s inevitable that we end up right back to where we are with them pretending we apparently haven’t done any potty training education so they go back to zero effort and miss after miss. I’m so unbelievably tired of cleaning up and dealing with this after over a year of this with no end in sight. It’s just we constantly end up back in this situation where we toggle between them both doing great or them both not doing anything or one doing well and one not. I have zero intention of working with only 1 child at a time b/c they like to do things together and pay close attention to what the other twin is doing so I think that would be a huge mistake. But I’m also wondering just how many months/years I’m going to have to put up with. All the advice is just completely misleading and spins you in circles too. We’re just keeping them in undies during the day and overnights at night…but I’m considering stopping that too even though they do wake up every morning with a very wet diaper. But I might just force the no diaper issue and just change their bedding every morning. I’m already feeling like the world’s biggest masochist at this point with the potty training anyway. Something has to give right? I’m tired of people telling me “oh they’re not ready” (should I wait for them to tell me they want to eat? to bathe? c’mon I just don’t buy that argument) or “oh they’ll get it eventually!” (yes i’m glad you’re cheery about the prospect of years on end of potty training 2 at the time, but I’m not…hey, are you volunteering to come here and potty train? of course not. no wonder YOU can be cheery). There’s no point in putting them back in diapers – there’s not a big difference to changing their diapers forever v. washing a ton of undies. Either way they aren’t doing anything with their own intiative. We aren’t using rewards and when we did try it didn’t see to matter. They aren’t people pleasers but strongly independent children just like their parents. I feel very cornered and frustrated with all of it anymore.