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13 Toilet-training Tips to Know Before You Start
6 Steps to D-Day: Diaper-Free Day
Helping the Child Who Won't Go
Toilet-training in Two Days: Fast Track Tactics
Twenty More Toilet-training Tactics From the Coaches
Traveling While Training

1. Toilet-training is a partnership, with proper roles assigned to each person. You can lead a baby to the bathroom, but you can't make him go.

2. You have not failed Parenting 101 if your baby is the last on the block to be dry. As with eating and sleeping, you can't and shouldn't force a baby to be dry or clean, but you can set the conditions that help baby train himself.

3. The bottom line is helping your baby achieve a healthy toilet- training attitude. Approach toilet-training as an exciting interaction rather than a dreaded task; consider this event an initiation into your role as instructor. From baby's viewpoint, toileting is his initiation into "bigness"-a rite of passage from toddlerhood into preschoolerhood. (This explains why the desire to stay little makes some procrastinators resist.)

4. Toilet-training is a complex skill. Before you rush baby to the potty at the first squat, consider what's involved in learning toileting skills. First, baby has to be aware of the pressure sensations of his bowel and bladder. Then he must make the connection between these sensations and what's happening inside his body. Next he learns to respond to these urges by running to the potty, where he must know how to remove his clothes, how to situate himself comfortably on this new kind of seat and how to hold his urges until all systems are go. With all these steps, it's no wonder many babies are still in diapers well into the third year.

5. The muscles surrounding the opening of the bladder and bowel (I call them doughnut muscles when explaining the elimination process to six-year- old bed wetters) need to be controlled to open and close at the proper time. Bowel training usually precedes bladder training, mainly because the doughnut muscles surrounding the bowel are not as impatient as those around the bladder. When a baby senses the urge to defecate, he has more time to respond before soiling his diapers. A solid substance is easier to control than liquid. When the bladder is full, the urge to go is sudden, strong, and hard to control.

6. The usual sequence of gaining bowel and bladder control is (1) nighttime bowel control; (2) daytime bowel control; (3) daytime bladder control; (4) nighttime bladder control.

7. Girls are rumored to be trained earlier than boys. This observation reflects more the sex of the trainer than the trainee. Culturally, toilet-training has been left to mothers; naturally, women feel more comfortable training girls, and baby girls are more likely to imitate their mommies. Picture mommy standing and trying to show baby Bert how to urinate. By imitation, babies learn that girls sit and boys stand, but in the beginning boys can sit, avoiding sprays and dribbles on walls and floor. When your son figures out he can stand just like daddy, he will.

8. The pressure is off parents to toilet train early. Don't equate toilet-training with good mothering. The idea that the earlier baby is eating three squares a day, weaned, toilet trained, and independent, the "better" the mother is nonsense.

9. We do not mean to imply that you lazily leave baby alone until he is old enough to order his own potty-chair. Some training is necessary on the parents' part, and some learning is needed by the baby. Children need parental guidance to get control of their bodies.

10. The temperament of the mother and baby play a role in readiness, too. A down-to-business baby tends to learn quickly and may even "train himself," especially if he has a mother who thinks the same way, but who is wise enough not to pressure. A laid-back baby with a casual mother may still be in diapers at three years and no one worries. With a laid-back baby and a down-to- business, mother toilet-training gets more challenging.

11. Take the pressure off you and baby. Don't cave in to in-law pressure. You know when your infant is ready. Of course, the "diaper-free" policy at your desired preschool looms over you like a due date.

12. Diaper company market research shows that toddlers are being toilet trained later than in the past, and to go along with this trend diaper companies are making bigger and better diapers. Children learn to use the toilet the same way they learn to walk and talk: by imitating their caregivers- and when the appropriate nerves and muscles are mature enough to be coordinated. For these reasons, the time of training will vary from home to home and child to child.

13. Toilet-training is so difficult for parents and a battle for toddlers because:

1. The infant was encouraged to use the diaper as a toilet, so the toddler has to unlearn what he has previously been taught.
2. The child has not yet developed body language to make the connection between feeling and going, since prior to toilet-training, parents were not looking for these cues and the baby did not give them.
3. Toddlers, especially boys, are on the go and the last thing they want to do is "sit still" on the potty.

• Imitates your toileting
• Verbally communicates other sensations, such as hunger
• Understands simple requests, such as "go get ball"
• Begins to pull diapers off when wet or soiled, or comes to tell you he's dirty
• Follows you to the bathroom
• Able to pull clothes off
• Climbs onto the potty-chair or toilet
• Has dry spells: stays dry at least three hours
• Investigates his or her body equipment

• Peers into diaper
• Squatting
• Grabbing diapers
• Crossing legs
• Grunting and grimacing
• Retreating to the corner or behind the couch like a mother cat about to deliver

About to go: retreats to quiet place, stops play quiets, squats. Going: grabs diaper, grunts, crosses legs.

Gone: peers at diaper bulge, senses different feel, resumes play or verbalizes production. These signs tell you that baby is developmentally mature enough to be aware of what's going on inside his body.

Timely training. There are developmental phases when toilet-training is untimely. If your toddler is going through a generally negative mood in which he resists all interventions and his vocabulary is limited to the two-letter word "no," hold onto your techniques a few more weeks and catch him at a more receptive time.

Are you ready? Choose a time to train when you're not preoccupied with other commitments, such as during an older child's high-need period, work stress, a move, a week before childbirth (a new baby in the house tends to cause regression anyway), and so on. Also, warm-weather training works best-you don't have snowsuits to contend with.

• Sense of humor
• Endless patience
• Creative marketing
• Potty-chair
• Training pants

Show-and-tell. Capitalize on a prime developmental interest at this stage-the desire to imitate. Let baby watch you go potty and explain what you are doing. Girls naturally do better in the bathroom classroom with mommies, boys with daddies, but same-sex training is not crucial.

Peer pressure. If baby has a friend in training, arrange for her to watch what her friend does. If baby is in daycare, her teammates may show her a trick or two. However, some preschools won't accept children in diapers, so the pressure is already on.

Potty props. Some parents use a doll that wets to model the toilet- training steps. Baby sees where the "urine" comes from, removes the doll's diapers, places the doll on the potty seat, changes the doll's diapers, removes and empties the potty-chair bowl into the toilet, and then flushes the toilet. The combination of live models (parents and peers) and a doll model makes toilet-training easier.

Feeding for easy passage. Remember, the food that goes in at the top end affects the ease of passage at the bottom end.

Book learning. Besides live models and doll models there are clever books that show pictures of a child in training. Exposing your child to these potty- trained characters gives your child the message "If they can do it, so can I." Try the book Toilet Learning: The Picture Book Technique for Children and Parents, by Alison Mack (Little, Brown, 1983). Other helpful books are: Going to the Potty by Fred Rogers or Once Upon a Potty by Alona Frankel.

Picking a place to go. The teacher's next decision is whether to buy baby her own potty-chair or an adapter for the toilet. The pupil's decision is which one, if any, he prefers. Most babies prefer their own potty-chair, which alleviates flushing fears. Many children normally fear having a bowel movement in the adult toilet because they are afraid of seeing "parts of themselves" come out of their body and go swoosh down the drain. Potty-chairs securely contain babies, and potty-chairs can be carried from room to room and even put in the car. With a potty-chair baby can plant her feet squarely on the floor, instead of dangling them in mid-air from the adult toilet.

Toileting Tip Little legs dangling from big potties tighten rectal muscles making defecation difficult. Be sure your baby's feet rest comfortably on the floor, or on a footstool if he prefers the adult potty.

Potty Picking. Play the pick-a-potty game. Take baby to the toy store with you and let him pick out his own potty chair. Toddlers are more likely to use the potty they choose. There are as many varieties of potty-chairs as there are contours of babies' bottoms. Choose one wisely. Baby may prize it, much like his first riding toy. When purchasing baby's first potty, consider the following:

Baby's opinion. Take the baby to the store with you for a test sit. See how comfortable your fully-clothed baby is using it as a chair before using it as a potty. In fact, at home he may like using it as a chair long before using it as a potty.

Ease of cleaning. Be sure the catch bowl lifts out easily. A catch bowl removable from the top is easier to clean than one removable from the rear or side.

Safety. Beware of sharp edges or hinges on the seat that can pinch baby's fingers or bottom. Also, avoid the older "urine deflectors" that pop up. In theory they act like a basketball backboard to rebound the penis-directed urine. In practice, your little boy can get hung up on the deflector and injure his little manhood parts.

Stability. Be sure the chair doesn't tip easily when baby squirms. Since you will be using it on slippery surfaces (such as kitchen or bathroom tiles), it should have rubber tips on the bottom to keep it from sliding.

Design. Your toddler may enjoy trying one of these new designs: 1. Musical pots. To entice the squirmy toddler to stay put, some first-class seats even play music while baby sits. 2. Multiple-use potty-chairs. These clever designs contain three parts-a potty-chair for the rookie, an adapter seat that fits on an adult toilet for the graduate, and a step stool for the veteran ready to go at it alone.

Teaching toileting talk. Teach your toddler words for his body parts and for their actions. Putting a label on what baby does makes any developmental skill easier.

Give baby the proper names for proper parts (penis, testicles, vulva, vagina), but don't expect him or her to use them accurately until three years of age. Say these words as comfortably as you would "arm" or "hand," so baby does not pick up vibrations that you are uneasy about these mysterious parts.

Now that the action is ready to begin, give baby easy words and phrases such as "go potty," and later get more specific-for example, "go pee-pee" or "poo- poo." Avoid words that imply shame: "stinky," or "Did you dirty your diapers?" Use terms that you are comfortable with and baby can say and understand. "Urination" and "defecation" are beyond toddlers.

Games Little Boys Play
Remember, a sense of humor is top on your list of tools for successful toilet- training. Little boys like to:

• "Write" in the snow or dirt
• Play criss-cross pee with dad or an older brother
• Sink floating pieces of toilet paper
• Hit floating targets-these can be purchased as incentive gadgetsBeginning squirters need a few lessons in target practice to improve their aim.

Feeling and Telling. Tell baby what to tell you. As soon as you notice the about-to-go signs, query, "Go poo-poo? Tell mommy!" (or "Tell daddy!") You are planting another mental connection: When he feels the urge, he says the words.

Once baby masters these two connections-urge to go with running to the potty and urge to go with asking for help the rookie trainee is ready to advance. Notice the proper role-playing: You set the game plan, but it's up to baby whether or not he chooses to play. If after many rehearsals baby isn't getting the message, wait and try again.

DRESS FOR THE OCCASION
Dress baby for a quick change. If he has to struggle to remove complicated clothing enroute from urge to potty, he is likely to let go before getting unhooked, unbuckled, unbuttoned, and so on. Then you wind up with a double mess, a soiled baby and soiled clothing. Elastic waistbands and quick-release Velcro fasteners are a must. In warm weather, very loose training pants are all baby needs around the house. Use pants or shorts that are easily pulled-down when in public.

Potty times. The next connection to teach your trainee is that when you sit him on the potty, he goes. This is called conditioned reflex. This won't work unless baby is about to go. The key is to catch him at the time when he is about to go, and sit him on the potty before he makes the deposit in his diapers. He will then associate sitting on a potty with having a bowel movement and, eventually, with urinating.

Tips to Tell Potty Times:

1. Short of shadowing your baby all day long to catch him in the act, try these elimination-time clues. Make a potty time chart. For a week or two, record the time or times of the day when your baby has a bowel movement. If you detect a pattern, say after breakfast, put him on the potty each day at that time. Provide baby with an attention-holding book and let him exert his squatter's rights to sit until he goes. If you do not see a pattern, put baby on the potty every two hours, or as often and as long as your time and patience permit.

2. A physiologic aid for bowel training, called the gastrocolic reflex, may help predict when your baby will have a BM. A full stomach stimulates the colon to empty around twenty to thirty minutes after a meal. Try potty sitting after each meal until baby's patience runs out. Best odds for a predictable daily BM is after breakfast. Another benefit of this daily routine is that it teaches baby to listen to his bodily urges. It's a physiologic fact that bowel signals not promptly attended to will subside, and this can lead to constipation.

3. Even when your baby goes in his diapers, take him into the potty-chair room and empty the contents into baby's toilet. At least this will teach him where his productions go. Typically, you have to first catch your baby in the act, so that you can train him to eventually catch himself in the act.

Bare-bottom drills-an undress rehearsal. Covering up the evidence delays toilet-training. Diapers keep baby from making the connection between the urge to release and what he needs to do about it, and they do for baby what baby needs to learn to do for himself.

Outdoor training. For warm-weather training, if you have a private yard, bare bottoms make training easier. Remove your toddler's diaper and let him run around the yard bare bottomed, covered mostly by a long t-shirt if you wish. (T-shirts from an older child make good cover-ups.) When the urge to go hits, he stops and maybe squats because he suddenly realizes what's going on. Amazed by this revelation, baby may talk about what he's doing, "Go pee-pee" or "Go poo-poo," or look toward you for "What do I do now, coach?" guidance, or let go puppy-like with his puddle or load.

Now it's your move. Watch how baby handles this uncovered elimination. He may look confused, proud, or even upset, especially if he soiled his legs. Praise his productions and clean up matter-of-factly. (If he protests bare- bottom drills, wait a while and try again.)

Have the potty-chair available so you can show him where the BM goes. Then next time if you catch him squatting, show him how to sit on the potty instead. Don't resign as toileting coach if your baby plays with what he produces. Avoid showing disgust, as this only plants counterproductive connections that something is wrong with what comes out of him.

Toilet Tip To save having to clean out the receptacle bowl after each BM, place cling-wrap in the bowl and lift out the contents.

Indoor training. After trying outdoor drills for a week or so, you are ready to venture back indoors. Remember what you learned from the yard scene: bare bottoms promote quick learning. The early days of indoor, bare-bottom training should be spent, as much as possible, on a non-carpeted floor-easier to detect and easier to clean. You may need a few days of catching baby in the act and offering the reminder "Go potty" as baby enjoys his new diaper freedom.

Training Pants. Training pants look like super-absorbent, padded underwear and are used in transition from diapers to pants. You can make your own or get extra absorbency by sewing a piece of cloth diaper into oversized underwear or into regular training pants. Be enthusiastic about this step up, but be careful what you call them. "Big boy" or "big girl" pants is a loaded term, especially if your toddler isn't sure he or she wants to be big. This dilemma occurs with hurrying the older child into pants to make room on the changing table for a new baby. When the older child sees all the attention the diapered baby gets, he may not want to be a big boy. We prefer to call them special pants. Buy around six pairs, and be sure they are loose fitting for quick slip down by impatient hands.

When accidents happen. In all developmental milestones, babies take two steps forward and one step backwards. Expect soiled and wet pants when baby gets his signals crossed. This is normal when learning a new skill. Prepare for accidents during intense play when babies are so preoccupied that they miss their bladder and bowel signals. Babies become so engrossed in what is going on outside that they forget what's occurring inside. Trainees in these big-league pants may need an occasional bare-bottom reminder to keep their mind on their body.

Flushing fears. Flushing is a matter of preference for the child. Some children fear the loud swoosh of the flush as their production disappears into a swirling hole. Others consider flushing part of the whole package and insist on doing the honors. Be prepared for an increase in your water bill from the frequent flusher who likes the sound-and-water show at the pull of the handle. Invest in a seat latch to be sure the right stuff gets flushed, not toys.

Praise success, overlook "failure," relax. One day I heard a joyful "yeah" coming from another room as our teenage daughter, Hayden, cheered our two-year-old's potty-chair deposit. There is no place for punishment in toilet- training, just as you wouldn't scold the beginning walker for tripping. Serious long-term emotional problems can result from angry scolding or punitive attitudes toward accidents or resistance. If you are struggling with your child over toileting and recognize negative feelings toward your child, get some help from trusted advisers or even a counselor. Your goal is for your child to emerge from toilet-training with a healthy self-image. Then he or she can tackle the next phase of development-sexual identity-feeling good about himself or herself. Try to relax-what's one more year in diapers?

There are babies who refuse to announce their productions, hold onto what they have, and resist any attempt to toilet them. If you're still buying diapers and the potty-chair remains unused, read on.

Later toilet-training, like late walking, may be your child's normal developmental pattern and one shared by mom or dad when they were in training. The nerves and muscles involved in toileting may not yet be mature. Suspect this cause if your child has been on the late end of normal in other developmental milestones. Most children are well on their way to daytime bowel and bladder training by three years. If by that time you and your child have made no progress, in addition to consulting your baby's doctor, consider:

• A child won't perform any bodily function that hurts. Constipation is painful, often causing tiny tears in the rectum while the child is straining, which further makes the child hold onto his bowel movements and a painful cycle continues. Suspect this if your child squats, grunts, and painfully grimaces but produces nothing. Starting the day with a stool-softener breakfast (fresh fruits, whole grain fiber-rich cereal, and lots of fluids throughout the day) can open resistant little bottoms. (See )
• Bottom burning from food allergies could be another culprit. Look for the telltale allergic ring and raw area around the anus. High-acid foods, such as citrus fruits, and lactic-acid-producing foods, (such as dairy products) are the usual offenders. Diarrhea stools during the flu or after taking antibiotics may also temporarily hinder bowel control. (See treating )

• Is baby going through a negative phase in which he is not receptive to anything new?
• Is there a disturbing situation in the family: a new baby, a major move, family stress, long working hours, a return to work, or an illness?
• Is your child angry? Anger shuts down proper functioning of all physiologic systems, especially toileting.

Sometimes toilet-training is easier while on vacation. You have more time and patience, baby is often a bare-bottomed beach bum, and you are not so concerned about messes. One of our children trained during a week-long beach vacation where going without diapers was appropriate beachwear. Some children relapse while on vacation. If this happens, delay until you return home. If driving, take along his potty chair, since little bladders need frequent pit stops. We have precious pictures of our trainee sitting on his throne in the back of the family van doing his thing. A folding, plastic, adapter ring that fits onto an adult toilet seat is useful for going in strange restrooms. Also, remember that a change in diet during family vacations is likely to bring about a change in bowel habits, either constipation or diarrhea, and a corresponding slump in training progress.

A message for young and old: Don't forget to leave home with an empty bladder.

Most parents prefer gradually training their babies over several weeks or months and progressing at baby's own rate. Some, however, would rather plunge right into an intensive course during the weekend or on vacation. A crash course in toilet-training does work for certain parent-child pairs, but we don't advise this method for all babies. Some babies resist being pushed out of diapers too quickly; others welcome help to master their body. The quick method is the same as the gradual method, just more concentrated.

Concentrate on the game. Approach this as a weekend of intensely relating with your baby, not as a contest, but as a game. You will be with your baby constantly during the waking hours, watching your child's every move for bowel and bladder signals. Shelve all other commitments. This is a private training session not open to the public.

Select the right season. Just as you don't schedule basketball games in midwinter, don't set P-day when baby is in a negative stage. Choose good mood weather, and you can always end the game if a bad mood prevails.

Schedule the game ahead of time. The day before, announce to baby that tomorrow is a special day: "We are going to play a special game," and repeat "special game" over and over during that day. (You will notice that we use the word "special" as one of our marketing tools. It works, perhaps because it has a special ring to it.)

Hold a pregame warm-up. Continue to emphasize that this is a special day and that you are going to do something special today: "We are going to play the game of no-more-diapers and use the toilet like mommy and daddy do." Throw in "like brother Jim" as an added incentive. Let baby catch your excitement. Babies get excited about what we get excited about.

Select the right uniform. Best is baby's birthday suit, weather permitting, otherwise a long, loose shirt. No diapers, please. Show baby the training pants-his "special pants." Show him how to put on the special pants and how to push them down and pull them up.

Publicize this event. Take pictures, preferably Polaroid, and show them to your baby. Demonstrate the push-down and pull-up maneuver in front of a mirror. All the while, keep a game-like atmosphere. If baby periodically loses interest or protests, take time out for a snack break.

Hand out the equipment. Bring out "special prizes." Like handing out party prizes, one by one unveil the tools of the trade: potty-chair (that you and baby picked out together at the store and kept in a box until P-day), a doll that wets, training pants, and reward stickers or other prizes.

Instruction manuals. As you're sitting on your respective potty- chairs, read a picture book about potty training.

Getting-on-potty-chair-and-what-to-do-there drill. Let him watch you (for real or just pretending)-an enthusiastic grunting sound can give him the idea.

A practice dummy. Go through the drill with a doll that wets, explaining each step of having the doll wet: removing pants, changing the doll, and emptying the potty-chair bowl into the toilet.

If this crash course isn't working, don't feel that you're a failure as a teacher or demote the pupil. You may have a casual kid who needs a casual approach. The need for diapers does pass.

Here are some tactics we have collected over the years from toilet-training our own eight children and from our pediatric practice.

1. Start a boy sitting to minimize sprays and dribbles on the walls and floor.

2. Try target practice. We let our boys "write" in the snow or dirt. Also, play criss-cross with dad or older brothers, or sink bits of toilet paper.

3. Try a pee-pee tree. For a resistant boy who refuses to go anywhere but his diapers, as part of the outside bare-bottom drill, paint a target on a tree and show him how to water it.

4. Point out how nice it feels to be dry rather than wet so the child is motivated to keep clean.

5. Plan ahead. Take your child to the toilet before you leave the house, before a movie, or before anytime in which a sudden announcement of a full diaper would be inconvenient. Simply announce to the child, "Do you have to go?" before you leave.

6. Don't be too quick to announce "no more diapers," since some children protest the sudden change so vehemently that they hold onto their bowel movements, become constipated, and you end up with a problem worse than a child in diapers.

7. Set a timer to go off every two to three hours throughout the day as a reminder for your child to go potty. This way the timer becomes the cue instead of the parent.

8. For the child who insists on depositing his productions only in his diaper, put the diaper in the receptacle of his potty-chair and let him go in that. This also saves you from having to clean it up. Eventually, replace the diapers with foil or some other paper.

9. For a child who seems to fear having a bowel movement in the adult toilet, let her watch her little productions "swim."

10. Some children go more easily with their feet planted firmly on the floor in a sort of semi-squat position, as if they need some "pushing power" from their legs.

11. Some children need privacy and will not go if anyone is looking or is in the bathroom with them. Respect this.

12. To entice the busy toddler to sit still and become one with the toilet or potty chair, put his favorite toys in the bathroom and encourage him to sit and "read" awhile.

13. Think of weaning from diaper dependency like weaning from the breast: timely and gradually.

14. Praise productions. "Yeah! You did it!" Some children temporarily need a cheerleader.

15. When a child is old enough to understand what's going on in his body, he's old enough to do it.

16. To avoid getting caught in the "big girl" trap, reserve these terms for a phase your child is going through when he or she wants to be big. Some children are ambivalent about becoming "big" because they see little ones get more attention.

17. In training twins, don't compare their progress. Train the more ready and willing twin first as a role model. Splurge on two potty-chairs, if you wish.

18. If using an adult potty, some children do better sitting backwards on the toilet and straddling it (teach little boys to point their penis downward) with their hands on the tank of the toilet, where they can rest a book or play with a toy. Playing and reading help take the pressure off the other end.

19. For boys, be sure the seat is completely up, so it doesn't fall down and strike his penis.

20. If your child is in daycare, ask the caregivers about your child's toileting experiences. Perhaps there are some tricks they use that you could copy at home.

21. To avoid bottom burn, share with the caregivers the about-to-go signs and the just-went signs that you have noticed in your child at home.