Potty Training Tips: Overcome the 6 Most Common Obstacles
This is the most comprehensive & helpful article on potty training you’ll find!
by Steve Silvestro, MD @zendocsteve
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Besides sleeping through the night, there is one thing that every parent dreams of: Having a diaper-free kid.
Of course, once that happens you realize that now you need to know where the bathroom is in every Target, grocery store, and subway station…!
But after over a year or two of multiple diaper changes a day, the diaper-free dream is a wonderful one to make a reality.
So how do you do it—and how do you do it in a way that’s easy on your child and on you?
This article is going to cover everything you need to know to successfully—and happily—potty-train your child. I’ll also cover some of the obstacles you might face along the way so that you’re well-prepared if they come up.
WHY YOUR CHILD MIGHT NOT BE READY YET
There’s a half-joke in pediatrics when it comes to potty training: You can potty train at 2 or 2 ½ and be done by 2 ½ or 3…or you can potty train at 18 months and be done at 2 ½ or 3. You end up being officially potty-trained around the same time no matter when you start.
True, some kids figure it out at a very young age. We all have a friend or relative whose wonderchild slept through the night at 2 months and potty trained at a year. But in reality, those kids are few and far between.
And yet, many parents get the idea that their 18-month-old might be ready to potty train.
Well, many 18-month-olds begin to tell you that they’re going to the bathroom or that they’ve already gone. You can sometimes even just see in their eyes—you get this little look of worry or wonder, or sometimes even a bit of fear and anxiety as they’re in the middle of pooping or peeing. If you ask: “Are you going?” they might say yes or they might say no, or some kids might even come up to you and let you know. It’s around 18 months that many kids start to really notice the sensations of going to the bathroom, whether while they’re going or after they’ve gone.
But knowing that you’re in the middle of pooping or peeing—or that you just did—doesn’t really help all that much, does it?
THE TWO KEY REQUIREMENTS OF SUCCESSFUL POTTY-TRAINING
The truth is that there’s there’s a really big leap between knowing that you’re going or that you’ve gone, and knowing that you have to go. Noticing the urge to go before it comes is what gets a child to the potty in time. Noticing that it’s already happening—that’s just an accident.
So the first key requirement of successful potty training is your child consistently having the realization that she has to go before she starts to poop or pee.
The second key requirement is actually being willing to use the potty.
This second requirement is why it really stinks that we try to potty train right smack in the middle of an age range in which kids are super stubborn and often unwilling to do anything that they don’t already have their minds set on doing. I often tell parents that kids from 12 months on are like little teenagers. They want to be in charge. They want to be independent. Anything that isn’t their own idea is just the worst idea in the world.
Potty training? That’s a power struggle for everybody. Your child has to learn to control their habits and wait until they get to the potty. You are faced with an occasional power struggle of getting your child to the potty when he doesn’t want to go. And all this is happening right at an age at which your child is trying to assert control whenever and wherever she can, all on her own terms. Yikes!
That’s why in order to get a child of potty-training age to agree to actually try potty training, we have to somehow introduce it as a thing that is not intimidating, that is good for them, and that they will have some sort of interest in doing.
THE BEST WAY TO INTRODUCE POTTY-TRAINING
So here’s a way to introduce potty-training that’s fun, non-intimidating, and lets you know that your child has met the Two Key Requirements of Potty-Training:
Naked Dance Party.
Here’s how you do it: Twenty or so minutes before bed or bathtime, turn on some music, strip your child down naked, have a portable potty right there in the room—and run around, dance, and play. Every few minutes as you dance and play, point to the portable potty and say: “If you have that funny feeling, if you have that special feeling, if you have to go potty”—whatever you want to use to describe it—”this is where you go.” And you run around and you play and you make it fun. And every couple of minutes you ask, “Do you have to go potty? Do you want to sit on the potty? Do you have that funny feeling?”
What you’ll see is that sometimes your child might say “yes,” sit, and nothing happens. Sometimes she’ll say “no” and run around and have an accident. And then you might have times where your child sits on the potty when you ask and is successful—and that’s a good sign.
But the really clear sign that your child is ready to move on to full-on potty-training is when your child sits—without you having just asked—and has success and produces something. When your child sits on her own without you having asked—and she poops or pees—that’s your sign that she has the Two Key Requirements of knowing when she has to go and being willing to go and do it.
Naked Dance Party is the easiest way for you to know that your child has the capability and the willingness to potty-train. Plus, it also introduces the idea of sitting on the potty as a fun experience. Naked Dance Party has none of the pressure and anxiety that’s involved in many of the techniques you might find on the Internet, like the “three-day weekend bootcamp,” in which your child is naked and drinking all weekend long and you’re glued to your house for three days cleaning up accidents and setting alarms every 45 minutes. That might work for some families, but for a lot of kids that’s pretty scary.
But Naked Dance Party? It’s fun, no-pressure, and tells you when your child has hit the Two Key Requirements. Perfect!
Once you start to more officially work on potty-training, the most common approach that many people use is some sort of positive reinforcement. Sit on the potty and you get a sticker; get enough stickers, maybe there’s a prize.
Instead of stickers, the most common reward that I’ve come across is some sort of treat. A lot of people use M&Ms, chocolate chips, or some other food treat. I’ll be honest—we actually did this with my kids at one point, too.
Ideally, though, it’s best to try not to ever use food as a reward. The worry is that—theoretically—it impacts kids’ development of a healthy relationship with food. The concern is that if we do this enough, then over time our kids grow up as people who think that junk food is a reward. That’s certainly something that many adults struggle with—and even if you don’t, then you’ve probably had an occasion or two when you felt like you “deserved” a less-than-healthy treat because of something you did (hey, I know I have!).
Using treats as a positive reinforcement reward for potty-training won’t doom your child to a lifetime of poor eating habits, but if you’re able to avoid it all the better. One tool that we used with my daughter was the Princess Potty book (or this Pirate Potty book). It came with a crown (the pirate one comes with a pirate hat) and stickers of jewels that we gave to my daughter each time she sat on the potty. She got to decorate the crown and wear it each time she sat, making the experience a bit more glamorous for us all!
Whichever technique you use, giving your child some sort of praise and positive reinforcement when he sits on the potty can increase his motivation to keep working at it—which then makes it more likely that he’ll be successful.
Of course, even once you’ve started on the path of potty-training, you’re bound to encounter an obstacle or two along the way…
OBSTACLE #1: YOUR CHILD ISN’T INTERESTED
Really? Even with Naked Dance Party?? Sheesh!
In all seriousness, some kids show no interest at all, while others will start the process and then seem to lose interest altogether. There are a handful of reasons that might explain why your child isn’t interested in potty training at the moment, and figuring out your child’s particular reason is key to helping him move past it.
For one, he just might not be ready yet. The worst thing about baby books and parenting websites (except this one, of course!) is that they make it sound as if all kids hit any given milestone all at the same time. But the truth is that children are different, and most milestones—especially behavioral ones like potty training—occur over a range of ages. What one child does at 2 ½ might not happen in another child until 3, and yet both kids could be considered “normal.”
Boys in particular are often a little slower than girls when it comes to potty training. This isn’t always the case, but it is something I’ve noticed over the years in my practice. It’s more common to see a girl potty trained at 24 months than it is to see a boy figure it out at the same age. Plus, boys will often figure out how to pee on the potty months before they consistently decide to poop on the potty. It’s not uncommon to see a boy who is 3 ½ and still only partially potty-trained.
For some children, that magical potty training switch in the brain simply hasn’t flicked to “on” just yet, but certainly will in time.
OBSTACLE #2: YOUR CHILD ISN’T JUST NOT INTERESTED—SHE’S REFUSING
Remember how I said that toddlers after 12 months of age are like little teenagers, wanting to be in charge and independent?
Well, just like any good teenager, toddlers are pros at being contrarian the moment they sense that you have a strong opinion about something—and for some kids, potty training is a great time to assert their stubbornness.
If potty training has become a big challenge in your house—if it’s something you talk about every day without much success, or it feels as if your child is defiantly peeing or pooping anywhere but the potty—the problem could be that your child is feeling too much pressure.
Like a teenager, toddlers want to be in charge of their own bodies. You telling your kid to sit on the potty or setting alarms and rushing around to the bathroom? That can feel like you trying to assert control, and the result may be that your child will dig in her heels and push back.
How to fix this?
Take a break. Don’t talk about potty training for a week or two. Let your child let do whatever she wants to do. Then after some time, come back to potty training with even more positivity, more fun, bigger rewards.
The key thing for us as parents is not to think that taking a 2-week break is taking a step backward. Simply think of it as not taking a step forward! You’re just holding steady for right now. What can ideally happen in that short break is that your child will forget about the pressure she felt and stop digging in her heels—making it easier to be successful than it would have been if you’d pushed on through without a pause.
OBSTACLE #3: CONSTIPATION—CAUSING MORE PROBLEMS THAN YOU MIGHT THINK
Another obstacle is a very secret, subtle obstacle that we pediatricians often have a hard time convincing parents is the problem: constipation.
Constipation has less to do with how often your child poops, and more to do with how hard it is when it comes out. The ideal poop has the consistency of toothpaste—anything else is technically constipation to some degree.
When a child is constipated and has hard poop, it can hurt to have a bowel movement. And when pooping hurts, your child isn’t going to want to sit on the potty—I mean, if it hurts to poop, why actively try to poop?
But here’s the problem—while our small intestines absorb nutrients from food, the only job the large intestine has is to suck water out of poop so that we don’t have diarrhea all the time. That means that the longer your child holds the poop in, even more water is pulled out of it—making it even harder still. So the more your child holds her poop, the more likely it is to hurt even more when it finally comes out.
When a child is constipated while you’re trying to potty train, he’s essentially going to be afraid of sitting on the potty to poop. The result is that he might do it in a pull-up under the dining room table, or maybe wait until he’s in a diaper at naptime, or stand stiff-legged with a look of fear in his eyes as he tries his hardest to hold it in.
Your first job here is to make your child’s poop softer. How? Increase the number of “P” fruits in your child’s diet—pears, prunes, peaches, plums, pineapple, papaya…and mango. This is also the only time I ever prescribe juice—two to four ounces of pear or prune juice each day often do the job. Don’t water the juice down, as it’s the sugar that pulls more water into the intestine. Another thing to do is to slow down on bananas and high-iron foods (i.e., Cheerios, which have 50% of a day’s worth of iron for kids under 4) as these can be very constipating.
Ultimately, it may take several weeks of consistently soft poop for your child to break the mental block associated with constipation. Essentially, he needs to forget that it can hurt to poop before he’ll routinely let himself go on the potty. The most common reason constipation treatment fails is that parents stop the treatment as soon as the poop gets softer. Instead, stick with whatever approach is effective for several weeks to help ensure your child has continued success.
OBSTACLE #4: YOUR CHILD IS AFRAID OF THE POTTY
If your child seems nervous around the party and you know he isn’t constipated, then it might just be the fact that a toilet can be rather scary to a toddler.
After all, it’s this monstrous thing that makes a loud noise and has a giant hole you could fall into—who wouldn’t be afraid of that!
That’s why I am a big fan of starting off with a small, portable potty like this one. It’s kid-sized and fairly friendly appearing. The other nice thing about a portable potty is that to your child, it’s theirs. Identity becomes a big thing as your child approaches the age of three, so having his own potty is special.
Another way to ease your child’s anxiety around the potty is to make the experience fun. In addition to Naked Dance Party, you can entertain with books, play games, or sing songs while she’s on the potty.
Personally, I’m not a fan of using an iPad on the potty, as games and videos are quite addictive to a developing mind and you often end up with fibs of “I have to go potty” when it’s really “I want to watch videos.”
If all else fails, then try something that, on the outside, doesn’t seem to make sense—dissociate sitting on the potty from actually pooping or peeing. Getting your child used to sitting on the potty without any pressure of actually producing something can take some of the anxiety away. Give praise or a reward simply for sitting, whether or not he actually goes to the bathroom. Once he’s comfortable, have him sit within 20 minutes of a meal—the time the body is often primed to produce a bowel movement—and you might find that he’s more successful.
OBSTACLE #5: ACCIDENTS
Accidents are an annoying, expected part of potty training.
But what if your child has had a good run of several months without accidents, but then suddenly starts having them again? There are a few reasons this might happen:
Urinary Tract Infection (UTI) – These aren’t common, but they aren’t rare either—especially while potty training and the year or two after. Kids experience the same symptoms as adults—pain with urination, a sense of urgency, and sometimes accidents—plus the possibility of fever and vomiting. While it’s more common that these symptoms (minus fever and vomiting) are due to irritation from not-fully-wiped-away urine, the only way to officially rule out a UTI is for your pediatrician to do a urine test.
Your child doesn’t want to stop what he’s doing – Ah, FOMO! If it seems like your child knows he has to go but doesn’t want to interrupt his play by going to the potty, there are two things you can do. The first is to make using the potty interesting again using all the rewards and fun approaches mentioned above. The second is to make using the potty part of his routine. This is where setting regular alarms on your phone or giving your child a Potty Watch can be helpful.
Secret Constipation – That’s right, “secret” constipation! Your child may not seem significantly constipated to you, but many kids actually are. And here’s the problem—the last part of the bowel goes right behind the bladder. If that last part is filled up with hard poop, then the bladder can’t fill up as much as it should. The result is that not only can your child not last as long between pee times, she may not even know she has to go—as a fully-distended bladder is part of the signal that we have to urinate, and the poop behind it keeps the bladder from getting fully distended. It almost never hurts to give your kid more fruits and veggies in an attempt to soften poop, so have at it.
OBSTACLE #6: BEDWETTING
Getting your child to stay dry overnight is the Holy Grail of potty training.
But even though there are a handful of kids who get the nighttime part figured out once they’re potty trained in the daytime, it’s actually not unusual for most kids to wet the bed through 7 or 8 years of age. That’s because sleep patterns often change when kids are somewhere between 6 and 8. For a very small number of kids, betwetting might still occur even into the teen years, especially if there is a family history of it.
There are some tools that you can buy, such as bedwetting alarms, though these tend to work best after age 8 once the sleep patterns have begun to change.
One secret fix? Yup, subtle constipation. Again, if there is hard stool behind the bladder, your child might not be able to hold enough urine to go through the night. Many studies in older kids who wet the bed have confirmed by X-ray that they are often constipated. Increasing P fruits, more water in the daytime, decreasing bananas, and decreasing how much your child drinks at dinner can all improve the odds that she’ll stay dry through the night.
There is also some newer research looking at the possibility that sleep apnea and other problems with disorganized sleep can lead to prolonged bedwetting. So if your child routinely snores, if your child has very large tonsils, or if you’ve been told by your child’s dentist that she has a high palate, then talk with your pediatrician about the possibility of sleep apnea preventing your child from staying dry at night.
So there’s a tour through everything you need to know about potty training, plus fixes for almost every obstacle you might encounter.
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Do you have an obstacle not mentioned here? A favorite potty training approach? DM me on Instagram and let me know!
Potties & seats
- BABYBJORN Potty Chair — with 1,700 reviews, it’s one of the best-reviewed potty chairs out there & is what I used with my own kids — PERFECT for Naked Dance Party!
- BABYBJORN Toilet Seat — sits right on top of a regular toilet seat to let your little one comfortably fit without falling in
- BABYBJORN Step Stool — having a step stool is important when using a regular potty in order to prevent your child’s legs from falling asleep, as well as to create the right angle to make having a bowel movement more comfortable (have you ever seen the hilarious Squatty Potty commercial?)
Bedwetting Alarms (For kids 8 & up–NOTE that there tends to be mixed success with alarms)