Potty Training basics with CHOP Pediatrician Nathan Blum

Nathan Blum is a developmental-behavioral pediatrician at the Children’s Hospital of Philadelphia. Blum has researched potty training, and he sees children in his practice who have difficulties with this issue.

He discussed the potty training basics with Maiken Scott:

MS: Are parents reluctant to tackle this issue?

NB: It’s a topic that’s very much on parents’ minds. They aren’t sure when to begin, some parents have tried and failed, and feel frustration.

MS: When should toilet training begin – is the right time to start about age or readiness?

NB: Most experts recommend using indicators that a child is ready. These are somewhat related to age, children between 24 and 30 months usually hit these milestones. Here are some of the behavioral indicators:

Expressing interest in using the toilet

Being able to communicate that you have to or want to use the toilet

Being dry for at least an hour during the day. If the child has a wet diaper every 45 minutes, it’s too soon to start toilet training

How well a child listens, and how much the child wants to please

MS: So, if your child is ready, how do you get started?

NB: It’s a good idea to place a potty chair in the bathroom during bath time. Some parents bring their child in when they are using toilet. There are many books and videos and those are legitimate ways to introduce the topic

MS: When it doesn’t work, potty training can become frustrating for parents and kids. What to do?

NB: You have to think about age of child. If you have a young child, and you have shown them the potty and they are not interested, stop for a period of about three months and try again later. When children get older, parents are reluctant to take a wait and see approach, and then there are behavioral strategies. You can use small rewards and encouragement to get a child to use the potty. Also, check and make sure your child doesn’t have constipation, that can cause problems with potty training. If your child is older than 4 and not trained, then you want to bring your child to a medical professional, to see if there a reasons your child is having trouble.

MS: Parents tend to feel a lot of pressure around this issue…

NB: Remember, almost every child gets toilet trained eventually, it’s not something you need to put a lot of pressure on yourself about, or feel like it reflects your parenting or child’s skills or anything along those lines. You can be confident that it will happen, take some time off if it gets really frustrating for you and your child.

Also, you don’t want to take a punitive approach with the child, if the pressure a parent is putting on kid involves punishing it’s not the right approach. Encouragement is much better way to go, including small rewards, you run into problems when you put too much pressure on the child

MS: Do you recommend any specific methods?

NB: There’s no evidence that one method works better than another. You have to work with the individual child, and see what they respond to.