Potty Training Tips from Your OT Bestie
Take the "scaries" out of potty training with expert advice from our pelvic floor specialized pediatric Occupational Therapist.
When it comes to parenting toddlers, potty training can feel like a roller coaster. You spend weeks preparing - reading every book, buying every tiny toilet, and stocking up on all the bubbles and stickers. Finally, it’s time to go pants-free! You spend every 5 minutes running to the potty, only to find your little one in a puddle of peepee with a sheepish look on their face. You take a breath, clean up, and try again.
You might be wondering, “Is this normal? Does anybody else feel this lost and frustrated?” You’re not alone. As an occupational therapist, I’ve helped people of all ages and stages master this important activity of daily living. And yet, with my own kids, my mind would go blank in the chaos of soiled undies and Lysol on every surface. That’s why I’m here to be your potty-training-bestie, teaching you what typical potty development looks like, and giving you all the tips you need for successful toddler potty training.
Typical Toileting
After their first birthday, most toddlers indicate discomfort when their diaper is wet and generally begin to poop at around the same time each day. At around 22-24 months of age, toddlers learn to hold and release their pee and poop. This is when caregivers will often see that their diapers remain dry for 2 hours or more at a time. Generally, children will begin using the potty regularly between 32-35 months with occasional accidents. In the United States, the average age for staying dry both day and night is 3.5-4 years old. Children typically learn how to stay dry during the day first, and nighttime dryness follows about 6 months afterwards.
Once potty training is established, it’s important to take note of your child’s toileting health. Toileting should be initiated by the child, meaning they can feel the need to go potty. Toileting should be pain-free and without straining, for both peeing and pooping. Accidents should be rare, and dry nights should follow about 6 months after mastering daytime potty training. Children will typically go to the bathroom at around the same time each day, and will poop a similar amount each day/week. Typically, the child will feel “empty” after they go and will not have to return to the toilet frequently. Constipation should be rare, and should quickly resolve. Difficulty staying dry during nighttime could indicate other underlying medical issues, and should be discussed with your pediatrician. If you’re concerned about your child’s toileting, always discuss it with your healthcare provider to rule out any medical concerns.
Signs of possible toileting dysfunction include:
- Frequent belly pain and bloating
- Inconsistent appetite/weight gain
- Being afraid of toileting, or negative emotions associated with toileting
- Pooping less often or a different amount than usual
- Withholding poop (i.e. dirtying their underwear)
- Pooping or peeing without intending to
- Nighttime bedwetting more than 6 months after potty training
- Frequent diarrhea or constipation
If your child is experiencing any of the above, it’s best to consult with their doctor. There may be underlying medical conditions or pelvic health concerns present. If this is the case, your child may benefit from an occupational or physical therapy assessment to support their toileting needs.
Potty Training Tips
There is no magic age that dictates when your child should be potty trained. There are many skills that go into toileting, and each child grows at their own pace, so it is difficult to go by a simple checklist to determine if they are ready. For that reason, I usually recommend for the child to have matured enough to hold the need to potty until they reach the toilet. This can be as early as 18 to 24 months of age. I generally recommend that children at least show an interest in using the potty before beginning potty training. I also recommend that parents feel emotionally and socially ready to begin the process.
When you are ready to begin potty training, select a method that works for your child and your family. Methods range from more gradual and child-led, to more structured and parent-facilitated. There is little evidence to support one best way to potty train. It’s best to make sure that both parent and child are ready, and to take a positive and consistent approach. As a parent, your emotional regulation has a huge impact on your child.
Make sure that you have a support system and the emotional bandwidth to start this journey before beginning.
Make extra time to connect with your child doing something that you both love. Celebrate the small wins, and find ways to remain grounded and present through friends/family support, talk therapy, exercise, and restful sleep.
Physically, it can be helpful to make sure your toddler is comfortable and positioned well on the toilet. Make sure their feet are supported, and that the toilet seat is an appropriate size. I usually encourage children to use a standard toilet with a potty training ladder, so they feel comfortable accessing the toilet in a wider variety of settings. Potty training toilets can be a useful stepping stone for children who are intimidated by a standard adult-sized toilet.
Often, children might feel overwhelmed by the noises and sensations associated with using the toilet. Relaxing the muscles of the pelvic floor (the small muscles in your hip bones that help you use the toilet) is an important component of releasing urine and feces. Show them how the toilet works when you or an older sibling goes on the potty. Let them flush without using the toilet and teach them to wash their hands. If your child is nervous, use calming sensory lights or turn off the bathroom fan to reduce noise. Children love when they have a selection of special toys to use when they’re sitting on the potty.
Some of these toys can also assist with pelvic floor relaxation, such as bubbles, pinwheels, and party-blowers.
Help them remember the steps of using the potty by purchasing or creating a simple visual schedule. Use frequent verbal reminders and praise when they remember the steps on their own. Songs can also be a helpful way to make cognitive connections to associate the urge to pee with using the toilet.
Summing It Up
For some children, toileting can be a challenging hurdle. Toileting involves many different skills that, as adults, we might not even be aware of. Toileting can be impacted by diet and hydration, sensory processing, fine motor skills, whole body coordination, emotional regulation, posture and body positioning, social changes, and many more components. Any challenges in one area of functioning can manifest as toileting difficulties. But don’t worry, you’re not in this alone! Occupational therapists are experts at helping you identify the underlying cause of any toileting troubles, and are here to help. If you have questions or concerns about your child’s potty training journey, reach out to our team and we can guide you in the right direction.
Helpful Products:
- Potty Ladder
- Convertible Potty Ladder to Step Stool
- Potty Training Mini Toilet
- Collapsible Travel Potty
- Car Seat Protectors
- Calming Sensory Light
- Ms. Rachel "Potty Time with Bean" Book
- "Potty Time with Elmo" Book
*This article contains affiliate links. Lemon City Collective makes a small commission from purchases through these links. All commissions help fund our mission.
Author: Joana Pernia, OTD, OTR/L
Doctor of Occupational Therapy at Lemon City Collective
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