Potty Training Q&A: Pediatrician-Backed Answers

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Welcome to Toddlers Made Easy, the podcast that gets straight to the point because you've got about 3 minutes before someone needs a snack or a Band-Aid or finds the permanent markers. I'm Dr. Cathryn Tobin, a pediatrician with 35 years experience, and in fact, I just recently retired. I'm the mom of 4, and I'm here to give you the tools to make toddler life a whole lot easier. Today's episode is a little different. It's a Q&A chat based on your questions and we'll be diving into all things potty training. So let's get going. A mom asked, is there anything I shouldn't do before starting potty training? And well, honestly, this is a really unusual and it's a great question and I'm so glad you've asked it. It's tempting to dive into potty books and potty songs and potty talk around the clock. But the problem is it so often backfires. Over-talking and turning everything into a potty-related moment can make your child feel pressured, and instead of getting excited, they start resisting the potty before they even begin. So go by this general rule of thumb: the less hype usually means less resistance. The next mom shared this scenario with me: My 23-month-old keeps asking for a diaper to poop. What do I do? I've tried begging, I've tried offering iPad time, but she keeps screaming and screaming until I give her a diaper. Well, this is a really, really common problem, and unfortunately it happens soon after potty training begins. The big question is, do you insist on your child pooping in the potty, or do you give a diaper when they ask? And here's the problem. If you refuse to give a diaper, well, your child may start to withhold poop, which can lead to painful constipation, and that is a big challenge to reverse, or at least it can be. On the other hand, if you give a diaper, it can potentially prolong potty training. So what do you do? Well, here's what I would recommend. I fear constipation more than prolonged potty training, so I'd give your child a diaper. And well, to be honest with you, even more than that, I believe a child deserves the right to be the boss of their bodies. And you can help them transition from diapers to the body with gentle, big-hearted approaches. So personally, I'd give your child a diaper and I'd say something like, here you go, sweetheart. You know your body the best. But be aware of this one thing. Most kids will not just stop pooping in their diaper. Without a nudge from you. And this is where a lot of confusion begins. Parents often think that being gentle or kind means letting your kids lead the way, but kids need us. We're the ones that need to provide them with direction. That's our job. So giving a diaper is step one, but we need to take further steps to make potty training and pooping on the potty easier for your child. So there's less conflict and fighting around it. Now, before we talk about how to redirect your child back onto the potty, I'd just like to take a moment and look at why do kids prefer their poop in a diaper? So the first reason can be fear. It may be that they don't like the splash that the poop sometimes makes, or they don't like the sound of flushing the toilet, or they just don't like the different feeling of pooping without wearing a diaper, or they may have had a painful or uncomfortable poop and they would prefer to squat to have a poop. Another issue, and it's a very common one that's often overlooked, is privacy. And this is especially true of those kids who go and hide to poop. It may be they're not appreciating or wanting to poop on the potty because they're missing the privacy they had in a diaper. Constipation is another reason, and it's harder to pass a hard bowel movement, especially in that posture that's associated with sitting on the toilet or the potty. And lastly, your child just may not want the change. What's in it for them? Why, they're perfectly happy the way things are. So let's talk about some steps to make pooping on the potty easier, more comfortable, and even a little fun. But focus most of your energy on the one that you think is causing your child grief. The first thing is, regardless of the reason why your child is struggling on the potty, softening up your child's stools with foods like prunes or pear juice or making a constipation smoothie or using yogurt with fiber. All of these can help because a softer stool is easier to pass, which is an easier way to adjust to pooping on the potty. The next thing is ideally get your child into a position that's similar to a squat. So let's say you're using a potty. Well, put books under your child's feet to make the sitting position more like a squat. If you're using a toilet, use a stool that raises the knees above the hips. If privacy is an issue, once you get your child settled on the potty, don't hover. Give your child the privacy they need and want. And remember, this is something that's so easy to overlook. Lastly, I'd put some toys in the bathroom, but be strategic about which toys you're using. Use ones that will help your child have a poop, and by that I mean When we blow out, our pelvic floor relaxes. So we want to focus on toys that involve blowing out. So for example, that could be a party whistle or a harmonica or a pinwheel or bubbles. All of those are great options and help your child relax and poop. Have you ever seen a child sitting on the toilet and pushing down with both hands on the toilet seat? Well, kids will do that when they're trying to stop themselves from pooping. They'll push against the toilet seat. So by giving them something to hold, it prevents them from pushing down and holding. I want to share this really lovely little strategy that helps get your toddler back sitting on the potty. And it's a simple strategy that a parent shared with me that I think is terrific, and I've used it a lot since then. And so it's a little game, and you start off by noticing where does my child usually have their poop? Well, I'd cut out a little footprint and put some tape underneath it and then tape it on the floor. And each day, move the footprint slightly towards the potty and tell your child you want them to poop where the footprint is every day. And inch by inch, you move your child back to the potty. Now here's the really surprising thing. When you arrive at the potty, it's amazing how many kids will just sit down and poop at that point. They're into the game by now. What if they don't? Well, that's where you focus on making sitting on the potty to poop fun and playful. That's where the bubbles and harmonicas, anything involving blowing comes in along with you've already softened their stools. You've got them in a squatting position, so it should make pooping easier. Regardless of the why your child is refusing to poop in the potty, wait till your child's stools are soft before before encouraging them to give up the diaper. Now, you know your child the best, so trust your gut on this one. Whether the problem is fear or confusion or independence, or just your child has other priorities, whichever one of these is the issue, that's what you want to also focus on. So let's say you think it's fear. Well, you want to work on raising your child's comfort level with play. If you think it's confusion, Then I would go bare bottom for a day and focus on teaching about the process. If it's independence, you think your child just doesn't want to be told what to do, give them lots of choices and really commit to a no-pressure approach. And what if it's just your child has other priorities, meaning they're more interested in doing other things? Well, work on making the trip to the bathroom fun. Now that will give you some strategies to start with and help move your child out of the diaper. Just remember, Don't wait for them to take this step. You've got to make the first nudge. My next question is, what if I get upset or mad and then my child stops trying? And the mom wrote in question marks asking for a friend. Well, you're human and this is fixable. I would simply apologize. I'm sorry I got upset. I was thinking about the mess, not your feelings. Then encourage your child to sit on the potty fully dressed while you read them a book. And work forward from this point. Next comes sitting on the potty with a bare bottom, and then comes using the potty to pee or poop. Break your goals into small steps. It's more manageable for both you and your child. The next mom asked me, why don't you recommend rewards during potty training? And I get it, offering a sticker or a treat can feel like a quick win, but rewards can backfire. What if your child sits on the potty but doesn't pee or poop? Do they still get a treat for sitting? And then are you negotiating what treat they get for sitting because they didn't pee or poop, but they sat. Suddenly you're in a mess of negotiation and it's really hard to get out of that. Over time, you might find yourself needing bigger and better rewards just to keep your child motivated. And this also could lead to power struggles and stress for everyone. So instead, I encourage you to focus on the real reward, which is your child's own pride, that magical "I did it" feeling. That builds true confidence and motivation that no sticker ever could. But that said, you know your child best. Every toddler is different and every family has their own rhythm and priorities. So use this advice as a guide and feel free to fine-tune it so it fits your particular situation. My next question came from a mom who asked, how do kids learn to listen to their bodies? We talk about it all the time, but I'm not really sure what to do. So teaching your toddler to tune into their body is a gradual process. It doesn't happen overnight, but it doesn't actually take that long, usually a day or two. And here's what it typically looks like. First, your kid will notice after they've gone, or point it out to them. Oh, it looks like you've had a pee or a poop. Then they realize their diaper is wet or soiled. But next comes noticing as they're going pee or poop. So first they notice after the fact. Then they notice during the act, and eventually they recognize the urge before it happens. This is when true body awareness starts to blossom and your child can begin learning to use the potty with more intention at this point. Another mom asked me, "Well, how do I know when to start?" Most kids are ready somewhere between 18 months and 3 years. I'd say in general, 20 to 30 months is that window of opportunity. There's physical and cognitive readiness, which includes staying dry for 1 or 2 hours, being able to sit still for a few minutes, able to follow simple instructions, and your child can get to the potty and pull up and down their pants. But here's the thing: emotional readiness matters just as much as physical readiness, and actually probably more. So what does emotional readiness look like? Well, kids are typically out of that no stage, you know, the one I'm talking about. They're starting to copy some of the things you do, like pretending to talk on the phone. They're curious about everything and they're not resistant to potty talk or books or even the potty itself. Now we can't fast-track physical or cognitive readiness, but we can influence willingness. And unfortunately, we can influence it both in good or bad ways. So it's something to keep an eye on. The next mom asked, "What if my kid is excited one day and refuses the next? This keeps happening to me. Her interest comes and goes. Some days she wants to use it, some days she doesn't." Well, I want to reassure you, this is totally normal. Toddlers, anyone really, are famous for changing their minds. So here's something to say: "Hey sweetheart, I know you're excited about using the potty, and I know you're also unsure." It's okay to feel both things. However, don't change your plan. Keep going with the potty encouragement. Invite your child to use it. Don't push and never force your child to sit on the potty. Kids need to know they're the boss of their own body. The next mom asked me, daycare says my child is ready, but I'm not so sure. What do I do? Well, as always, I would tell you, trust your gut. You know your child better than anyone in the world. Your child though is probably not far off. Depending on the daycare routine, you might consider letting them try the potty and toilet with the other kids while at daycare. Just see how it goes, as long as you're happy with how they manage the potty routine. The next question was, my son is 18 months old and he's showing interest. Is that too early? He seems ready. Well, it's not necessarily too early. If the physical signs are there and your toddler is curious, you can start laying the foundation. Think potty prep. It's never too early to warm up and then based on this, proceed. My daughter is almost 3 and not potty trained. Am I behind? No, not at all. This is completely within the normal range. Again, every child moves at their own pace. It's not an Olympic race. It's a process, but I would start potty prep now. The next question was, does my child need to be dry overnight before we start? And no, definitely not. Daytime dryness often comes months or even years before nighttime dryness. One has nothing to do with the other, really. The next mom said, my son hides to poop. Is that a sign he's ready? It's a great sign, and it means your toddler recognizes the urge to poop and prefers privacy, and that awareness helps potty training. But again, remember, there's readiness and willingness. So you've got to consider both. And lastly, one lovely mom asked me, what if I'm the one who's not ready? I'd encourage you, don't rush things. You matter in this process too. So ask yourself, what's holding me back? Plan ahead how you're going to manage accidents like laying mats down, rolling up carpets, putting towels over the carpet. I would encourage you to take a potty course, an online course, as it's much easier and typically more successful if you have a plan. Parenting is hard and it's one of the most important things we do, but you don't have to figure it out all alone. The Big Hearted School of Parenting is the only membership created specifically for parents of young kids. We focus on what actually works for this age and stage. We focus on big-hearted strategies practical everyday tools and expert guidance that makes sense for little ones. Loving your child comes naturally. Learning how to guide them through tantrums and bedtime battles and all the rest, that's where The Big Hearted School of Parenting comes in. If this way of parenting feels right to you, I'd love to have you join us. Thank you for listening. Keep up the good work and have a great week.