Toilet training need not drive you potty
For most children, toilet training is the last milestone to be celebrated on their journey from babyhood. But like learning to smile, crawl, walk and talk, the age at which toileting independence is achieved varies greatly.
Ngala education co-ordinator Julie Holschier says toilet training should not be forced but praised and celebrated for the coming of age that it signifies.
“You watch them smile for the first time at six weeks and then sit up at six months, then start to crawl and take their first steps, ” Ms Holschier says.
“The last connection that happens is the toileting. But every family and every child is unique.”
Research shows that 4 per cent of children are ready at two years of age, 22 per cent of children are ready at 2.5 years of age, 88.5 per cent of children are ready at 3.5 years of age and 98 per cent of children are ready at four.
Child and Adolescent Community Health principal nursing adviser Isabel Redfern says while in the past parents often initiated and managed their child’s toilet training, most people now realised it was best to wait for the child to take the lead.
“We say that your child will tell you when they are ready for toilet training, ” Ms Redfern says.
Signals to watch out for include tugging or pulling at wet or dirty nappies, an interest in what is happening when you go to the toilet, and an acknowledgment that they do not want to wear nappies any more. “They have an interest in the toilet — not sticking things down it but they are interested in what mum or dad are doing in the toilet, ” Ms Redfern says.
Drier nappies and an ability to hold their bladder for a couple of hours are other signs your child may be ready, as is hiding before they do a poo and taking off their nappy completely.
Ms Redfern emphasises the link between toilet training and the development of verbal language skills, and the importance of children learning correct and appropriate words for their body parts and wastes.
“Before you can actually get to that stage it is important that the child has some way of communicating with the family, ” she says.
“Generally easy words like wee or poo, penis or vagina.”
It is up to parents to decide if they want to use a potty or a toilet seat insert and step, but the potty or toilet needs to be easily accessible. “Make sure that it is easily available to them by having the toilet door open, ” Ms Redfern says.
“Put the potty in an easily accessible place like the bathroom or laundry. And if you think they are ready for getting up in the night have a night light on for them.”
Clothes that are easy to take on or off such as elastic-waisted shorts and pants are also important.
“Putting training pants on keeps the poo in but children’s little hands are quite short so it is very hard to get them off, ” Ms Holschier says. “We say strip them from the waist downwards.”
For those reasons most parents find toilet training much easier in the warmer summer months. Children should have their legs supported by a step or the floor to help them bear down to open their bowels, and eat a balanced diet with plenty of fibre and water to maintain healthy bladder and bowel function.
“A constipated child can feel that a part of themselves is being lost when they sit on the toilet, ” Ms Holschier cautions.
All child health advisors agree that positive reinforcement is the most important part of toilet training — and can include verbal praise, stickers, star charts or marbles in a jar.
“They don’t want to get wet, ” Ms Holschier says.
“You can’t be negative because they are going to regress.”
Ms Redfern advises parents to wait until they have a few weeks of unhurried time before tackling toilet training.
“Wait until you have got time when you are not going to be rushing around doing things and you can put some praising time in, ” she says.
Heading out of the home without nappies for the first time can be daunting but she suggests taking a change of clothes, a cloth nappy to mop up accidents and some wipes and taking the plunge.
“There will be accidents and you just have to wear that, I think, ” she says. “If there is an accident in a shopping centre so be it — leave the groceries. But do not scold the child because they are doing the best they can.”
While there is a great deal of variation in the age children achieve toileting independence, and most are not dry at night until about a year after they come out of daytime nappies, Ms Redfern says parents should see their GP if their child is still having trouble once they are over five. Once the child is checked for kidney or urinary tract infections they are usually referred to the Enuresis Clinic at Princess Margaret Hospital.
“It becomes quite an affliction for the kids — they can’t do sleepovers, ” she says.
“If the kids are not making any indication by the time they are three then they probably need to go and have a chat with their GP. But up
to five the occasional accident is OK.”
‘The last connection that happens is the toileting. But every family and every child is unique.’
Commencing toilet training. Picture: Michael O'Brien
SIGNS TO WATCH FOR
• Tugging or pulling at wet or dirty nappies
• An interest in what you are doing in the toilet
• They do not want to wear nappies anymore
• Drier nappies
• Can hold their bladder for a couple of hours
• Hiding before they do a poo
• Taking off their nappy
• Telling you their nappy needs changing
© The West Australian