Toilet training: 3 tips to help parents and kids be successful

Eastern Idaho Regional Medical Center - November 07, 2023

by Becky Frusher

Using the toilet and moving from diapers to “big kid” underwear is a huge milestone for children and perhaps an even bigger one for parents. While there is no “right” age to begin toilet training, the American Academy of Family Physicians (AAFP) says most healthy children have the skills needed to start between 18 and 30 months of age. If your child isn't ready during that time, it's perfectly ok to wait.

Toilet training may not be easy, but if you follow your child's cues you can set them up for success. If by the age of four your child is still having difficulty, contact your pediatrician about a referral to EIRMC's Pediatric Therapies.

Four signs of toilet training readiness

Your child may be ready to begin toilet training if they are:

Able to stay dry for about two hours at a time during the day
Letting you know when they're wet or dry and are uncomfortable in a soiled diaper
Starting to show interest in the potty habits of others and in the bathroom in general
Able to remove and put on their pants on their own

Proper potty posture

Having proper posture and being comfortable on the toilet are important keys for toilet training success. This allows children to relax the muscles necessary to have a good bowel movement and fully empty their bladder.

Using a wide toilet stool (such as a Squatty Potty) can help your child maintain correct position, which includes never having:

Their feet dangling over the toilet
To hold themselves up with their arms

Instead, proper potty posture looks like this:

Feet should be up on the stool, with knees slightly higher than hips

Knees should be pointed out slightly

Your child should be able to lean forward comfortably on their forearms or with their hands on their knees or thighs.

Constipation and bladder accidents

You may be surprised to learn of the relationship between constipation and bladder accidents in children. Constipation can actually cause daytime or nighttime bladder issues. Further, children may be constipated even if they have regular bowel movements, according to the Mayo Clinic.

Your child should be having three to seven bowel movements every week. However, if they're having bladder accidents, a daily bowel movement is preferred. Because the rectum and bladder are so close together anatomically, and because children have a smaller abdomen and pelvis area than adults, when the rectum and colon fill with stool it can put pressure on the bladder, causing irritation and preventing the bladder from emptying completely during urination. It can also limit the amount of urine the bladder can hold. This can cause urinary urgency, frequency and leakage — which children will be unable to control or stop.

If your child is potty trained and you're suddenly seeing these regressions, it's important to have them assessed and treated for constipation. If you have any questions about your child's bowel or bladder health, talk to your pediatrician.