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  • Steve Hodges, M.D.

7 Crazy Important Rules for Potty Training Success

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By Steve Hodges, M.D.

As a culture we’re obsessed with luring kids out of diapers — early, quickly, and in style.

Parents used to bait little ones with sticker charts, M&Ms, and cool undies; now it’s medieval-themed potties and door-mounted devices, like the Poop ‘N Pull, that deliver encapsulated treats with the tug of a cord.

One blogger noted that the Poop ‘N Pull, a Kickstarter venture, seemed like something you’d use to house train a puppy. “But, hey, if it gets the job done,” she wrote, “who are we to knock it?”

I’m a pediatric urologist, so let me take a shot!

As parents we are defining potty-training “success” all wrong.

The goal of toilet training should never be “getting the job done.” The real triumph is setting your child up to avoid a future of visits to my continence clinic.

Virtually all the problems I see daily — bedwetting, pee and poop accidents, recurrent urinary tract infections — stem from my patients’ potty-training days. In many cases, those days were a decade in the past. I regularly treat 7th graders who poop in their pants and 10th graders who wet the bed, in addition to 4-year-olds who can’t seem to graduate from diapers.

All of these children are chronically constipated.

Our single-minded focus on getting children out of diapers primes them to become chronic holders of poop (and pee). Eventually, the holding habit catches up with many of them.

In brief: poop piles up, forming a large, hard mass that stretches the rectum and presses against and irritates the bladder. Eventually, the child may lose tone and sensation in the rectum — that’s when poop falls out without the child even noticing. Holding pee exacerbates toileting problems.

When I explain all this to parents, they’re blown away. They say, “I wish I’d known this back when we were potty training” or, “I’m going to do things differently with my youngest.”

Most tips for potty-training “success” focus on motivating and rewarding the child, ignoring whether the child is developing unhealthy toileting habits that may plague her to adulthood.

Potty training isn’t a pursuit with a finish line. Just because you’re able to bypass the diaper aisle at Costco doesn’t mean toilet training is a “done deal.” Everything can easily unravel, as my co-author, Suzanne Schlosberg, discovered upon potty training her twins.

In reality, it’s not the awesomeness of the potty or the ingenuity of the reward system that will make toilet training happen. It’s the readiness of the child and the absence of constipation.

If your child is struggling to use the toilet — if you’re not achieving that coveted “success” — it’s either because your child is chock full of poop or too young or both.

Luring Toddlers Into Training Can Seriously Backfire

In a recent blog post I read, a mom compared the thrill of a child’s successful trip to the potty to “that of your first kiss, getting a work promotion and winning the lottery — combined.”

As a dad of three young girls, I get it.

When my oldest was first trained, she’d shriek, “See, there it is!” demanding that we pay tribute to the yellow specimen in the toilet. I know how exciting it is to watch your child gain the confidence and independence that comes with using the toilet. And believe me, I look forward to the day my youngest is trained and we can unload our diaper bag.

But enticing toddlers to do something they're not ready for can seriously backfire.

The problems I treat daily are both epidemic and entirely preventable. Follow these 7 CRAZY IMPORTANT RULES FOR POTTY TRAINING SUCCESS, and it is highly unlikely your family will ever set foot in my clinic.

For details about each rule, please see the rest of our blog post on the Everything Kids blog! To download a PDF of the infographic, scroll to the bottom of our Downloads page.

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Must-read books for kids by Steve Hodges, M.D.

• Bedwetting and Accidents Aren't Your Fault

• Jane and the Giant Poop