Busting the Myths of “Waiting Until they are Ready”

“Waiting Until they are Ready” is largely a myth. It is a persistent set of post-modern myths that came about thanksto 1 pediatrician: Dr. T. Berry Brazelton. Literally, the whole mess is largely down to this one guy’s opinion from 1962!

From the National Library of Medicine:

“The first description of a standardized method of toilet training was published in 1962 by Brazelton. He developed a “child readiness” approach, which was child-focusedandunregimented. The children started training at 18 months of age, and, in a group of 1,170 children, daytime continence was achieved by a mean age of 28.5 months.

Children were considered “ready” to start training when they were physiologically capable of the process and when the child and parent were emotionally ready. Both the child and parent needed to be interested and had to be in a social situation where toilet training was possible.”

Big Diaper glommed onto this idea and ran with it, resulting in children spending longer and longer and longer in disposable diapers. Girls in the U.S. are currently notfully potty trained until 3 years 6 months. Like with many statistics concerning boys and young men, boys don’t reach this same milestone on average until 3 years 9 months. That’s only the average, so some children are being artificially infantilized for much, much longer.

The first paragraph in the NLM article is key:

“Toilet training is felt to be a natural process that occurs with development, yet very little scientific information is available for the physicians who care for children.In reality, toilet training is a complex process that can be affected by anatomic, physiologic and behavioural conditions. Accepted norms of toilet training relate more to cultural differences than scientific evidence.”

Moreover,

“Both the child and parent needed to be interested and had to be in a social situation where toilet training was possible. The child required some degree of bowel and bladder control, identified by the ability to suppress reflexes of the bladder and bowel, and had to have the neurologic capability to cooperate, as seen in children who can perform basic gross motor skills.”

Essentially, “waiting until they are ready” may never come if an adult doesn’t decide to step up and train their child. Children rarely magically decide on their own to be potty trained. Waiting on your little to suddenly come up with this idea is akin to waiting on Congress to pass meaningful Immigration Reform - chances are it’ll never happen.

However, there are a few things to look out for in deciding if now is the right time to potty train:

1. Are you, the parent, ready to take this on and fully commit?

2. Can you reasonably take off enough time to do this? Ideally, this means one full work week, plus both weekends on either side where you do nothing, go nowhere and focus solely on potty training. If you can only string a holiday weekend and 1-2 additional days that could work, but you may run into some stumbling blocks if your little simply needs more time to get the fundamentals down pat.

3. Are you currently pregnant in your 3rd trimester or do you have a newborn under 3 months of age? If you do, you should highly consider waiting until your newest arrival is on a set schedule, is at least 3 months old and can’t yet crawl.

4. Does your little one have a good grasp of some basic vocabulary? Speech delayed kiddos can potty train. However, it’s much easier if they can speak in two word phrases.

5. Has your little one been walking unassisted for a number of months or years now? (Special needs kiddos with mobility challenges can potty train, but it’s naturally harder and takes longer).

6. Can your little one follow simple one or two step directions?

Myths to utterly ignore:

1. Your kiddo staying dry during the day while in a diaper. Many won’t achieve this until you start potty training.

2. Before potty training they understand urgency and/or alert their grownup that they went poop after the fact. This is not necessary for a child to first achieve before pottytraining.

3. They can sing the ABCs by themselves. This is too high of a bar for many kiddos that are not yet in Kindergarten (first year of formal schooling).

4. They show interest in the potty. Some kiddos do this, because they like to mimic us. Others do not. It has zilch to do with whether or not they are capable of being potty trained.

5. All children “ready” to be potty trained express interest in being more independent. This one is laugh inducing. PullUps/diapers make life easier for nearly all kiddos andmany are loath to see that ease disappear.

Phew! This is a lot and I want to leave you, Reader, on a happier note.

Do not punish your child for accidents. Accidents are part of the learning process. Please consider not using rewards either, especially food-based rewards. Kiddos that aresubjected to both potty training punishments AND rewards are more likely to develop pee and poop withholding problems and their resulting medical conditions.

You might be thinking, is warm praise really enough to convince my child that he/she is doing the right thing by going in a potty? Can I skip the Skittle or M&M? Yes, you can and you should:

“One retrospective case–control study of 4,332 children found that children who had symptoms of incontinence or infections were more likely to have been rewarded and punished during toilet training, whereas children with no symptoms of the lower urinary tract were more likely to have been encouraged by their parents to try again later.”

Retrospective case studies are less efficacious than double-blind clinical trials, but we’ll take it.

Caveat: Eldest children that are routine-oriented, especially if they also have (or are suspected to be getting one day) an autism diagnosis, do much better with a visual sticker chart. 

Note: The reward needs to be the sticker itself, nothing more, placed on a poster and in the shape of their favorite character or item, that goes onto a simple chart forpoops and pees in a potty.

Children under 5 often do NOT understand delayed gratification and making them work towards earning a larger goal down the road usually does not work. However, you know your kiddo and if you think that motivating him to use the toilet with a trip to Disneyworld will work, by all means, do it.

In sum, the best time to potty train is between 2 and 2 ½. You want your kiddo in the “eager to please mommy” phase when they are still compliant.

Waiting until age 3 invites the possibility of very real behavior problems, because they have crossed the threshold of Individuation - they now fully understand that they are separate human beings from you and can follow their own whims. They also have much stronger wills, hence the term “threenager” and can be quite moody. A 2 year old will very rarely hop onto a parent’s bed and poop in retaliation for hating potty training, but a 3 year old very much might.

Leaving potty training until 4 is dicey. By then the brain has fully tuned out the signals coming from the bladder. The kiddo has been in diapers for so long that urinationand defecation have faded deep into the background of the noise in their minds, if they are there at all thanks to just how great PullUP moisture-wicking technology is these days. Potty training a 4 year old often requires reacquainting them with the physical feelings of their body and the use of OT.

Can potty training occur before the age of 2? Yes, it can, often with girls at 18 months. Girls are not inherently easier to potty train. It’s just that we’re women, teaching little women, using our flowery language and loads of words. It’s only natural that many women feel like they can communicate more easily with their female children. Potty training before 2 often takes longer, but can be done for neurotypical kiddos, who have reached all other milestones timely, have basic vocabulary, can understand 1-2 step directions, are steady on their feet for both walking and running and have ample time at home with either their mother or a dedicated professional nanny. I would not suggest potty training an 18 month old that attends full-time commercial daycare.