Potty training. Yuck. My brain is about to explode. I literally just read a 50 page evidence report called “The Effectiveness of Different Methods of Toilet Training for Bowel and Bladder Control” done by The Agency for Healthcare Research and Quality. It was about as exciting as it sounds.
Why was I reading an evidence report, the kind of literature that includes lots of abstracts and objectives and executive summaries? I’m starting to not trust anything about toilet training and it’s driving me crazy. Some people claim we Americans are waiting too long (white Americans I should say) by pushing toilet training to 2.5, 3, or even beyond years. Others suggest we make like our forebears and Europeans and force the issue before 18 months. Still others are all about elimination communication, the practice of toilet training from birth. Some say do it all in a day. Others say wait for the kid to decide. The American Academy of Pediatrics and Mayo Clinic support the child readiness approach, as does the Canadian version of the AAP, but Google toilet training and you will find a plethora of opinions, most of which have very little actual research to back them up, which means like with so many other parenting topics, no one really knows what is best.
What is an overthinking girl to do? Look up dry reports that analyze the limited studies that have been done. This evidence report from 2006 notes that healthy children will be potty trained by most methods, but that when comparing the Azrin-Foxx method to the child-oriented approach, the Azrin-Foxx achieves results faster with as good if not better follow up results. Still, overall, the difference between the two isn’t that great. In other words, both will work. Okay, then I want the one that works better. Azrin-Foxx it is.
But what exactly is that method. I found their 1970s book on Amazon advertising to potty train your kid in one day. I guess it can work, as long as you wait until your kid is showing at least some signs of readiness. For the record, my almost 16 month old is not showing the signs. However, despite mostly positive reviews, a couple negative reviews of the book noted it can be harsh, e.g. marching your kid in wet undies to the toilet 10 x and telling him how upset people will be that he wet his pants, although, to be fair, a lot of positive reinforcement is also required. You also have to somehow get your child to sit for 10 minutes on the potty. As one reviewer noted, how exactly does one do that? Hmmm. Maybe this approach, although effective, isn’t going to work with my personality. I like things to be done fast, but I really can’t see Amelia sitting still and I just imagine a really stressful day that may or may not result in some level of toilet training.
Elimination communication is also out because I already missed that boat and I think having to read all the bathroom cues is a little overwhelming and not very practical for anything other than a first child, meaning baby #2 ain’t gonna do that method either.
I found some books advertising a three day version of the Azrin-Foxx method, a version that can be started even sooner than that one, yet requires three months of a diaper free baby. I’ve already learned the joys of steam cleaning our rental carpet and the last thing I want to do is watch a diaper less baby in the house while also caring for a newborn, so I suppose that method is out as well.
This leaves the most common and lengthy child-led approach. According to the evidence report, if you start potty training around 18 months (as in introducing the concept), your child should be consistently going without accidents 10 months later. Wow. I had no idea it could take so long. This is the approach that involves getting your child used to the potty, putting her on it every once and a while, then moving to training pants, etc… If you wait too long you can have a very obstinate child who refuses to poop in the toilet and if you try too early, you will frustrate yourself. Now I see why the other early toilet training methods, although labor intensive, are appealing to people. I really really really hate changing Amelia’s diaper. She screams and wriggles around and makes life generally miserable. At the same time, the thought of being locked in the kitchen with her for one day or three makes me cringe.
I guess I’ll go with the gradual approach even if none of them seem appealing. I told Dave I would do the “normal” thing for this one parenting topic, realizing as I said this that “normal” is relative. What is normal in America isn’t normal in other countries. What is normal for white Americans apparently isn’t as normal for black Americans (I had no idea). Instead, we’ll do the approach that fits both Amelia’s and my personalities. That kid hates to be forced to do anything and I love order and schedules. Not a great combo. In my mind, I start potty training her at 18 months by slowly introducing the concept and we magically reach a conclusion in a few months. However, I absolutely know that won’t work. All the methods have one thing in common. They recommend not starting the process when another baby is arriving. Amelia will be 19 months when baby #2 makes his grand entrance. She has already gotten jealous of the little doll we are pretending is the new baby. Even if early toilet training is preferable for some, I can’t see it working out logistically for Amelia or me. Plus, who said anything old and European has to be superior? The history of potty training is not a straight line from wonderful early training to wussy child led training. That’s what I keep telling myself anyway. We’ll see how it goes. Maybe in 8 months I will be locked in a kitchen with Amelia after all, pumping her full of liquids and begging her to sit on the potty.
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{ 4 comments… read them below or add one }
Maeve and I are doing it right now, although I admit to not having done a lick of research. She just started knocking on the bathroom door right before she pooped, so I figured it was time! She has so far peed in her potty like 5-6x in the last 2 weeks. I am expecting it to take a long time, but she seems to be figuring things out pretty well for a 15 month old. We use pull-ups because she wants to go sit on the potty about a dozen times a day and HATES having her diaper changed. Also, I have to physically hold her on the potty for 10 seconds, which is about her limit, so no way would she ever be able to do 10 minutes! I honestly think kids show you when they’re ready to start, and you should definitely be prepared for it to last awhile. But it never hurts to talk and explain things about the potty before they’re interested. I really like “A Potty for Me!” by Karen Katz – it’s a lift-the-flap book which Maeve loves, and is gender neutral.
Wow. Knocking on the door before pooping? That’s awesome. When Amelia poops (or I think she does), I ask her “Did you poop?” She shakes her head no. If I don’t ask, she’ll never even let on that she has pooped. I have to follow the scent. Then when I try to change her diaper, she runs away. So I’m guessing she isn’t quite ready for the potty training, even though I am prepared to start sitting her on the toilet when we get back home (all this traveling isn’t helping). Thanks for the book tip. I’ll look it up.
Meredith, my son, Bryce, who will be 24 months in 2 weeks is the same. He will never tell me he pooped not even when I can see on his face he’s pooping and he doesn’t mind staying with the poop in the diaper for a while.:) I, personally, believe every kid is different and I really don’t stress much about it. He will certainly let me know when he’s ready for it. He sat on the potty several times and knows what it is for, he knows what pee and poop mean, he’s just focusing in learning some other things then this “toilet” thingy.:) I don’t mind changing his diapers for a little longer, even if sometimes he’s a little restless, too (that’s when I tell him that if he’ll tell me when he wants to poop and pee this diaper change will be unnecessary) but I just go with the flow and let him choose the right moment. For me, it’s the same as when he learn how to crawl, walk, eat, chow etc, he did it on his own time.
Hi Meredith,
After going through the potty process with four children, I can honestly say they trained themselves. Any time that I tried to push the issue, they pushed back. I bought a potty seat for my oldest son when he was 18 months – forget it! No interest whatsoever. He started preschool in a pull up at 2 1/2. INHO there is no easy, fool-proof way – it’s a messy process. All of my kids were potty trained well before the age of four. My youngest watched the older kids and was “trained” by age three; however, I still need to wipe him (this goes on for months, so even when they are trained, they still need help!) and there are still accidents.
I’m sorry if I’m the bearer of bad news :(