Getting ready for toilet training

• Teach your child the words needed for toilet training, such as wet, dry, susu, poop, it's coming. Choose words that you are comfortable with.
• Choose either a potty, or a special toilet seat with a footstool. A step is necessary if you choose to use a toilet, so that your child can get up to the toilet and can feel safe and relaxed there. A potty can be moved around the house but you may need to take it out with you if your child is not used to using a toilet.
• Some toddlers are afraid of being flushed down the toilet because they don't yet understand that they cannot fit down such a small hole. For these children a potty is better or let them learn to flush the toilet with you or by themselves. You may need to flush it when they are safely out of the way.
• Make sure that the toilet area is safe. Keep household cleaners, deodorants and toiletries out of reach.
• Make sure your child is wearing clothing that is easy to get on and off, and easy to wash, such as trainer pants.
• Put your child in pull-up or trainer diapers so that it is easy to get on and off and you don't have to worry if there is an accident.

If you are alert to your child's signals, you can be ready to guide her to the potty or toilet in time.

Starting toilet training

Note: it is best not to start toilet training at a time when your child is adjusting to other changes, for example, when there is a new baby in the family or starting a new daycare. If you think your child might be nearly ready to start training, choose a time when you are likely to have the time and patience to give your attention.

• Some toddlers can be introduced to toilet training by getting comfortable with the potty first, for example, leaving the potty in easy sight and touch or letting teddy sit on the potty 'to do susu'.
• You might start by noticing when your child is doing a poop in her diaper and tell her, 'I think you're doing a poop dear'. Later watch for signs that she is about to do a susu or poop and tell her as you guide her to the potty or toilet. You might say something like 'Let's see if there's a susu coming'. Eventually she will be able to know and get there herself.
• If your child tells you before she does a susu or poop, thank her for telling you and take her to the toilet or potty. If she doesn't get there in time at first, give her praise for whatever she has managed, for example, pulling down her pants, trying to get to the toilet, or sitting on the toilet.
• Make sure she sees that the praise is for learning a new skill, not something she has to do to please you. For example you might say, 'You did that really well' rather than 'You are a good girl for daddy'.
• Children should not be made to sit on a potty or toilet for long periods of time. This feels like punishment to the child and does not help toilet training.
• Teach girls to wipe themselves from the front towards the back to avoid the chance of getting any poop (soiling) into the vagina.
• Teach boys to shake their penis after a susu to get rid of any drops. For little boys who are not circumcised, they need to be especially careful as the foreskin can trap some susu.
• Some parents have found it helpful in the early stages of toilet training to float a ping pong ball in the toilet for little boys to aim at.
• Most toddlers don't have the skills to wipe their bottom properly, so you will need to do this with them until they get it right.
• Teach boys and girls to wash their hands after using the toilet or potty.
• Reward successes with cuddles. Say things like 'I am proud of you for trying'.

Remember that a toddler is not able to 'hold on' to a susu that is ready to come out. Children are often busy with what they are doing, so they don't always notice their body's message that their susu or poop is coming.

Toilet training troubles

Learning to control bowels and bladder is a big task for your toddler and sometimes there are problems for a variety of reasons

• Starting too soon.
• Pressure from relatives or friends, 'Surely Druv isn't still in nappies?'
• Parents setting a date to have their child trained or parents feeling they must get their child trained. If the child feels tension and pressure she may become afraid of making a mess, and it will be hard for her to get it right. Toilet training works best when there is no pressure for either the parent or the child.
• Children and parents getting into a battle over toilet training. Everybody loses in this sort of battle. Toilet training should not be a power struggle.
• If you think your child is purposely not trying to succeed and you become angry or even punish her, leave it for a while and try again in a few weeks when things are less tense.
• Any stress in your child's life, such as a new baby or starting a new daycare can set her back. Temporary loss of control is common when children are unwell or stressed.
• Accidents are common in the early weeks. She may not want to stop doing something interesting, or not get to the toilet quickly enough.
• It is common for toddlers to relax and 'let go' as soon as they stand to walk away from the potty. She may not be fully ready for toilet training if this is happening a lot.

Control over poop may happen a long time before control over susu – sometimes it happens many months later.

Physical problems

Sometimes after an illness or due to constipation, a small tear (or fissure) in the bowel can occur, which causes pain when a child does poop. This can make the child try to hold on and eventually small amounts of poop leak out whenever the bowel becomes too full to manage. This can cause great distress to the child. If you feel this is happening, or your child seems to be in pain, or there is blood in the poop, it is important to see a doctor.

Sometimes the bowel gets used to being full of poop all the time. Then it loses some of the feeling, so the child will find it hard to know when he needs to go to the toilet—he doesn't get the message that he needs to go. Medical help is needed to get it started again.

You should also see your doctor if there are signs of urinary (bladder) infections:

• doing susu very often
• pain when doing susu
• blood in the susu
• wetting frequently during the day after the age of two
• if your child's susu changes in smell

a child of four years or over is still wetting during the day.

What parents can do

• The most important thing is for your child to feel that she has your support in learning to know when it is time to use the toilet or potty. If she is resisting toilet training, or there has been a bit of a battle she needs at least a few weeks with all the pressure off. In the meantime spend lots of time making her feel good.
• Making your toddler feel special needs to be worked on first, especially if the problem is due to having a new baby (or other stress). After all she can see you happily changing the baby's poopey nappies, while inside she is wanting some babying herself. If she asks to wear a nappy or have a bottle again for a while, let her. Once she feels that she is still special to you she will be able to go forward again.
• The first step towards a new beginning is to tell your toddler whenever and wherever she does her poop, that poop is good and doing poop is good for her. This will help her to feel free to tell you when she is doing it, or when she is ready to.
• Sometimes it helps to put the potty in a place chosen by the child.
• If she is relaxed about it you could take her to the toilet or potty at a time when she usually does poop, or soon after a sleep if she wakes up dry. The first praise needs to be just for sitting there for a short time, or for pulling up her pants or whatever she can manage.
• Children learn new tasks in small steps and each step can be praised. Don't wait until they can do the whole task properly before praising her.
• It is not helpful to make toddlers wash their own pants or sheets. This usually makes them feel bad and may make things worse.

The more you can take the pressure off and help your child to feel that success will be her own doing, the quicker success is likely to come. When children feel tension or anger in their parents, it makes them tense and then it is harder for them to learn new skills

Constipation (over six months)

It is normal for some children not to poop everyday. Constipation (when it is difficult for your child to poop) can cause distress. Your child might have pain and tummy ache, say it hurts to poop, or hold on because it hurts.

The causes can include:

• the food your child eats (make sure there is plenty of fiber from fruit, vegetables, bread, cereals, beans, lentils)
• not drinking enough fluids (make sure your child is given plenty of water)
• some medicines
• not enough active play
• your child is put off going to the toilet.

What to do

Talk with your doctor, child health nurse, dietician, and do so before using laxatives or other treatments.

Special notes

Once your child is using the toilet, don't be disappointed if there are a few accidents. A few accidents are to be expected even when children are trained. Try and avoid getting cross because if your child sees that you are upset or angry, it is likely to set back all your good work! Sometimes toilet training can go backwards when there is a new stress or something is troubling your child. This is very normal.

Many children go on wetting the bed long after they are dry during the day. Don't worry about bedwetting if your child is under five or so, but if bedwetting continues after this, or your child has been dry and starts wetting again, check with the doctor to make sure there is no medical problem. Also check if one child is bedwetting much later than others in the family. It helps to know that over 10 per cent of children in the younger primary school years still wet their beds and most will grow out of it naturally. Sometimes children continue to wet the bed for other reasons.

The information above is for parents of children under five years of age. If problems with soiling go on longer than this you may need professional help. Soiling or wetting during the day can be a distressing problem for children and they need our help.

Reminders

• Toilet training is a difficult new skill to learn.
• Start toilet training when your child shows he is ready.
• Don't try to set a date by which you want your child trained—it puts pressure on both of you.
• Give praise for small steps—don't wait for the success of being completely toilet trained.
• Go at your child's pace, don't expect too much.
• If there are any setbacks give up for a few weeks and then start again.
• Don't get into battles over toilet training. It needs to be your child's achievement that he can be proud of.
• Punishment has no place in toilet training.