THE KID’S DOCTOR: When is the best time to potty train?

By Sue Hubbard, M.D.
   Every parent wants to know when their child will be ready to potty train. A study that was published in an issue of the Journal of Pediatric Urology is one of the first to show that timing of potty training children seems to be more important than the technique. 
  I found this quite interesting, as the lead author, Joseph Barone, M.D., stated that this is the first study “that gives parents an idea of when it’s a good time to toilet-train.”  The best time to potty train has typically been thought to be somewhere between the second and third birthday, but that is a wide range. This study suggests that age 27 months to 32 months is the appropriate time to move a child out of diapers. 
  In the study, children who were toilet trained after 32 months were more likely to have urge incontinence, and problems with daytime wetting and bedwetting when they were between the ages of 4 and 12. This data was gathered from a retrospective study of children who were being seen by pediatric urologists for problems with urge incontinence (daytime wetting episodes) and their parents’ answers to a questionnaire on when they started potty training and what method they used; this was compared with children who did not have urge incontinence. The results showed that the average age for children with wetting problems were trained was 31.7 months while those children who did not have problems were toilet trained at 28.7 months.  
  Potty training continues to be at the top of the question list for parents with toddlers. I still believe and this study tends to support that children who are potty trained younger seem to have “fewer issues” than those that are older. That is not meant to say that your child will be potty trained by 28.7 months, but in most cases if you begin discussing the potty and following a child’s cues and follow through with reinforcement and consistency than the majority of toddlers may be potty trained by age 2 1/2 (which would be 30 months). In my experience as both a mother and pediatrician, those toddlers who are put in pull ups and never asked about going to the potty or are not taken to the potty seem to be the ones that I see at 3-year-old check-ups still wearing their pull-ups. By this time if you ask them if they want to go potty they all say, “NO.”  I believe this is termed “the child directed approach,” which seems analogous to me as saying “what time do you want to go to bed?” 
  In most cases, if a toddler is introduced to the toilet, goes with their parent to “sit or practice or watch Mommy and Daddy potty” early on at age 2, and is given some incentive to perform, whether that be a sticker or M&M’s or both,  they will become interested in the potty and then they will become ready to potty train. I guess this is a combination of both the parent directed and child directed approach. Once you see your child is interested, you have to “go for it” and put them in good ‘ole cotton training pants and go to the bathroom frequently. You can’t ask if they want to go. Again, it is a statement (i.e., “Time to go potty!”) and most will be trained by the “magical” 27 months to 32 months of age. To me, potty training is somewhat like a space shuttle launch. “The window is not that wide,” and you have to potty train during that magical window or the launch window may not come around again for a long time! 
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. “The Kid’s Doctor” TV feature can be seen on more than 90 stations across the U.S. Submit questions at The Kid’s Doctor e-book, “Tattoos to Texting: Parenting Today’s Teen,” is now available from Amazon and other e-book vendors.
January 7, 2018 – January 20, 2018