When and how to start toilet training are big topics with the parents who come to my office. There are countless opinions on the topic, and many different strategies from training you child to crawl to the toilet as an infant to setting up camp in the kitchen and getting the job done in 1 day.
My advice: let the child decide when he or she is ready. Why? Because the whole point of teaching your child to use the toilet is to transfer the responsibility of realizing it’s time to go (or that it was just time to go) from you to him. If you start too early and become the “potty police” asking your child every 20 minutes if he has to go, what’s the point? Wait until the child is developmentally ready and self-motivated and the process will go much more easily.

My other nugget of advice is to try to stay relaxed. If your child senses stress, a power struggle might ensue. This can have bad consequences such as withholding stool, which can lead to pain and leakage around the hard stool that gets stuck (called encopresis)-NOT FUN!

Some cues that your child might be ready include (1) Your child tells you when she needs a diaper change. (2) Your child tells you before she is going. (3) Your child stays dry for 2 hours straight in a diaper, and (4) Your child asks to wear underwear.

Once you start to see the cues, read books and watch videos about toilet training. Allow your child to accompany you to the bathroom. You can place a potty seat in the bathroom, but I suggest you wait until the child asks to use it before you offer it. I think the process should be completely driven by the child for the greatest chance of success.

Once your child has decided to make the switch to underwear, I say go for it all day long (nighttime dryness usually occurs later). The message is, “You wear underwear now.” Don’t put a diaper on for your own convenience-be completely committed to the process or you will be giving mixed messages. I am not a big fan of pull-ups. I like to see children either in diapers that they are allowed to pee in, or underwear that ill get we if they have an accident (it’s a natural negative reinforcer).

If you child has a successful day, praise him lavishly for the accomplishment. But, try to avoid punishment for accidents. Positive reinforcement is more powerful. If you are seeing a lot of accidents, most likely your child isn’t ready. That’s okay. Put away the underwear and try again when your child shows interest. Remember, it’s up to him to decide when the time is right. Don’t worry, I have never seen anyone get married in diapers!