Zen and the art of potty training

When my eldest, Michaela, was a toddler (she’s 17 now), I felt ahead of the game when it came to potty training.  After all, I was a pediatrician. A brand new pediatrician, perhaps, but I’d learned about potty training in my pediatric residency at an esteemed Harvard hospital.  And I’d learned that it was a remarkably straightforward process: assess readiness, buy potty, use lots of positive reinforcement, be patient. It was with remarkable confidence that I embarked on getting Michaela out of diapers at the age of two and a half.

More than a year later, with total potty training still elusive, trying very hard to “be patient,” I was thoroughly humbled — and realized that it wasn’t a straightforward process after all.  It’s not that potty training is incredibly difficult — most kids and families figure it out just fine — but it’s a far more individual process than I realized. Fifteen years of doctoring and parenting later, as my husband and I do potty training for the fifth time, I’ve come to believe that potty success requires a Zen, being-in-the-moment approach. 

Take the whole readiness thing.  We were taught that to be “ready,” a child should have the vocabulary (pee, poop, potty, whatever words one wants to use),  some aversion to being wet or soiled,  some awareness that they are about to be wet or soiled, and some interest in potty training.  They all sound simple enough, but except for the vocabulary one, it turns out that it isn’t necessarily easy to figure out when a child reaches those marks. Our second child, Zack, enjoyed following people into the bathroom, but it turned out to be an age-appropriate interest in anatomy that led him there — his intent staring at everyone using the toilet didn’t translate into any potty training progress at all.  You can and should use the signs of readiness, but ultimately readiness comes down to a guess, a leap of faith, a willingness to take it all on.
 

There’s another very real aspect of readiness that nobody talks about: family readiness. Potty training is no small endeavor.  There are endless trips to the bathroom, multiple stops on car trips (nearly always when you are running late), not to mention all the laundry and poop- and puddle-cleaning — all of which must be carried out with an encouraging smile and attitude.  Try mixing that with a new baby, new job, house renovation, or marital stress. And if your child is in daycare, your daycare provider needs to be ready too. Postponing until it’s a convenient time for your family doesn’t make you a bad parent. It makes you a realistic parent.

We postponed with our fourth trainer, Natasha. She was clearly ready at 2 ½ — but it was September, and we were really busy with getting kids back to school and activities. So we waited until after Christmas. This worked out well because of another factor nobody taught me about: personality. Potty training can be a big change in a child’s life, and every child reacts differently to change. Tash is a child who likes to be in control; she needs things to be her idea, not ours. In September, potty training would have been our idea. By delaying, talking about it, buying pretty panties (she’s a clothes horse), she began to feel like it was her idea — and made the transition out of diapers without an accident. (Really!) 

I encourage parents to think about their child’s personality when they approach potty training.  If your child is the bold, jump-right-in type, then billing potty-training as something new and exciting will work well — but if your child is the tentative type, or one who needs control, you’ll need to approach it in a more stepwise way, with preparation (reading books on potty training together helps) and a pacing to meet your child’s needs. 

Even the “positive reinforcement” part is very individual. Every child (and every adult) has different things that make them proud and happy. Hurrahs and sticker charts may work for some children, but they will fall flat for others. What did it finally for Zack, who didn’t respond to any reward I tried, was realizing that he couldn’t go into the big pool at the summer program until he was out of diapers.  After months of puddles, he was trained within five days of seeing that pool (and has gone on to be a competitive swimmer). Our third trainer, Elsa, was even more challenging because she hated attention. She did best if we gave her privacy and didn’t make a big deal of her efforts. “Don’t be happy at me!” coming from the bathroom was how we knew she was using the potty.

Don’t get me wrong ― it’s good to get advice from doctors and friends. And many of those books out there have great ideas. But ultimately, you are the expert on your child and your family.

So now we are potty-training with Liam, who just turned 3. What is remarkable to me is how unworried about it we are on this fifth go-around. We’re following his lead. We’re working with his independent streak by letting him empty his own potty — and with his distractible nature by being sure he sits on towels if he’s playing video games with his brother. We’re having fun making silly pooping noises and giggling with him. We are enjoying being in the moment with our great little boy. 

Which, I think, is a good way to approach parenthood in general.

Claire McCarthy, M.D., is a senior medical editor for Harvard Health Publications. She is an instructor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and co-director of the pediatrics department at Martha Eliot Health Center, a neighborhood health service of Children's Hospital. The author of two books, "Learning How the Heart Beats" and "Everyone's Children", Dr. McCarthy was a regular columnist for "Sesame Street Parents Magazine" from 1995 to 1998 and is currently a contributing editor for "Parenting Magazine".
 

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