Toilet Training : Blog
Laurence H. Miller, MD
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Toilet Training

by Doctor Laurence H. Miller on 09/03/11

The successful accomplishment of toilet training is one of the most important and gratifying milestones of childhood.  Most parents worry and ask about "the correct method" to train their child.  I answer by pointing to the head and the heart.  "The child has to be ready UP HERE and IN HERE".  They have to KNOW, to UNDERSTAND what is required of them, and they have to be READY, to WANT to COMMIT to this civilized behavior.

I didn't invent this approach to the training, but I subscribe to it because it works, and it takes a burden off the parents AND the child.  Some authorities in child development advise an ACTIVE TRAINING process:  INTRODUCE the child to the potty.  PLACE the child at the right time on the potty.  ASK repeatedly about the child's urge to urinate or have a bowel movement (BM).  My reason for a more passive role for the parent is that it avoids another situation of child rearing CONFLICT.  Parent is not really being passive. Mom and Dad make sure child has regular opportunity to SEE how the BIG people use the toilet every day.  These young kids are VERY OBSERVANT and the repeated exposures will make a tremendous impression on them.  The grown-ups or older brothers and sisters needn't even SPEAK about what they're doing.  Little kids love to imitate what their family does.  (Just watch how DESPERATELY a toddler tries to stand up and walk like Mommy and Daddy.  No one has to badger her to try!)  
But KNOWING what to do is only HALF of the project.  When the little one feels really BIG, grown up, they will feel  a strong need to join in and also use the toilet the way the other BIG people do.  So the parent's task is a natural and pleasant one, really WITHOUT PRESSURE:  treat the child respectfully, and give them the opportunity to join in on gradually more mature, grown up activities.  Every child will arrive at success at HIS OR HER OWN TIME.  I warn parents not to let a nursery school or relative state an age limit by which the finish line must be crossed!  Our children are not "cookie cutter gingerbread men and women" that come out the same at the same time!
My younger daughter was always stubborn about doing things the way she wanted to and also very determined to accomplish something when she set out to do it.  It was just before her second birthday when she came toddling into the bathroom where I was shaving.  She was naked from the waist down, and purposefully climbed up onto the toilet seat, next to my sink, turned around and squatted, balancing on the balls of her feet on the toilet seat, and proceeded to have a bowel movement into the toilet.  I experienced a surreal moment of disbelief.  She had never before shown any interest.  We had pointedly encouraged her to sit on the portable potty chair that we'd placed in her playroom; but she refused steadfastly for months.  (Our older daughter had been delighted to play with and sit on the same potty chair when she was training, and was successful in using it.)  We knew even then why she shunned the little commode:  she never saw her older sister, or her mother, or me use this potty.  If she was going to do something, it would be done properly!  The same way the rest of the family performed!  And she would NEVER use a little booster seat that folks put over a regular toilet seat so a toddler can practice on it.  For the same reason:  WE DIDN"T SIT on the booster!   Of course, SHE couldn't sit properly on a standard toilet seat, as her little butt would fall right through!!  So she squatted!  Our whole family made a big fuss over her feat and she continued this way for a few weeks.  Then, to my dismay, she approached me one day and demanded:   Doo doo in the diaper.  I tried to reason with her; that she was already adept at balancing nicely on the toilet seat and how nice it was to be clean without messing in the diaper.  She was adamant!!!  Doo doo in the diaper!!   Then I had a moment of clarity:  If I persisted to badger her and pressure her, she would not be persuaded but would defy me by withholding her BM!     This could lead to a CHRONIC CONSTIPATION PROBLEM  and likely a need for a psychologist at a later date.
With this foreboding of doom if I didn't relent, I accommodated her and she went back to using her diaper for stooling, although she was content to use the toilet to urinate. We were sure she'd come around soon.  And so 3 months passed, 6 months, a year, a year and a half!!  We would playfully tease her, cajole her, but she persisted in her diapers for BM's.  
When she was 3 1/2 years old, we took her skiing for a weekend in Massachusetts.  We had to bring a box of diapers with us!  I spent an afternoon riding up the chairlift with her and skiing down the "bunny slope".  I was really impressed at how well she did!  I thought we might have a toilet breakthrough, but she persisted in demanding the diaper for BM's.
Spring came.  She was 3  3/4 years old.  We went back to ski in Massachusetts for a weekend.  As she'd done so well the last visit, we put her in ski class with a bunch of other 3 and 4 year olds.  She joined in happily and went up and down the bunny slope with a teenage girl teacher.  Lunchtime, she waved to us from across the cafeteria where she ate with her fellow skiers:  "Hi Mommy! Hi Daddy!" (Proud and feeling her oats!)  To celebrate her successful class experience, I offered to take her to the top of the mountain and ski all the way down!!  She was game and we took two chair lifts to the top.  Then we skiied down together.  I was behind her leaning way forward with my arms hooked under her armpits.  Mostly she was fine but whenever her skis got tangled and she began to trip up, I'd lift her up quickly so she could straighten her skis, and then I'd lower her back down.  All this while "racing" downhill.  My back was KILLING ME!   We laughed all the way, and after several "near misses," finally fell, sprawling across the path and shrieking with the fun and adventure of it.  We got ourselves back together and finished the ride down.  Tired but happy and proud of how far we'd come!  We returned the rented skis and drove back to our hotel.
As we entered our room, the little one announced matter of factly, "I have to make doody," as she headed alone into the bathroom..  My wife, older daughter and I were stunned! Was this really happening!!  We SILENTLY jumped for joy.  Shortly, we heard the flush, and  our big girl emerged from the bathroom.  In a casual voice I beamed at her, "Congratulations, darling, we're so happy for you!"  
Why did we downplay our excitement of the moment?  The answer is in the way we expressed our happiness:  The event was about HER. ("...happy for YOU!")   It was HER achievement and it wasn't supposed to be that important to US.  (Even though we were VERY happy for her and us.)  If we'd made a big fuss in that hotel room, our little girl might have been tempted to use toilet behavior in the future as "political capital".  If we didn't buy her a doll or a toy she wanted, she might decide to "get even'  by returning to diaper days.  But since we'd made it clear on that big day that we were pleased but that "it wasn't THAT big a deal",  it wouldn't occur to her to use it for blackmail if she got angry about an unrelated issue.
And what was it about THAT DAY that caused our girl to finally choose to use the toilet for BM's? She'd had a great time AWAY from Mom and Dad, DOING WELL at a NEW activity, DINING with new friends like a grown up, and then ATTACKING the mountain with her Dad, like a real BIG kid.  And THAT was it!  She'd finally got it.  She was a BIG kid because she was doing all the stuff that BIG kids and people did.  And BIG people used the toilet for their BM!  A person who skis down from the top of a mountain (TWO CHAIRLIFTS!) doesn't POOP in a diaper!  It just ISN"T DONE!!   So she truly felt COMPELLED by HERSELF to use the toilet.  Her insight into the true maturity she'd attained put an end to the story.  She was a secure and happy girl. 
So, all that parents of young children need do is "find the right ski slope" for their kid!  Or help them enjoy any kind of "grown-up" activity and let nature take its course.

Comments (1)

1. Deborah, Joeys grandmother said on 1/20/15 - 07:51PM
Thanks Doc I truly enjoyed the ending of your story not to mention you 've given me a better insight on how to tackle toilet training . Which I now understand how simple it could be.


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