What’s normal?

In their second year, as toddlers’ bodies develop, they show signs of being ready to be toilet trained. Toddlers learn to recognise more subtle sensations in their anal and urethral areas and develop the ability to contract the muscles responsible for holding on to and letting go of poo and urine. Every child is different, and potty training can’t be rushed. Keep in the mind that by the age of three, 9 out of 10 children are dry most days, and by the age of four, most children are reliably dry. 

Toddlers are generally learning more about their bodies – they may feel that their poo is a precious treasure because it is a part of their body, and so can be anxious about getting rid of it. But at the same time, they are also learning from those around them that a poo is something dirty and smelly, which they shouldn’t touch or play with. Understandably, this can be quite confusing!

Across cultures, there is huge variation in expectations of what is an appropriate age to toilet train. It may be helpful to wait until the child can understand what is expected of them, so they can be an equal partner in the process – this is unlikely to occur before 15 to 18 months but could be later.

Along with their increased ability to notice and control their bodily signals in the second year of life, children become very interested in ‘cause and effect’ games, and the question of maintaining certain standards. For instance, you might notice that they may start worrying if clothes are dirty and getting upset if toys break. This can be a good time to introduce toilet training, as the child will be interested in living up to toileting standards. Other signs of readiness include awareness of when they are going to wee or poo and becoming upset at being wet or dirty. It’s important to bear in mind that children can become distressed at not being able to live up to what is expected of them, so reassure and praise them at every turn.

Problems in toilet training may be caused by physiological irregularities, which undermine the child’s confidence in controlling their bowels. If children experience pain due to constipation, they may withhold to avoid the pain, making the constipation worse. On the other hand, diarrhoea can make it difficult for the toddler to hold back, and they may therefore stop trying. The child’s health visitor or GP should be able to help with these issues.

Impact of the health crisis

For some children and their carers, spending more time together at home might make toileting easier, while for others it might be the opposite. Anxiety due to changes in routines, uncertainty, and the anxiety of those around the child may make potty training harder to learn. Or it could even lead them to go backwards in their toilet training – wetting or soiling where they didn’t before. It is important that adults don’t get angry, but try to acknowledge the toddler’s feelings, and their increased need for care at this time. After all, this is temporary, and they will be able to catch up soon.

Top tips for practitioners and parents
  • Go along with the child’s pace: read the signs and expect only what is age appropriate.

 

  • Potties are less scary for a toddler than an adult toilet – toddlers are less likely to worry they will fall in or be flushed away!

 

  • Children need to feel in control of their bowels – and parents and carers need to respect the child’s poos as ‘belonging to the child’, and acknowledge that they have the power to either produce or withhold it.

Useful links:

Institute of Health Visiting - Toilet training

NHS – How to potty train

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