Kirstin Campbell, M.D. is a pediatrician at St. Louis Children’s Hospital and an Instructor of Pediatrics at Washington University School of Medicine. She received her undergraduate education at the Johns Hopkins University in Baltimore, MD and is a graduate of the Washington University School of... View More

I am in the throes of potty training my preschooler. I have already thrown away at least one pair of “big boy pants.” Overall, it is going well. It has taken us an entire year to get to this point. By “us” I mean my son’s father and me. My little guy has been capable for quite some time, he just wasn’t that interested. Don’t ask me why, but suddenly when he turned 3 I began to feel like I had failed myself and my son. I began to feel embarrassed that he was still in diapers. In addition, he was about to outgrow the diapers available at Sam’s Club and then what was I going to do?

I shouldn’t have felt embarrassed at all. Mothers often put undo pressure on themselves and their children based on peers and other societal “norms.” I am vulnerable to this as well. I just hate to admit it to myself.

So here is my quick and not-too-dirty guide to potty training at three.

1) Be sure your child is developmentally ready. Most 3-year-olds are. Signs of readiness include the ability to keep a diaper dry for a few hours or through a nap, take off their pants, and communicate simple needs effectively.

2) Start a dialog with consistent language that you aren’t afraid to say in public. We use penis and bum, pee-pee and poop, both of which go into a potty.

3) Introduce the potty seat or chair to your child in a fun non-threatening way. Consider allowing them to decorate it, sit on it with clothes on, or put toys near it.

4) Decide if and what kind of reward system you might offer your child. We use jelly beans, M&Ms, chocolate covered sunflower seeds. Friends have used stickers, tiny cars, etc. The main point is that it has to be something small that you can afford to give your child with every real attempt. Notice I say attempt and not just success. Not all kids need rewards, but you aren’t going to ruin them for their adult life by training them in this way.

5) When you and all caregivers are in agreement, the daytime diapers must go. I embarrassingly spent months switching him back and forth between potty and diapers because I wasn’t ready to deal with the risk of mess in the car or in public. Part of me just thought it would “happen.” With some children it just does. They almost do it themselves. My wonderfully busy and laid back 3-year-old was fine going in his diaper. It wasn’t just going to “happen” for us.

6) Try it naked. This is a tactic used by many parents. My son easily noticed the difference between diaper and no diaper and if naked would seek out the potty. It also saves them time at the last minute when little hands get tangled in little pants and the “pee-pee is coming.”

7) Invest in a few pairs of thick training underwear that have plastic liner or add plastic pants over them. When my son was first put in underwear he could not remember that they were not diapers and went in them repeatedly, which is how I always ended up putting him back in diapers . Don’t do what I did. Stick to the training pants. They will help contain some of the mess but your child will eventually realize they aren’t diapers.

8) Create a bag with extra undies, clothes, wipes, empty Ziplock bags, paper towels and anything else you might use to clean up and accident in the car, playground etc.

9) Take the potty seat with you… if your child is fond of their special seat, take their seat with you. Yes, it is a pain, but you are only likely to need it until potty training is established. The easier you make it for them, the more successful they will be and trust me you will be thrilled. My son now loves to “make a fountain in the big potty,” but it took several days.

10) Accept that accidents will happen. It’s part of the process. You will hear “Mama, I need you! There is pee-pee all over the couch.” If you are mentally prepared for this you are less likely to get frustrated and quit, or get mad and yell or scold. Overly negative reinforcement when potty training tends to result in children who withhold urine and stool and create lots of problems down the road such as chronic constipation and urinary tract infection.

11) Remind your child to use the potty on a regular basis, but resist the urge to have them pee every 15 minutes or sit for long periods. Reinforce normal toileting patterns. This may include going to the potty when you get up from bed, before and after meals, before getting in the car, before bed. Eventually you will need to let them have some control over this. Poop often happens 10-20 minutes after eating. Food in = food out. You’ve been warned.

12) Be a cheerleader. If you are proud they will be, too, and that is a powerful motivator. If they forget or make a mistake, remind them calmly of what they need to do and tell them that you know they can do it next time.

13) Sleeping is the exception. Naps and nighttime dryness may not happen for months or years. There is a different mental/physical control for this and bedwetting into double digit ages is normal and common especially in boys. This is the one time of day you might go back to pull ups or diapers.

It took about 3 days of reminders and mess for my son to really get it. Now, a week in, he has been accident-free for about two days. We chose to keep him out of daycare during this period, so that training would be consistent with less distraction. I am crossing my fingers for when he starts back. I could have/would have done this much sooner, but I just wasn’t ready.