Potty Training

In the 1930s, federal guidelines suggested that babies complete toilet training by 6 to 8 months of age. To which a modern parent might respond: Bwahahaha!

Today's kids aren't in a rush to get to the throne. Most children start potty training around their second or even third birthday, an age that has steadily risen over the years as diapers have become more comfortable and widely available.

Critics say postponing this milestone can be unhealthy for the child, stressful for the parent and hard on the environment and wallets because of the extended use of disposable diapers. They advocate starting toilet training as soon as possible, often before a baby can walk or talk.

But experts say the child must be physiologically and behaviorally ready. Trying earlier and failing can set up a cycle of frustration, negativity and other problems, said pediatrician Mark Wolraich, author of the American Academy of Pediatrics' guide to toilet training.

Plus, the time you spend working on and agonizing over incontinence could probably be better spent simply enjoying your baby, he said. "Children do almost all become potty-trained," Wolraich said.

Still, if you want to initiate toilet-training your toddler before he turns 2 — and everything becomes a battle of wills — keep these facts in mind:

Little research has been done. There's no official definition of what it means to be toilet-trained, and there are no universal guidelines for when and how to begin the process. The AAP recommends customizing the approach to your child.

For the first year, babies can't control bladder or bowel movements. So while they may learn to associate the toilet with elimination, the parent is really the one who is being trained. Pediatrician Ari Brown likened it to teaching a 4-month-old to walk, something that children are developmentally ready for around 12 to 15 months.

"Parents are also welcome to try toilet training earlier than age 2, but the odds would be that success would not happen any earlier and just means a longer duration of work for the parent and potential frustration for the child," said Brown, co-author of "Baby 411" (Windsor Peak Press, $14.95).

Still, infants can be conditioned to use a potty. Other cultures use "assisted toilet training," which can begin at 2 or 3 weeks.

Parents carry the infant 24/7 and learn the subtle cues the baby makes just before he needs to pee or poop. In the U.S., however, this can be difficult, especially for those who work outside the home.

Even if you recognize Pookie's signals you have about 15 seconds to get him to a bathroom.

Diapers can increase the risk of bladder infections.

"This happens mostly for girls only because poop is sitting in the diaper and the germs can track up into the urethra and cause infection," said Brown, who doesn't think the risk is high enough to warrant infant toilet training. On the other hand, once girls are toilet-trained, they are also at risk for bladder infections because they wipe the wrong way, she said.

Two- and 3-year-old children love to say "No!" and are learning independence, which often makes toilet training tricky. Positive reinforcement is good, but try not to be overdramatic, said Dr. Harvey Karp, a child-development specialist and assistant professor of pediatrics at the University of Southern California School of Medicine.

"If the child thinks toileting is so important to mom and dad that they applaud and jump up and down, it puts too much pressure on them and they may regress," said Karp, the author of "The Happiest Baby" series of books. Or they use it against you, Karp said. "They think, 'I know what you love so I won't give it to you.'"

Instead, Karp suggested trying a technique called "gossiping." "You say, 'Good job, sweetheart!' You're happy, pleasant, not over the top. Five minutes later, you whisper to the Elmo doll, 'Hey, Elmo, Bobby peed all by himself! Good job!'" And Bobby is thinking, 'I'm hearing this a lot lately from people.' The words don't matter as much as the way you say them."

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