Parents Offered Toilet Training Guideline: When is The Best Time

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When is the best time to begin toilet training? Researchers from several institutions have identified the period between 24 and 32 months as being the most effective for parents to begin toilet training lessons. Success also seems to depend more on timing than on the specific training method used.

The question about when it is best to begin toilet training is one that haunts many parents, especially first-time parents. The American Academy of Family Physicians (AAFP) suggests that parents not begin toilet training until they and their child are ready. Parents are ready “when you are able to devote the time and energy necessary to encourage your child on a daily basis.”

Children typically give signs that they are ready. For example, they may: become interested in the toilet, say they would like to go to the potty, seem uncomfortable when their diaper is soiled, wake up from naps with a dry diaper, be capable of pulling their pants up and down, and be able to understand basic instructions. The AAFP notes that parents may start noticing these signs at age 18 to 24 months, although it is not uncommon for children to still not be toilet trained at 36 months.

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In the new study, conducted by experts at The Bristol-Myers Squibb Children’s Hospital (BMSCH) at Robert Wood Johnson University Hospital and UMDNJ-Robert Wood Johnson Medical School, the results indicate that age 24 to 32 months is the best time to begin potty training. To arrive at their conclusion, researchers observed 150 children divided into two groups, and which included children ages 4 to 12 who had experienced urge incontinence. The researchers found that children who had undergone toilet training after 32 months of age were more likely to have bed wetting, day wetting, and other urge incontinence issues than children who had been toilet trained at an earlier age.

According to Joseph Barone, MD, surgeon-in-chief at BMSCH and associate professor and chief of the division of urology for the department of surgery at UMDNJ-Robert Wood Johnson Medical School, this is the first study to offer parents a specific time frame to begin toilet training.

Bed wetting and day wetting are common among young children and can lead to emotional problems. A recent study published in the Journal of Urology found that among 2,856 children (mean age, 7.3 years +/- 1.3 years), 18.2 percent had episodes of bed wetting: 12.3 percent mild (1-6 nights per month), 2.5 percent moderate (7 plus nights), and 3.6 percent severe (nightly). A National Institutes of Health study (January 2009) also found that attention deficit hyperactivity disorder was strongly associated with bed wetting.

Dr. Barone notes that their study “gives parents a guideline for the best time to begin training with their children.” He notes that parents should not feel pressured to begin toilet training, but that they “can be proactive and start training exercises before the child is 32 months old.” This step may help prevent incontinence issues such as bed wetting and day wetting and any emotional problems associated with them.

SOURCES:
American Academy of Family Physicians
Robert Wood Johnson University Hospital, news release Jan. 7, 2010
Shreeram S et al. Journal of the American Academy of Child and Adolescent Psychiatry 2009 Jan; 48(1): 35-41
Sureshkumar P et al. Journal of Urology 2009 Dec; 182(6): 2893-99

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