Babies have no control over their bladder or bowels. They simply eliminate their waste material as the organs become full. Around the age of two, the ability to exercise control develops, and gradually, in a combination of both physical development and learning, a child acquires the ability to urinate and defecate only when appropriate. Obviously there is no point in trying to toilet train a child who is not physically ready to control its bladder or bowels. To try is the equivalent of trying to teach a six month old baby to talk and will simply lead to frustration on both sides.
Parents often feel a child should be clean by the age of two, and dry at night by the age of two and a half. In fact, only about half of all children achieve these goals and many are at least a year later. Complete control is rarely reached before three in any child.
Toilet training usually starts around 15-18 months by placing the child on a potty after meals. This is the time they are most likely to want to void, and gradually, with much praise if the potty is used, the child will learn that this is what is required. A young child, of course, has no way of knowing what is expected and patience is needed. A child with an older brother or sister who sits on a potty will usually latch on more quickly than a child without such a model to imitate.
Most toddlers react vigorously against being forced into things and a parent who is aggressively insistent about toilet training is likely to find the attitude counter-productive. Toilet training can only succeed with the voluntary cooperation of the child, and if you make the process a battle ground, you are the one likely to lose out.
It is much easier for a child to learn to be clean than dry. Most children only move their bowels once or twice a day, usually at regular intervals. You are likely to be able to recognise the signs of an approaching motion and provide a potty or take them to the toilet to collect it. Generally after a few weeks, especially if you make it clear you regard it as desirable and grown-up behaviour, your child is likely to have become proud of its new skill and will seek out the potty or toilet when it is needed.
Urinating is more haphazard. Children urinate many times in a day and since it is a less “major event”, they may not even notice it if they are absorbed in play. The urge to urinate is also not enough to wake them in the early days of developing control, so they remain used to urinating in their nappy while they are asleep. If a child wakes dry, make the potty available or take them to the toilet and be liberal with praise if it is used.
Gradually the child will learn that when the urge to urinate is felt they should head for the potty or toilet. It is worth remembering that children want to learn and want to acquire new skills – all children do eventually stop wetting themselves, even those who seem impossibly slow.
As a rule, the only children who are referred to a doctor because of failure to learn bladder control are those who have been subjected to excessive training. Bed-wetting that persists in an older child is a rather different problem for which various types of treatment are available.