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    The Early-Start Plan for Toilet Training

    Excerpted from
    Diaper-Free Before 3: The Healthier Way to Toilet Train and Help Your Child Out of Diapers Sooner
    By Jill Lekovic, M.D.

    Before you can begin toilet training you have to get a potty. There are many styles of children's toilets out there, and I think every home with a six-month-old (or older) child in it should have one. A baby needs a few basic things in life, and one of them is a potty that fits his body. The best come with as few pieces as possible, as they feel more stable and last longer. There should be some support for the baby's back, even though he may lean forward at first. It should be a normal object in your house long before your child is particularly aware of it, and it should be sitting there in the bathroom so the first time that the thought crosses your mind that he might be able to sit on it, you can give it a try.

    It has become popular for many people to skip the training potty entirely and introduce their child to the regular toilet with a little seat on top. Part of the reason for this is that people are starting training when their children are already getting too big for a little potty chair. There are several reasons why skipping the little potty is less preferable. First, it is much more difficult for the child to get onto an adult potty, and there is always the possibility of a fall. Second, many children are frightened of the water, of falling in, and of flushing. Finally (and most important), the ideal posture for both voiding and stooling involves some support for the feet. Can you imagine climbing onto a toilet that was so large that your feet could not touch the ground and then trying to have a bowel movement? You must have your feet on the ground to properly use those pelvic muscles, and so should your child. The famous developmentalist Dr. Arnold Gesell argued in 1949 that a small potty that allowed the child's bottom to be well supported with her feet on the ground was essential, and that fact remains true.

    Having a little potty in the bathroom also makes it possible for you and your child to go potty together. This can be very helpful with training, even with opposite-gender parents, as she sees you go through the little routine of going to the bathroom and washing your hands, and she has such a strong desire to imitate you. I have often found myself in the uncomfortable position of going through the whole routine of getting everyone to the potty, dressed, and with shoes on before we head outside, only to realize I forgot to use the bathroom myself. This is a secondary benefit (but an important one) to having a small potty: Keep the big one available for the adults. Most children express a desire to use the regular potty by the time they are three or four years old, and of course you should support that transition when they are ready. If they want a little step stool, encourage them to use it as a footrest as well, as that will really help them use their muscles effectively.

    Once you have the potty you have to think about the plan to use it. I have read in some of the old articles that people defined the beginning of training as the first time they had a child's potty in the home. I think that is a great place to start, and it makes everything else seem less dramatic (as it should be).The goal is not to train kids early as some mark of their precocity or intelligence but to give them the familiarity with the process that provides them with the opportunity and the skills to go about the task in the way that suits them. Too often by delaying training we are failing to give children who would be much happier going on the potty the chance to do so. The process of toilet training occurs over three phases that I have labeled: introduction, practice, and good habits. The idea is to focus on the process and the specific objective of the phase you are in, and to avoid the common mistakes made when expectations are not well understood.

    Before you start it is important to understand a few basic things about your baby's body. Babies empty their bladders at regular intervals. Modern technology has demonstrated that this is true even before birth. At no point with a normal baby does urine simply dribble out constantly. There is a system in all babies where the bladder fills up and then at some point the signal comes to contract the muscles that empty the bladder, and this occurs every few hours. This occurs around twenty times a day in a normal newborn baby. It is important to know from the start that there is no real understanding about (and probably no specific age or time) when the baby becomes aware of this process. Instead there is a gradual process of growth and development occurring over time involving not only the growth of the baby's bladder but also increasing awareness of his body and his environment. Once you recognize how gradual this process is, and you see the great satisfaction your baby has as he begins to put the pieces together, you will find it easy to stick to the plan.

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