A developmental milestone that many families celebrate is when a toddler or young preschooler learns to use the toilet independently and can stop wearing diapers. Cultural practices, family and/or caregiver circumstances and the child’s physical and emotional development all play a part in the toilet learning process. This Q&A describes supports and strategies for families with children who are learning to use the toilet during the later preschool years (ages 4 and 5 years old).
What toilet learning strategies may be helpful for older preschoolers?
Sometimes there are developmental reasons for why an older preschooler has not shown an interest in toilet learning. No matter the child’s age, family members and caregivers should always approach toilet learning in a calm, relaxed manner. The older preschool-age child should show signs of physical and emotional readiness for toilet learning.
Watching a child-friendly video about toileting, like Sitting on the Potty, and singing along with a caregiver may be a fun, relaxing way to engage older preschoolers as they learn to use the toilet. The resource list on Toilet Learning has a list of engaging picture books about learning to use the toilet that young children and adults might read together.
Some caregivers have found it helpful to write down times of the day when they notice that the child has a bowel movement and make sure to take the child to the bathroom at that time. Toilet Training Your Child suggests caregivers have the child sit on the potty at a regular time following meals and/or snacks. This regular routine may help the child have success using the toilet.
Adults should always provide encouragement and never show any anger or frustration if the child has an accident or is not able to eliminate in the toilet. Adults should remember that toilet learning takes time, patience, and effort on the part of caregivers and the child.
What strategies might families use to address bed wetting?
Preschoolers may continue to wet the bed at night or during naps although they are able to use the toilet during daytime hours. It is not unusual for preschoolers (ages 4-5 years) to still wear a pull-up or diaper at nighttime. Nighttime bed wetting is typical for this age group and is often due to physical development. Unless the child is experiencing other concerns or issues, it is not unusual for children to wear diapers or pull ups at night. It can take several years for a child to stay completely dry overnight.
The web resource Bed-wetting in Kids: Why It Happens and What to Do lists the following possible reasons why a child wets the bed at night:
- The child’s body is still developing
- There is a family genetics factor (If either parent experienced bed-wetting, then a child is more likely to experience it.)
- The child produces too much urine at night (Drinking too much fluid before bed may be a factor; however, restricting fluids does not cure bed-wetting.)
- The child sleeps very deeply
- The child’s routine is disrupted (e.g., minor illness, new sibling, new school)
It is important to know that according to the American Academy of Child and Adolescent Psychiatry most children outgrow bed-wetting on their own by age 7. Most health care providers do not routinely suggest bed-wetting treatments, such as a bed-wetting alarm, for children younger than age 7.
Strategies such as limiting the amount of liquids before bed, using the toilet before getting into bed, and having the child wear pull-ups when sleeping may bring about less instances of bed wetting. Caregivers should also note that bed-wetting may occur when the child is feeling ill.
How might families and caregivers provide emotional support during toilet learning?
Some young children may experience Emotional Issues and Potty Training Problems that interfere with toilet learning. Caregivers should be warm and supportive to children who may be experiencing challenging times at home (e.g., death in the family, divorce, moving). These situations may cause children to regress in their toileting habits. Caregivers should be aware of the child/family situation and show understanding to the child. Some children may have fears about using the toilet, so it can be reassuring to have a caring, calm adult close by when the child is using the toilet. Some older preschoolers prefer privacy when using the toilet. In this situation, a caregiver can stand just outside the bathroom or stall door for comfort and safety. Caregivers should assume that young children will have occasional accidents and treat it as a normal part of a child’s development.
When should caregivers seek medical help for their child regarding toilet learning?
If an older preschooler (ages 4-5 years old) is not showing any typical physical or cognitive signs of readiness for toilet learning then caregivers may want to arrange a physical examination with the child’s health care provider to determine if there are any physical reasons why the child is not demonstrating any interest in using the toilet. The Cleveland Clinic recommends that parents talk to their child’s health care provider if they have any concerns about their child’s physical readiness or emotional issues around toilet learning. More information can be found in the article How to Potty Train: Our Best Tips.
IEL Resources
Resource List:
Web Resources
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Bed-wetting in Kids: Why it Happens and What to Do
Source: BabyCenter
This online resource gives information for parents about bed-wetting and how to help the child who wets the bed. Suggestions are given for talking to siblings about bed-wetting and how to handle situations when traveling away from home.
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Bedwetting
Source: American Academy of Child & Adolescent Psychiatry
This article provides information about the possible reasons for bedwetting in children.
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Emotional Issues and Potty Training Problems
(also in Spanish)Source: HealthyChildren.org
This web resource includes the types of emotional issues that may contribute to toilet learning problems.
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How to Potty Train: Our Best Tips
Source: Cleveland Clinic
This article gives families tips about toilet learning from staff of a nationally recognized medical clinic.
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Sitting on the Potty
Source: Super Simple Songs – Kids Songs
This one-minute video and simple song about sitting on the potty is intended for young children and caregivers to sing along together.
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Toilet Training Your Child
Source: FamilyDoctor.org
This article gives information for caregivers about toilet learning and young children.