Potty training: when to start, the methods compared, and what to do about setbacks

When is a child ready?

Age is a rough guide. The Canadian Paediatric Society notes that some children are ready at 18 months but most start between 2 and 4. Look for these signs instead of a date:

• Stays dry for about two hours at a time, or wakes dry from a nap.
• Has regular, predictable poos, or knows when they are peeing or pooing.
• Can follow one or two simple instructions.
• Can sit steadily on a potty or toilet.
• Can tell you, in words or signals, that they need to go.
• Shows interest in the potty, or wants to do things by themselves.

On average, girls gain these skills a few months before boys. In one US study the last skill to arrive, pulling training pants up and down, came at about 29.5 months for girls and 33.5 months for boys.

The five methods compared

• Elimination communication

  From the first weeks or months

  You learn the baby's signals and timing and hold them over a potty, using few or no diapers.

  Common in many parts of the world. It asks a lot of attention from the adult; the baby is not expected to be independent for a long time.

• Early, parent-led

  Before 24 months

  You set regular potty times and lead the process instead of waiting for the child to show interest.

  This was the norm in North America in the 1940s, when training commonly began before 18 months. Most children do not have all the needed skills until after 24 months.

• Intensive, in a few days

  About 20 to 30 months

  You clear a few days, take diapers off, give plenty to drink, and practise over and over with lots of praise. Books such as “Oh Crap! Potty Training” follow this pattern; it goes back to Azrin and Foxx's “toilet training in a day”.

  Studies of the Azrin and Foxx method report high success, but how long the results last is unclear, and intensive training seems to have little benefit before about 27 months.

• Child-oriented, readiness-based

  When the signs of readiness appear, usually 2 to 3

  You introduce the potty gradually, let the child sit on it clothed, then without a diaper, and move at the child's pace. This is the Brazelton approach.

  This is the approach the American and Canadian pediatric societies describe. It is gentle and can take months.

• Wait until the child asks

  Whenever the child wants to

  You keep diapers on and a potty around, and start only when the child says they want to use it.

  The least effort and the least conflict, with the latest finish. Finishing after about three and a half is linked with more refusal to poo in the toilet.

A US government evidence review looked at 772 studies and could not rank the methods, because the studies were too different and too weak. One study found that 68% of children who started before 24 months were trained by 36 months, against 54% of those who started later. Starting earlier may mean finishing a little earlier, and in a large parent survey a later start meant a shorter process.

How to begin

1. Choose your words for pee, poo and the potty, and use them consistently.
2. Get a potty chair, or a seat reducer and a step so the child’s feet are supported.
3. Let the child see how the toilet is used, and sit on the potty clothed at first.
4. Offer the potty at regular times: after waking, after meals, before bath and bed.
5. Watch for the child’s signals and praise each attempt, whatever the result.
6. Teach wiping (front to back for girls) and handwashing from the start.
7. Move to training pants or underwear after about a week of success.

Rewards, accidents and refusal

Accidents are part of learning. Stay calm and do not punish or shame. The Canadian Paediatric Society says rewards are not necessary and praise is enough; many families use stickers or small treats anyway, and that is a choice for the two of you.

If your child refuses, take a break of 1 to 3 months and try again. Some children will pee in the potty but insist on a diaper to poo, or hide to do it. In one study 22% of children refused to poo in the toilet for a month or more. It is tied to constipation and painful poos and usually passes without treatment. Let the child use a diaper for now, because holding poo in makes constipation worse.

Going backwards after a new sibling, a move or starting daycare is common. Going back to diapers for a while is fine.

Nights are a separate step

Staying dry overnight depends on the body maturing and cannot be trained the way daytime use can. It often comes months or years after daytime training, and it is not expected until somewhere between five and seven. Pull-ups at night are not a step backwards. If bedwetting continues past that age, an alarm that wakes the child is the usual first treatment.

When to see a doctor

• Your child is not using the toilet by age 4.
• Your child used the toilet well for six months or more and is now slipping back.
• Your child is holding in poo, has pain when going, or has blood in the poo.
• You notice a rash, a change in the pee, or a sudden change in how often they need to go.

Common questions

What age should you start potty training?

Most children show signs of readiness between 18 and 24 months. In the United States training usually begins between 2 and 3, and most children are trained by 4. Readiness matters more than the birthday.

How long does potty training take?

The Canadian Paediatric Society says it can take 3 to 6 months before a child is out of diapers in the day. Staying dry at naps and overnight can take months or years longer.

Which potty training method works best?

No method has been shown to be better than the others. A US evidence review found the studies too weak to compare them. Both gradual, child-led training and intensive few-day training succeed for healthy children.

Should you use rewards for potty training?

The Canadian Paediatric Society says rewards are not necessary and praise is enough. Many families use stickers or small treats anyway. All pediatric bodies advise against pressure and punishment.

What if my child refuses to use the potty?

Take a break of 1 to 3 months and try again. If the child will pee in the potty but not poo, let them use a diaper to poo for now, because holding it in leads to constipation.

The three decisions to make together

• Toilet-training approach

  Potty training, also called toilet training or toilet learning, is teaching a child to pee and poo in a potty or toilet instead of a diaper. Approaches range from watching a baby's cues from the first months (elimination communication), to an intensive few-day method, to waiting until the child shows they are ready.

  Ask each other: How did we each learn to use the toilet, and what do we remember?

• Toilet-training motivation and setbacks

  How you encourage potty training and respond when it goes wrong: whether you use praise, stickers or treats, and what you do about accidents, refusal and steps backward. Setbacks are a normal part of the process.

  Ask each other: Would we use rewards, and if so what kind?

• Night dryness and bedwetting

  Staying dry overnight is a separate step from daytime potty training and usually comes later. This is about how you handle nights: pull-ups until it happens by itself, training day and night together, lifting the child to pee, alarms, or medication.

  Ask each other: What would we do if our child is still wetting the bed at six?

Sources

• Canadian Paediatric Society: Toilet learning
• American Academy of Pediatrics: The right age to toilet train
• American Family Physician (2008): Toilet training
• ParentData (Emily Oster): Potty training
• Royal Children's Hospital Melbourne: Bedwetting guideline

Last updated 2026-10-05. General information, not medical advice. Talk to your child’s doctor about anything that worries you.