Potty training and daycare: how to work with your child's teachers

Readiness is about signs, not age. The AAP says training can begin whenever you and your child want to start. Look for these signs:

• Stays dry for at least 2 hours during the day or after a nap
• Grunts, squats or goes still before peeing or pooping
• Follows simple instructions
• Walks to the bathroom and helps pull pants down
• Dislikes a wet diaper and asks to be changed
• Asks to use the potty or to wear big-kid underwear

The AAP suggests holding off during a move, the arrival of a new baby, a serious illness or a family crisis. Once you start, training often takes 3 to 6 months, and starting too early tends to make it take longer, according to Nemours KidsHealth.

Talk with your child's teacher before you start, and agree on the details together. KidsHealth advises that every caregiver, daycare staff included, use the same routine and the same words, and the AAP's training plan also stresses one consistent approach.

Ohio's licensing rule for centers backs this up. Toilet training must be based on a child's readiness and on consultation with the parent about practices at home. The center must also make sure training is never forced (Ohio Adm.Code 5180:2-12-23).

• Words: Pick simple, positive words like pee, poop and potty. The AAP suggests avoiding words like dirty, naughty or stinky.
• Times: The AAP suggests a sit first thing in the morning, and KidsHealth suggests trying 15 to 30 minutes after meals and after waking up dry. Ask when the class goes to the bathroom and use similar times on weekends.
• Praise: Decide together whether to use stickers or just specific praise.
• Accidents: Respond calmly every time, with no punishment. The AAP suggests reassuring your child and letting them help clean up.
• Pull-ups or underwear: Make the same choice in both places.

Dress your child in clothes they can pull down on their own. KidsHealth says children need to be able to undress themselves and suggests avoiding clothes that are hard to remove, such as overalls.

• Pull-on pants or shorts with an elastic waist
• Several complete spare outfits, including underwear and socks (ask how many to keep there)
• Bags for sending wet clothes home, if your center asks for them
• Diapers or pull-ups and wipes for naps, if you and the teacher agreed to use them

Ohio's rule requires centers to change wet or soiled clothing right away, so spare outfits are what get your child back to playing after an accident (Ohio Adm.Code 5180:2-12-23).

The AAP leans toward underwear once training starts. It says cloth training pants are thicker and protect clothing, while diapers and disposable training pants send a message that children don't need to take over yet (AAP).

Disposable training pants still have a role. KidsHealth calls them a step between diapers and underwear that some families use at night, and suggests switching to underwear after your child stays dry for a few days.

Nighttime bladder control often comes months or even years after daytime training. If nighttime accidents are frequent, the AAP suggests training pants or a diaper at night for as long as your child is comfortable with it (AAP).

Regression is common and usually passes within a few days or weeks, according to the AAP. Child care changes, such as a new caregiver or starting a program, are among the triggers it lists, along with a new sibling, a move, illness and stress at home.

• Rule out a physical cause: The AAP says to have your pediatrician examine your child first, since constipation or a urinary tract infection can be the cause.
• Talk with the teacher: Ask about any change at school, such as a new room or a new friend who isn't trained yet.
• Keep it low-key: Keep the potty easy to reach, offer it at likely times and show confidence. The AAP recommends responding calmly and using a setback as a chance to support your child.
• Avoid going back to diapers if you can: The AAP suggests training pants under underwear for a while instead (AAP).

If regression lasts a month or more, the AAP suggests asking whether your child was fully ready for daytime training.

Call your pediatrician for any of these:

• Signs of a urinary tract infection: pain or burning when peeing, peeing often, blood in the urine, or new daytime or nighttime wetting after your child was trained (AAP).
• Constipation or holding in poop: The AAP's symptom guide says holding back stools during power struggles is the most common cause of repeated constipation in children, often around toilet training. Call within 24 hours for bleeding from the bottom, or for a child who needs to poop but is afraid to or refuses.
• Severe pain: Call right away for stomach or rectal pain that lasts more than an hour, or for repeated vomiting with a swollen belly.
• Age 4 and not trained: KidsHealth suggests calling if your child is 4 or older and not yet trained, or if a child who was trained keeps having problems.

If your child holds in poop, the AAP suggests a treatment plan from your doctor and a short break from training in diapers or pull-ups. It notes that holding back stools is harmful.