Fairfax, VA: Our 3yr old son is completely trained during the day but doesn't want to give up the pull ups at night for fear he will wet the bed. We have tried "big boy underpants" several times at night. Sometimes he makes it through and sometimes he wakes up wet. We've never reprimanded him for wetting in the past, just told him it was ok, and it was only an accident. Any ideas on how we can get him to give up the pull ups for good?

Dr. Charles E. Schaefer: Since your son's only three years old, I would continue to be very relaxed about night-time accidents, and allow him to use pull ups for the next six months.

Washington, DC: I have a 20 month old daughter. What can I be doing with her NOW to best prepare her for this task?

Dr. Charles E. Schaefer: Ask her to help potty train a wetting doll. Use a toy potty and brown crayons for BM. Also read one of the many books for children about potty training. Suggest that she be using the potty herself.

Oklahoma City,OK: My son shows an interest in potty training, but has not been consistent in complaining about wet-dirty diapers... are we close? He'll be 3 in 4 months w- a new baby due at the same time- we'd really like to only have to buy diapers for one of them at a time.

Dr. Charles E. Schaefer: About every hour or so, ask him to feel his diaper to see if it is wet or nice and dry. Reward him with a small treat for any successes on the potty. Read children's books about potty training. If you still need help, my book "Toilet Training Without Tears" contains many other suggestions.

Lexie Verdon: Dr. Schaefer, should parents expect a difference in how easily children come to potty training based on their gender? I know some parents argue that girls are easier to train than boys. Is that true? Should parents handle training differently based on the sex of the child?

Dr. Charles E. Schaefer: Girls tend to train sooner than boys. Also children with easy temperaments train sooner because they're eager to please their parents. Some children are distractable and impulsive and need more guidance from their parents to successfully use the potty.

Washington, DC: Every child is different, I know, but the daycare centers don't seem to care. Our center made it mandatory to have all toddlers potty trained by the time they entered the 3 year old class or else they won't promote them.
Now I have my youngest in a home environment and at 18 mos, wants to try to potty. How do I encourage without discouraging him? He prefers just to sit and wipe off with toilet paper vs actually doing something, an inquiry which is countered by "No!".

Dr. Charles E. Schaefer: I would be relaxed and be pleased that your son shows interest in using the potty just to sit. Have an edible treat nearby to give him immediately if he has any success on the potty. Do not quiz him or show any disappointment if he does not go on the potty.

Temple Hills, MD: My 23 month old daughter would tell me she has to pee pee or she has to boo boo...after she had already urinated or defecated. So, I bought a potty and put her in pull-ups, now she does not say either and she will say I want to go potty but sits for only a few minutes says she is done will wipe herself and run from the potty. I try to make her sit on her potty longer because what has been happening is that as soon as she jumps off of the potty she uses the bathroom on herself. I remain very calm and explain that she should have released herself in the potty. Did I rush her? She initiated the interest, but now I am not so sure that I did the right thing in putting her in the pull-ups and getting the potty.

Dr. Charles E. Schaefer: I would verbally comment that she is doing pee pee or poops whenever you observe her in the act. Try to entertain her when she is on the potty so she sits for a while longer. Immediately give her a treat for any successes on the potty. You might also ask her to help you train a wetting doll to use a toy potty. Avoid any signs of criticism or disappointment. Simply say, "Soon you'll be putting you poops (pee pee) in the potty" when she has an accident. I think you're doing the right thing in encouraging her interest in using the potty as long as you avoid pressure at this young age.

Lexie Verdon: Dr. Schaefer, you mentioned rewards for children during toilet training. Many parents turn to these toys or treats as motivation for kids. Is this a good tactic? How extravagant should parents get?

Dr. Charles E. Schaefer: I believe in positive reinforcement to motivate children to get over a developmental hurdle like toilet training. The treats should be small (e.g. raisins or stickers) and given immediately within a few seconds of any elimination on the potty.

Washington, DC: Can you expand a bit more on the three schools of potty-training? Perhaps give some specific examples of how they differ.

Dr. Charles E. Schaefer: The first approach to toilet training is the "child-centered" approach of Drs. Spock and Brazelton. In this approach, you wait for clear signs of readiness, usually around age 2, and then demonstrate what the potty is for and suggest that the child use it. But leave the decision entirely up to the child. The "gentle guidance" approach, which I recommend for most children, involves more active guidance from parents. For example, schedule times to sit on the potty, offer concrete rewards for success, practice modeling with a wetting doll, and switch to training pants. The third approach by Dr. Azrin involves an intensive, pressure training over a 24-hour period as described in his book "Toilet Training in Less Than a Day."

Boston, MA: Dr. Schaefer,
My child is almost 2 months shy of 4 years of age. He is the only one in his group of peers in preschool who is not potty-trained. His peers have constantly put him down and made fun of him for not being potty-trained. This has made it more difficult to train him as it is putting a lot of pressure on him. The teachers aren't being very helpful. Any advice?

Dr. Charles E. Schaefer: I would suggest some active guidance on your part because this delay can have a negative effect on his self-esteem. I have detailed guidance for parents for resolving delayed toilet training in chapters 9 and 10 of my book "Toilet Training Without Tears." If he does not make substantial progress by age 4, I would consult a specialist such as myself because he is not likely to outgrow this problem himself.

Lexie Verdon: Although it can be difficult, generally most families eventually succeed at toilet training. What do you recommend to parents so that they keep a good attitude and keep this effort in perspective?

Dr. Charles E. Schaefer: Although it can be difficult, parents should remember that by age four, 98 percent of children are toilet trained during the day. Also, there are a number of very successful interventions for children who are three and over and still have not achieved daytime control.

Lexie Verdon: Dr. Schaefer, thank you so much for being with us. This is an issue that parents care deeply about. We have been overwhelmed by questions and we will try to get another session on this issue--using many of those questions--later this week. Thank you all for joining us.