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My three-year-old refuses to entertain the idea of potty training Add to ...

My three-year-old refuses to entertain the idea of potty training, even though I introduced the idea initially several months ago. I feel like I have tried everything. Is this common and what do you suggest?

You're not alone. Many parents fear that their child may be destined to be in diapers forever.

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Most kids begin to show signs they are ready for potty training between the ages of 18 and 24 months. Boys, however, may make up their minds a bit later.

Signs that a child is ready include the ability to follow simple instructions and understand words about toileting, verbally expressing the need to go, pulling down diapers and keeping a diaper dry for more than two hours. If a child is not interested in these behaviours, it's fine to wait a few more months.

During the wait time, model toileting yourself to the child, read books on potty training , keep the potty chair easily accessible, praise him/her for trying or making even a small degree of progress and think of incentives that may be meaningful and age-appropriate.

Constipation can be a huge issue in delaying potty training. The bulky stools may stretch the rectum to the point where the urge to go may not be sensed. Ensure your child's diet is rich with fresh fruits and vegetables, lots of water and plenty of fibre. Refined and process foods will make matters worse.

It usually takes an average of six weeks to complete the basic training process. Expect, however ,that there may still be some accidents and even regressions.

For more information see www.healthychildren.org.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Peter Nieman.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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