Potty Training: A Guide for Parents

Potty Training Child: First Steps

By Shilpa Vernekar, M.D.

If you are a parent, you can most likely relate to the unparalleled feeling of elation and excitement that comes when your child reaches a big milestone. In the early years, those major accomplishments may seem minor to the outside world, such as baby’s first words, baby’s first steps, and baby’s first poopy in the potty, but as a parent you alone are enchanted and just so proud of your little one. As both a pediatrician and a mother, I get it. I will never forget the first time my child said “mama,” and I celebrate with countless other parents every day over their children’s achievements.

However, it is important to first understand that potty training – like most processes with children—may or may not be easy or come naturally for you and your child. Although a bowel movement on the potty sounds so simple to you as an adult, it is important to understand that it may take time, understanding and patience on your end. Please know that you are not alone! As your child’s pediatrician, I am here to help if needed at any point along your journey of potty training. And one day, I assure you, that child who is still using his/her diaper, will be independently using the toilet thanks to your hard work and dedication!

So, let’s start at the beginning, and I will answer the most common potty training questions that parents ask in my office.

When is the right time to start potty training?

potty training Potty training can start anywhere as early as 6 months to when the child is 2-3 years of age. Each child is different, and you know your child better than anyone else.

He will show signs of being ready like informing you every time he has to do stools or pass urine. Parents can also identify that it may be time to begin potty training based upon the child’s body language. When children are about to pass stools or urine, they often change facial expressions, squirm, and/or cross their legs.

Also, prior to removing the diaper, it helps to know if your child can understand instructions or be able to rush himself to the potty if needed.

My child is ready for potty training. So, how do I start?

First, invest in a potty training device which can be purchased from any store for as low as $15-20. Next, allow your child to become familiar with the potty and ensure that the child is comfortable when he sits on the potty with his feet resting firmly on the floor. Let the child know that every time the child needs to use the potty, he needs to sit on the potty chair. The child can wear a diaper to pass stools or urine while sitting on the potty, but it is best done without the diaper. Therefore, the child can help undress and remove the pull ups before he sits on the potty.

Another strategy is to allow the child to sit on the potty every 2-3 hours to help void urine. If there is a specific time during the day that the child passes stools, then allowing the child to be on the potty at that time will help reinforce the behavior. Stickers and reward charts help older children to become potty trained.

potty trainingAdditionally, wiping from front to back is important, especially for girls, to prevent urinary tract infection. This is something that seems natural, so parents may forget to teach, but it is vitally important.

Finally, hand hygiene is important after using the potty. Parents should make it a habit that the child washes his hands each and every time after he uses the potty.

The parent should be patient with the whole process and understand that it may take 2 weeks to 2 months depending upon the child’s level of maturity. If you have tried for 1-2 weeks and feel your child is not ready, do not force the child. It will make the situation worse and make potty training even more difficult. Let the child grow, and try again few weeks or few months later.

While day time training and stool training happens in the first three months, bed wetting or being dry by night might take longer. Sometimes the child might continue to bed wet until five years of age or longer if there is family history of bed wetting. For further information of nocturnal enuresis or bedwetting, refer to this article.

When should I ask my child’s pediatrician to help with potty training?

If you child is unable to potty train by 3-4 years of age during the day or a previously potty trained child is now reverting back to passing stools/urine in the underwear on a routine basis, then it is time to visit your pediatrician.

But, remember it is normal to have some accidents at times, especially if the child is in an unfamiliar setting or with different care giver. Do not worry about it unless it happens on a daily basis.

For additional questions, please consult your child’s pediatrician. And remember: Stay calm and keep persevering: potty training will occur eventually.


Dr. Vernekar, M.D., F.A.A.P. is a board-certified pediatrician who works at Preferred Medical Group, which has locations at Phenix City Children’s, Fort Mitchell Clinic and Opelika Pediatrics and Family Clinic. Her special areas of interest include weight management and nutrition.

This post was originally published on Preferred Medical Group. Follow Dr. V. on Twitter at: www.twitter.com/shilpavernekar.

15 Questions to Ask Before Starting ADHD Medication

Considering ADHD medication for your child? Ask your pediatrician the right questions.

ADHD medicationMedication can be an important part of treatment for some psychiatric disorders in children and adolescents. In many cases, the right medication at the right dosage, can be extremely effective in managing symptoms of attention deficit hyperactivity disorder (ADHD).

But the decision to use medication as part of your child’s treatment plan can be daunting. If you are considering ADHD medication for your child, be sure to ask your pediatrician the following questions:

  1. What is the name of the medication? Is it known by other names? Is a generic equivalent available?
  2. How is the medication administered? Is it produced in alternative forms, such as liquid suspension, tablet, or a patch?
  3. Has this medication been tested with children? Or is it being used “off label”? (ie. It has been tested with adults but not with children, or it has been shown to be effective in treating a similar, but not the same, condition.)
  4. Is this medication addictive? Can it be abused?
  5. How long will it take before we see improvement?
  6. What are the common side effects? Will it affect my child’s appetite or sleep patterns? What are some of the less common side effects?
  7. What do we do if a problem develops? For example, what if my child becomes ill, he misses doses, or we see signs of side effects?
  8. Under what conditions should we immediately stop use? Can this medication be stopped “cold turkey” or does it need to be tapered over a period of time?
  9. What is the recommended dosage? How often will the medication be taken and at what time of day?
  10. Do any tests need to be done before starting the medication?
  11. How long will my child need the medication? What are the risks of long-term use?
  12. Are there any other medications or foods that my child should avoid while taking the medication? Should the medication be taken on an empty or full stomach?
  13. Should my child stop participating in any particular activity while taking the medication?
  14. What is the cost of the medication (and its generic, if available)? Does my health insurance cover it? Is financial assistance is available?
  15. Are there other medications for this condition? Why do you recommend this one over the others?

Note: If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. Your child’s pediatrician can assist you with the process of diagnosing and treating ADHD.

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Better Bets for Back to School Nutrition

back to school nutrition

Better Bets for Back to School Nutrition

Food choices the whole family can feel good about

As you gear up for a new school year, it’s important to put your kids’ nutrition on the school checklist. Treat this season of “academic beginnings” as a chance for the whole family to take a fresh approach to better-for-you eating.

Creating healthier meals can be as easy as simply trading-up or swapping one food ingredient for a more nutritious choice.

Bring Breakfast-to-Go

Even if breakfast finds you crunched for time, prime the kids with morning nutrients to energize their day. Give them a breakfast boost with make-ahead options that can be enjoyed on-the-go in cars and buses. Try portable Scrambled Egg Cups or Oatmeal Cups, which provide plenty of protein to get them through the day. Serve with whole fruit like a banana, apple, strawberries, or grapes.

Unbeatable “Brown Bag” Tips

When it comes to packing school lunches, stick to what your kids like. If they aren’t crazy about something, it may end up in the garbage or get traded for an unhealthy snack. These simple swaps will make your kids’ brown bag lunch unbeatable:

  1. For sandwiches, swap white bread for healthier brown bread or pita.
  2. Replace deli meats with lean roasted beef or poultry or low fat cheese.
  3. For a delicious, nutritious sandwich spread, trade mayonnaise for a mashed avocado. Make fruits and vegetables a go-to snack. Chop up carrots, peppers and celery in advance and stash some in lunch bags with hummus; or sprinkle apple and pear slices with lemon and cinnamon to satisfy a sweet tooth.
  4. Choose water to hydrate and calcium- and vitamin D-rich milk to strengthen growing bones.
  5. Fruit like apples, bananas, tangerines and pears are perfectly portable for on-the-go ease.

Smart Swaps for After School

Chips and packaged cookies, move out of the way. Swap chips and packaged cookies for smart after-school snacks that are homemade, nutritious and fun to make.

Custom-create a smoothie. Have kids choose their favorite fruit and vegetables. Toss them into the blender with ice and fat free yogurt for a snack that’s easy, fun and filling.

Make banana sushi rolls. Top a whole grain tortilla with nut butter and a whole banana sprinkled with cinnamon. Roll it up and slice like sushi rolls. (These are great for lunches, too.)

Other after-school smart snacks include:

  • Apple slices topped with almond butter.
  • Air-popped popcorn (Avoid microwave popcorn, which is often high in trans-fat and sodium.)
  • Fresh salsa and tortilla chips.
  • Hardboiled eggs are a great option for an on-the-go snack.

Photos courtesy of Getty Images

Super Woman: the Working Mom Syndrome

Super Woman the Working Mom Syndrome

Super Woman – the Working Mom Syndrome

By Carrice Quinnie

Everyone wants to be the best. We strive to be the best wife, mother, daughter, sister, career woman and friend. Let’s be real, we can’t be everything to everyone at the same time. It’s impossible, but we continuously push ourselves.

Hello, my name is Carrice and I’m Super Woman. From 2007 to 2010, I worked two jobs, not getting home until 12 am every night, 5 days a week. I even volunteered to work some weekends. If I wasn’t working, I was cleaning something, cooking something, combing hair, trying to give the girls some resemblance of “normal” family time and I almost forgot… I volunteered with Hospice during my lunch breaks about twice a week.

Forget Shaun T’s Insanity… I was insanity!

Now fast forward to 2013, I’ve just returned to work from Maternity Leave. During my first week back, I scheduled an appointment with my 2nd Vice President. I was the ultimate career woman, Ms. Nine to Five! Meeting was flowing, but that wasn’t the only thing flowing. All of the sudden, my VP started to agree with everything I said.

VP: “Well Carrice just get it together and bring the proposal back to me.”

Me: “OK, great I also wanted to look at …”

VP: OK, yes sounds good. Just write it up and give it back to me next week.”

I thought this as strange because he never just agrees without having all the details. So any who, I did my George Jefferson strut back to my desk. I was making moves! As I logged back on to my computer, I felt something wet. I looked down and I had the two biggest circles on my white satin blouse!!! I looked like I had been milked, literally!!! I may have thought I was made of steel, but my maternity breast pads were NOT!!! Poor man, he didn’t know what to do. I’m busy being Super career woman, but I forgot to change my breast pads or pump ALL Day! Super Woman had milky “S” on her chest.

Right then and there. I burst into laughter! The open mouth, slapping thigh, snorting, crying laughter. I realized I was not super human – I was human.

Some days I didn’t know if I was coming or going, I was always doing, never being.

Now 2015, I’m working to bring more balance into my life. To help myself combat against the Super Woman Syndrome:

I invest in myself – What are your talents? What can you do with ease, which may not be so easy for others? When I found my talent, I began to cultivate that talent. Later, I promoted my talents to others and started to market my talents and eventually my talents started bring in extra revenue for my family. When you work in your purpose, work doesn’t feel like “work” anymore. You’re just living in your purpose and contributing to enhance this human experience for yourself and others.

I learned to say “NO”! – I do not volunteer for every PTA committee, every bake sale or field trip. This may be hard for some of us because, we don’t want to be that mother that all the other parents talk about. “I never see her, she never helps with anything.” But look at it this way… how many dishes have they washed in your household, how many meals have they cooked for your family, how many loads of clothes have they washed, how any school projects have they helped your child with, have they stayed up all night while you get a PowerPoint presentation or project together for work? If the answer is ZERO, then their opinion of you means just that much, ZERO!! Don’t feel bad. If you have the time, sure do what you can, but if you don’t have the time nor desire; just say no and you can even say it with a smile, if you like.

I work smarter not harder – I’m so glad I have two older children now. I now delegate some of the house chores to them. When they were smaller I did everything, but now I’ve taught them how to do some things for themselves. I’ve even taught them how to cook some simple meals. I do the same at work. I stop volunteering for every project. If the project is not in my realm of expertise and there will be no professional benefit to me, I let my peers take the lead.

I learned how to chill out! –Now I take time for myself. I bought a home with a garden tub and I was so busy and didn’t have the time to take a bath. I took my first bath in my new tub last year for the first time, after living in my house a year. That was ridiculous! I’m learning to stop doing and just be. I enjoy just looking out a window. Sounds funny, but do it. Sit down and just be.

At the end of the day find your balance. Balance between work and play, family and personal time and sometimes even chaos and peace. We put too much pressure on ourselves to be super women. I have never seen Super Woman driving children to soccer practice, dropping her 2-year old at day care, nor have I seen her with a laptop. So Super Woman isn’t real, she doesn’t exist.

Hello my name is Carrice and I’m a real woman.



Carrice Quinnie is native of Columbus, Ga.  She is a divorced, single-mother of three girls, ages 13, 11 and 2.  Through college, marriage, motherhood, divorce and single-parenting Carrice has learned valuable, maturing life lessons. Increasing in her own self-awareness, Carrice hopes her words will bring enlightenment and healing to women and their families.   

Make Children’s Vision Health a Priority

children's vision health

Make Children’s Vision Health a Priority

Learn how sight affects learning in children, teens

As children and teens gear up for another year of studies, parents should be aware of often overlooked obstacles that may hinder academic success: vision problems.

Challenges with learning and performance

Living in a visual world, almost 80 percent of what children learn through age 12 is from their sense of sight. In order to succeed in common activities, such as learning at school, reading, playing sports and being engaged in everyday activities, kids call on more than 15 visual skills.

For children, the most common vision issues are known as refractive errors, such as astigmatism, farsightedness and nearsightedness. These issues are more common than you may think – affecting 1 in 4 school age kids. Such problems, when left untreated, can hinder a child’s ability to learn in school.

In fact, studies conducted by the National Institutes of Health and the National Eye Institute reveal that over 60 percent of students with learning problems have undiagnosed vision abnormalities that contribute to their difficulties.

Eye exams for every child

children's vision healthAccording to the American Optometric Association, children should receive their first eye exam by age 1, a second at age 3 and another before beginning kindergarten. From then on, students should have a yearly comprehensive exam to evaluate their total vision.

While some students may receive a yearly screening from a school nurse, the American Foundation for Vision Awareness reveals that such exams only identify 5 percent of childhood vision issues.

Be aware of the signs

As a parent or caregiver, being aware of common health concerns in your children is part of your job. But are you aware of the warning signs for bad vision? Consider the following symptoms that indicate a child may have a vision problem:

  • Complains frequently about headaches or tired eyes
  • Avoids activities that require near vision, such as reading or homework
  • Avoids activities that require distance vision, including participation in sports or play activities
  • Sits too close to the TV or holds a book close to the face
  • Loses place or skips words while reading
  • Squints or tilts head to see better
  • Closes one eye to read, watch TV or see better in general
  • Writes uphill or downhill
  • Finds it difficult to copy material from the whiteboard

If any of these warning signs are detected, parents or caregivers should schedule an appointment with an eye care professional for a comprehensive exam to evaluate the child’s vision and identify any necessary treatment options.

Proper vision care is essential for overall health and wellbeing for children of every age. View videos and learn more about kids’ vision needs by visiting http://www.pbga.org/.

Photo courtesy of Getty Images