The Dangerous Consequences of Potty Training Too Early

Why Kids Have More Problems If They Complete Potty Training Too Early — by 2-Years Old

The reason kids who train at age 2 have more of these problems than children who train later, in my opinion, is that they have spent more months or years deciding for themselves when they should pee or poop – before they’re mature enough to understand the importance of eliminating as soon as they feel the urge. What’s more, the bladder needs about three or four years to grow and develop, and uninhibited voiding (read: diapers) facilitates maximum growth.

Parents often tell me their child has accidents because she has a “small bladder,” as if an undersized bladder is something the child was born with. The child’s bladder may be small, but that’s because its capacity has been compromised by holding.

Do you know how often I see children who are still in diapers and have recurrent UTIs? Never. Do you know how often I treat newly potty-trained children for recurrent UTIs? Every day. These kids fill a quarter of my clinic. This is not a coincidence and demonstrates quite clearly that potty training in very young children is harmful. There is no way that healthy, developmentally normal, un-constipated children who learn to use the potty at 3; have a higher rate of chronic pee or poop accidents than children who train at 2. Kids in diapers don’t hold; many toilet-trained children do. Every year of constipation-free, uninhibited voiding – in other words, wearing diapers – leads to bladder growth; every year of holding shrinks the bladder and makes it more overactive.

And consider this: Typical therapy for accidents involves giving kids laxatives and putting them on a pee schedule, taking the decision of when to eliminate out of their hands.

Perhaps you’re still not sold on waiting until age 3 to potty train. Maybe you’re wondering: What about the research suggesting that it’s actually late training, not early training, that causes constipation and accidents?

Well, there’s a major flaw in this research: The authors didn’t check, via X-ray, to see if these kids were constipated at the time they started training. The records we keep at my clinic suggest that among late trainers, it’s not the age of training, but rather unrecognized constipation that correlates with problems. We have found that children who trained after age 3 and have toileting troubles either trained late because they were constipated (their parents had tried earlier but failed) or trained late and are constipated.
In our published study, the sample of “late” trainers was small — we had 10 kids who trained after age 3 — but the results completely jibe with what I see in my practice. Of the 10 late trainers, seven had wetting problems, and all seven were shown by X-ray to be severely constipated. The three late trainers who did not have wetting problems were not constipated.
I often hear from parents: “I want to train my child before he starts pushing back and it becomes a struggle.” There’s this notion floating around that if you wait too long to teach a child to use the toilet, you’ll end up with a “potty refuser.” This is untrue. When a 3 ½-year-old has no interest in pooping on the toilet or seems afraid of it, it’s almost always because pooping hurts

Steve Hodges, M.D.
Steve Hodges, M.D.
Steve Hodges, M.D., is an associate professor of pediatric urology at Wake Forest University School of Medicine and co-author of Bedwetting And Accidents Aren’t Your FaultIt’s No Accident, and The M.O.P. Book: A guide to the only proven way to STOP bedwetting and accidents. His website is

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