Parents often ask their pediatricians for advice on potty training their kids. A new article in Canadian Medical Association Journal (CMAJ) will help physicians respond to these queries.

"Toilet training is felt to be a natural process that occurs with development, yet... in reality, toilet training is a complex process that can be affected by anatomic, physiologic and behavioural conditions," writes Dr. Darcie Kiddoo, Divisions of Pediatric Surgery and Urology, University of Alberta, Edmonton, Alberta.

Articles on how to potty train your children are a dime a dozen. Over 16 million to be precise. Even though you can have that barrage of information at your fingertips in milliseconds, parents are still tearing their hair out over the most tried and true means to get their kids using the can.

We've all been told (by older relatives) that Johnny was trained by his first birthday. But recent thought advises a more child-centred approach, resulting in children being 'trained' at an older age. Do rewards help or hinder? Inquiring minds want to know.

Both the American Academy of Pediatrics and the Canadian Paediatric Society recommend beginning the process when a child is 18 months old or whenever they express an interest in the toileting process.

Although there is some evidence to suggest that toilet training late (after age two or three, according to various studies) can lead to negative associations -- including "refusal to void stool, hiding while defecating, leakage and daytime wetting or urinary tract infections" -- this latest report fails to give hard and fast rules about best practices.

As usual, parents are left to trust their own compass, ie. the gut-hunch approach. So to all those out there fretting about when little Johnny is finally going to use the john, take heart and remember no one goes to college in diapers.

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