What happened? Removing the tonsils (tonsillectomy) may provide relief for children who struggle with recurrent strep throat.
Children with recurrent strep throat whose tonsils are intact are more than three times as likely to develop subsequent episodes of strep throat as are children who've had their tonsils removed, Mayo Clinic researchers report.
Researchers examined the medical records of 290 children between ages 4 and 16 who had three or more diagnoses of strep-related sore throat (pharyngitis) or inflammation of the tonsils (tonsillitis) at least one month apart, within 12 months. Among children who had a tonsillectomy, the overall risk of subsequent strep throat infections was 23 percent. For children whose tonsils remained intact, the overall risk of subsequent strep throat infections was 58 percent.
Strep throat is most common in children between ages 5 and 15, but it affects people of all ages. In addition to throat soreness, strep throat may cause a fever and tender, swollen neck glands. Younger children may complain of abdominal pain.
Although strep throat itself isn't dangerous, untreated strep throat may lead to potentially serious complications — including inflammation of the kidneys (nephritis), scarlet fever and rheumatic fever.
What does this mean to you? If your child has recurrent strep throat, removing his or her tonsils may decrease the number of infections. This may lead to fewer missed school days and an improved quality of life. Tonsillectomy isn't necessarily recommended for every child with recurrent strep throat, however.
While research continues, the decision to remove a child's tonsils must be weighed against various factors — including the risks of anesthesia and bleeding after the procedure and missed school days to recover from the procedure, as well as the risks and benefits of simply treating each recurrent episode of strep throat.
Wednesday, November 7, 2007
Soda being pulled from school vending machines
What happened? High-calorie beverages have lost their place in school vending machines. In a landmark agreement between major beverage distributors and the Alliance for a Healthier Generation — a joint initiative of the American Heart Association and the William J. Clinton Foundation — nearly all sales of soda to schools will stop.
Under the new guidelines, only lower calorie and nutritious beverages will be sold to schools. Cadbury Schweppes, Coca-Cola and PepsiCo have agreed to sell only water, unsweetened juice, and flavored and unflavored low-fat and fat-free milk to elementary and middle schools. In addition to these beverages, diet sodas, diet and unsweetened teas, flavored water and low-calorie sports drinks will be sold to high schools. Whole milk and regular soda will not be offered to any schools.
The new guidelines shrink serving sizes as well — 8 ounces for elementary students, 10 ounces for middle school students, and 12 ounces for high school students.
Although the changes will take effect in some schools sooner than others, the companies who've agreed to follow the new guidelines will work to implement the changes at all schools in the United States by the 2009 to 2010 school year. Officials hope that other beverage companies will follow suit.
The shift to lower calorie, more nutritious beverages is expected to help curb rising rates of childhood obesity. Beverage sales at school events open to the public — such as concerts and sporting events — won't be affected.
What does this mean to you? The average teenager consumes an estimated 250 to 325 calories a day in soda. More nutritious beverage choices at school may save students hundreds of calories a day. Encourage your child to make healthy food and beverage choices part of an active lifestyle.
Under the new guidelines, only lower calorie and nutritious beverages will be sold to schools. Cadbury Schweppes, Coca-Cola and PepsiCo have agreed to sell only water, unsweetened juice, and flavored and unflavored low-fat and fat-free milk to elementary and middle schools. In addition to these beverages, diet sodas, diet and unsweetened teas, flavored water and low-calorie sports drinks will be sold to high schools. Whole milk and regular soda will not be offered to any schools.
The new guidelines shrink serving sizes as well — 8 ounces for elementary students, 10 ounces for middle school students, and 12 ounces for high school students.
Although the changes will take effect in some schools sooner than others, the companies who've agreed to follow the new guidelines will work to implement the changes at all schools in the United States by the 2009 to 2010 school year. Officials hope that other beverage companies will follow suit.
The shift to lower calorie, more nutritious beverages is expected to help curb rising rates of childhood obesity. Beverage sales at school events open to the public — such as concerts and sporting events — won't be affected.
What does this mean to you? The average teenager consumes an estimated 250 to 325 calories a day in soda. More nutritious beverage choices at school may save students hundreds of calories a day. Encourage your child to make healthy food and beverage choices part of an active lifestyle.
Labels: child, soda health
Friday, November 2, 2007
Sleep and your child's health: Why bedtime matters
Children's health and behavior take a nose dive when their sleep habits are out of whack. Insufficient sleep makes children short-tempered and whiny. In school, a sleep-deprived child has trouble with concentration, memory, physical performance and decision making.
On the flip side, adequate sleep will boost your child's energy and enthusiasm. Good-quality sleep also can help your child learn more easily and reduce many behavioral problems.
Sleep: How much is enough?
Because each child is different, it's not possible to set an absolute amount of sleep that all children require. In general, children between 1 and 3 years of age seem to thrive on about 10 to 13 hours of sleep at night, with maybe a nap during the day.
Preschoolers sleep about 10 to 12 hours a night, and daytime naps become less common around the age of 5. Between the ages of 6 and 9, most children need about 10 hours of sleep a night, while preteens need a little over nine hours.
Too little sleep: Telltale signs
When adults don't get enough sleep, they're usually grumpy and lethargic. Children can act this way, too, but they may also swing to the opposite extreme and be hyperactive. Your child may require more sleep if he or she:
Has a short attention span, or is irritable or restless
Has unusually low energy and activity levels
Is more tearful, anxious, touchy, defensive or impatient than usual
The problem of frequent waking
Most children wake up several times during the night. They are capable of falling back to sleep on their own — they just don't know it. Giving them the confidence and tools to help themselves sleep is up to you.
It helps if you start when they're still babies. If you routinely put your 7-month-old to bed drowsy but not fast asleep, he or she will be familiar with the feeling of drifting off alone in a quiet room. If you wait a few minutes before responding to middle-of-the-night crying, your 8-month-old may quiet down and doze off without your help.
These strategies won't work every time or with every baby, but if you're lucky, they'll help you avoid bedtime struggles and interrupted sleep as your child grows older.
Going to sleep alone
Some children have never learned how to go to sleep alone. They often fall asleep being held by a parent, in front of the TV. They may want a parent to lie down with them as they go to sleep, or they may insist upon sleeping in their parents' bed.
Once begun, sharing a bed with your children is a hard habit to break. At some point, all children need to learn how to go to sleep and return to sleep on their own. Bedtime routines can help children feel more comfortable about going to sleep by themselves.
Bedtime routines
Most bedtime routines last about 30 minutes and include a bath, brushing teeth, reading stories and talking about the day. Try to keep the same sequence each night because familiarity is comforting for children.
Having a comfort item, such as a stuffed animal or favorite blanket, can help children soothe themselves to sleep. Soft music also may be helpful. Avoid giving your toddler a bottle in his or her bed because the liquid can pool around the teeth and cause serious dental problems.
Bedtime conflicts
If your young child won't stay in his or her bedroom, you may have to shut the door or put up a gate or barrier. You may even have to lock the door if your child tends to wander around the house after you've gone to bed. Children under the age of 5 don't understand the dangers of fire, hot water, knives and going outside.
If your child is truly fearful, don't close the bedroom door. Instead, promise to check on him or her every 15 minutes. During these checkups, praise your child for being so quiet. Leave the room within 30seconds. Eventually, your child will fall asleep.
Individualized treatment
Each child is different and has his or her own way of approaching sleep. Some take extra time to fall asleep, while others wake more often during the night. You know your child's personal habits best, so with a little trial and error, you should succeed in finding a schedule and routine that suits your family.
On the flip side, adequate sleep will boost your child's energy and enthusiasm. Good-quality sleep also can help your child learn more easily and reduce many behavioral problems.
Sleep: How much is enough?
Because each child is different, it's not possible to set an absolute amount of sleep that all children require. In general, children between 1 and 3 years of age seem to thrive on about 10 to 13 hours of sleep at night, with maybe a nap during the day.
Preschoolers sleep about 10 to 12 hours a night, and daytime naps become less common around the age of 5. Between the ages of 6 and 9, most children need about 10 hours of sleep a night, while preteens need a little over nine hours.
Too little sleep: Telltale signs
When adults don't get enough sleep, they're usually grumpy and lethargic. Children can act this way, too, but they may also swing to the opposite extreme and be hyperactive. Your child may require more sleep if he or she:
Has a short attention span, or is irritable or restless
Has unusually low energy and activity levels
Is more tearful, anxious, touchy, defensive or impatient than usual
The problem of frequent waking
Most children wake up several times during the night. They are capable of falling back to sleep on their own — they just don't know it. Giving them the confidence and tools to help themselves sleep is up to you.
It helps if you start when they're still babies. If you routinely put your 7-month-old to bed drowsy but not fast asleep, he or she will be familiar with the feeling of drifting off alone in a quiet room. If you wait a few minutes before responding to middle-of-the-night crying, your 8-month-old may quiet down and doze off without your help.
These strategies won't work every time or with every baby, but if you're lucky, they'll help you avoid bedtime struggles and interrupted sleep as your child grows older.
Going to sleep alone
Some children have never learned how to go to sleep alone. They often fall asleep being held by a parent, in front of the TV. They may want a parent to lie down with them as they go to sleep, or they may insist upon sleeping in their parents' bed.
Once begun, sharing a bed with your children is a hard habit to break. At some point, all children need to learn how to go to sleep and return to sleep on their own. Bedtime routines can help children feel more comfortable about going to sleep by themselves.
Bedtime routines
Most bedtime routines last about 30 minutes and include a bath, brushing teeth, reading stories and talking about the day. Try to keep the same sequence each night because familiarity is comforting for children.
Having a comfort item, such as a stuffed animal or favorite blanket, can help children soothe themselves to sleep. Soft music also may be helpful. Avoid giving your toddler a bottle in his or her bed because the liquid can pool around the teeth and cause serious dental problems.
Bedtime conflicts
If your young child won't stay in his or her bedroom, you may have to shut the door or put up a gate or barrier. You may even have to lock the door if your child tends to wander around the house after you've gone to bed. Children under the age of 5 don't understand the dangers of fire, hot water, knives and going outside.
If your child is truly fearful, don't close the bedroom door. Instead, promise to check on him or her every 15 minutes. During these checkups, praise your child for being so quiet. Leave the room within 30seconds. Eventually, your child will fall asleep.
Individualized treatment
Each child is different and has his or her own way of approaching sleep. Some take extra time to fall asleep, while others wake more often during the night. You know your child's personal habits best, so with a little trial and error, you should succeed in finding a schedule and routine that suits your family.
Labels: child health, sleep
Tuesday, October 30, 2007
Sex education: Talking to your teen about sex
You understand the importance of sex education. But don't count on classroom instruction alone. Although the basics may be covered in health class, your child might not hear everything he or she needs to know.
That's where you come in. Awkward as it may be, sex education is a parent's responsibility. By reinforcing and supplementing what your child learns in school, you can help your child make good decisions about sex.
Breaking the ice
Sex is a staple of news, entertainment and advertising. It's often hard to avoid this ever-present topic. But when parents and children need to talk, it isn't always so easy.
If you wait for the perfect moment, you might miss the best opportunities. Instead, think of sex education as an ongoing conversation. Here are some ideas to help you get started — and keep the discussion going.
Seize the moment. When a TV program or music video raises issues about responsible sexual behavior, use it as a springboard for discussion. If a good topic comes up at an inconvenient time, say you'd like to talk more about it later — then actually do so.
Keep it low-key. Don't pressure your child to talk about sex. Simply broach the subject when you're alone with your child. Sometimes everyday moments — such as riding in the car, putting away groceries or sharing a late-night snack — offer the best opportunities to talk.
Be honest. If you're uncomfortable, say so — but explain that it's important to keep talking. If you don't know how to answer your child's questions, offer to find the answers or look them up together.
Be direct. Clearly state your feelings about specific issues, such as oral sex and intercourse. Present the risks objectively, including emotional pain, sexually transmitted diseases and unplanned pregnancy. Explain that oral sex isn't a risk-free alternative to intercourse.
Consider your child's point of view. Don't lecture your child or rely on scare tactics to discourage sexual activity. Instead, listen carefully. Understand your child's pressures, challenges and concerns.
Move beyond the facts. Your child needs accurate information about sex. But it's just as important to talk about feelings, attitudes and values. Examine questions of ethics and responsibility in the context of your personal or religious beliefs.
Invite more discussion. Let your child know that it's OK to talk with you about sex whenever he or she has questions or concerns. Reward questions by saying , "I'm glad you came to me."
Addressing tough topics
Sex education includes abstinence, date rape, homosexuality and other tough topics. Be prepared for questions like these:
How will I know I'm ready for sex? Various factors — peer pressure, curiosity and loneliness, to name a few — steer some teenagers into early sexual activity. But there's no rush. Remind your child that it's OK to wait. Sex is an adult behavior. In the meantime, there are many other ways to express affection — intimate talks, long walks, holding hands, listening to music, dancing, kissing, touching and hugging.
What if my boyfriend or girlfriend wants to have sex — but I don't? Explain that no one should have sex out of a sense of obligation or fear. Any form of forced sex is rape, whether the perpetrator is a stranger or someone your child has been dating. Impress upon your child that no always means no. Emphasize that alcohol and drugs impair judgment and reduce inhibitions, leading to situations in which date rape is more likely to occur.
What if I think I'm gay? Many teens wonder at some point whether they're gay or bisexual. Help your child understand that he or she is just beginning to explore sexual attraction. These feelings may change as time goes on. Above all, however, let your child know that you love him or her unconditionally. Praise your child for sharing his or her feelings.
Responding to behavior
If your child becomes sexually active — whether you think he or she is ready or not — it may be more important than ever to keep the conversation going. State your feelings and calmly explain your objections. You might say, "I'm disappointed in your decision to have sex. I don't think it's appropriate or healthy for you to have sex right now. But the decision is yours. I expect you to take the associated responsibilities seriously."
Stress the importance of contraception and keeping a sexual relationship exclusive — not only as a matter of trust and respect but also to reduce the risk of sexually transmitted diseases. Also set and enforce reasonable boundaries, such as curfews and rules about visits from friends of the opposite sex.
Your child's doctor can help, too. A routine checkup can give your child the opportunity to address sexual activity and other behaviors in a supportive, confidential atmosphere.
That's where you come in. Awkward as it may be, sex education is a parent's responsibility. By reinforcing and supplementing what your child learns in school, you can help your child make good decisions about sex.
Breaking the ice
Sex is a staple of news, entertainment and advertising. It's often hard to avoid this ever-present topic. But when parents and children need to talk, it isn't always so easy.
If you wait for the perfect moment, you might miss the best opportunities. Instead, think of sex education as an ongoing conversation. Here are some ideas to help you get started — and keep the discussion going.
Seize the moment. When a TV program or music video raises issues about responsible sexual behavior, use it as a springboard for discussion. If a good topic comes up at an inconvenient time, say you'd like to talk more about it later — then actually do so.
Keep it low-key. Don't pressure your child to talk about sex. Simply broach the subject when you're alone with your child. Sometimes everyday moments — such as riding in the car, putting away groceries or sharing a late-night snack — offer the best opportunities to talk.
Be honest. If you're uncomfortable, say so — but explain that it's important to keep talking. If you don't know how to answer your child's questions, offer to find the answers or look them up together.
Be direct. Clearly state your feelings about specific issues, such as oral sex and intercourse. Present the risks objectively, including emotional pain, sexually transmitted diseases and unplanned pregnancy. Explain that oral sex isn't a risk-free alternative to intercourse.
Consider your child's point of view. Don't lecture your child or rely on scare tactics to discourage sexual activity. Instead, listen carefully. Understand your child's pressures, challenges and concerns.
Move beyond the facts. Your child needs accurate information about sex. But it's just as important to talk about feelings, attitudes and values. Examine questions of ethics and responsibility in the context of your personal or religious beliefs.
Invite more discussion. Let your child know that it's OK to talk with you about sex whenever he or she has questions or concerns. Reward questions by saying , "I'm glad you came to me."
Addressing tough topics
Sex education includes abstinence, date rape, homosexuality and other tough topics. Be prepared for questions like these:
How will I know I'm ready for sex? Various factors — peer pressure, curiosity and loneliness, to name a few — steer some teenagers into early sexual activity. But there's no rush. Remind your child that it's OK to wait. Sex is an adult behavior. In the meantime, there are many other ways to express affection — intimate talks, long walks, holding hands, listening to music, dancing, kissing, touching and hugging.
What if my boyfriend or girlfriend wants to have sex — but I don't? Explain that no one should have sex out of a sense of obligation or fear. Any form of forced sex is rape, whether the perpetrator is a stranger or someone your child has been dating. Impress upon your child that no always means no. Emphasize that alcohol and drugs impair judgment and reduce inhibitions, leading to situations in which date rape is more likely to occur.
What if I think I'm gay? Many teens wonder at some point whether they're gay or bisexual. Help your child understand that he or she is just beginning to explore sexual attraction. These feelings may change as time goes on. Above all, however, let your child know that you love him or her unconditionally. Praise your child for sharing his or her feelings.
Responding to behavior
If your child becomes sexually active — whether you think he or she is ready or not — it may be more important than ever to keep the conversation going. State your feelings and calmly explain your objections. You might say, "I'm disappointed in your decision to have sex. I don't think it's appropriate or healthy for you to have sex right now. But the decision is yours. I expect you to take the associated responsibilities seriously."
Stress the importance of contraception and keeping a sexual relationship exclusive — not only as a matter of trust and respect but also to reduce the risk of sexually transmitted diseases. Also set and enforce reasonable boundaries, such as curfews and rules about visits from friends of the opposite sex.
Your child's doctor can help, too. A routine checkup can give your child the opportunity to address sexual activity and other behaviors in a supportive, confidential atmosphere.
Labels: child health, Sex
Saturday, October 20, 2007
Potty training: How to get the job done
"I've gotta go!" If you're looking forward to ditching your child's diapers for good, these words may be music to your ears.
Potty training is a big deal for parents and kids alike. The secret to success? Patience. Perhaps more patience than you ever imagined.
Is it time?
Potty training success hinges on physical and emotional readiness — not a specific age.
Many kids show interest in potty training by age 2, but others may not be ready until age 2 1/2 or even older. And there's no rush. If you start too early, it may only take longer.
So how do you know when to start? Ask yourself these questions:
Does your child seem interested in the potty chair or toilet, or in wearing underwear?
Can your child understand and follow basic directions?
Can your child ask simple questions?
Does your child stay dry for periods of two hours or longer during the day? Does he or she wake from naps dry?
Does your child have fairly predictable bowel movements?
Does your child tell you when he or she needs to potty or poop?
Is your child uncomfortable in wet or dirty diapers?
Can your child pull down his or her pants and pull them up again?
If you answered mostly yes, your child may be ready for potty training. If you answered mostly no, you may want to wait awhile — especially if your child is about to face a major change, such as a move or the arrival of a new baby. A toddler who opposes potty training today may be open to the idea in a few months.
Ready, set, go!
When you decide it's time to begin potty training, set your child up for success.
Put on your happy face
Maintain a sense of humor and a positive attitude. Think of potty training as an adventure.
Start slowly
Place a potty chair in the bathroom. You may want to try a model with a removable top that can be placed directly on the toilet when your child is ready. Encourage your child to sit on the potty chair — with or without a diaper. Be cheerful and casual. Make sure your child's feet rest firmly on the floor or a stool.
As your child checks out the potty chair, help him or her learn how to talk about using the bathroom. Use simple, correct terms. Let your child see you and other family members using the toilet.
Schedule potty breaks
If your child is interested, have him or her sit on the potty chair or toilet without a diaper for a few minutes several times a day. Read a potty-training book or give your child a special toy to use while getting used to the potty chair or toilet.
Stay with your child when he or she is in the bathroom. Even if your child simply sits there, offer praise for trying — and remind your child that he or she can try again later.
Get there — fast!
When you notice signs that your child may need to use the toilet — such as squirming, squatting or holding the genital area — respond quickly. Help your child become familiar with these signals, stop what he or she is doing and head to the toilet. Praise your child for telling you when he or she has to go. When it's time to flush, let your child do the honors.
Also remember the importance of good hygiene. Teach girls to wipe carefully from front to back to prevent bringing germs from the rectum to the vagina or bladder. Make sure both boys and girls learn to wash their hands after using the toilet.
Consider incentives
Some kids respond to stickers or stars on a chart. For others, trips to the park or extra bedtime stories are effective. Experiment to find out what works best for your child. Reinforce your child's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big kids do!"
Be consistent
Make sure all of your child's caregivers — including baby-sitters, child care providers and grandparents — follow your potty-training routine.
Graduate to training pants
After several weeks of successful potty breaks, your child may be ready to trade diapers for training pants. Take time to celebrate this transition. Go on a special "big kid" outing. Call close friends or loved ones and let your child spread the news.
Once your child is wearing training pants, be careful to avoid overalls, belts, leotards or other items that could hinder quick undressing.
Treat mistakes lightly
Accidents are inevitable — especially when your child is tired or upset. When it happens, stay calm. Simply say, "Uh-oh. You had an accident. Let's change you. Pretty soon you'll remember to use the potty chair or toilet every time you have to go."
Sleep soundly
Most children master daytime bladder control by age 3 or 4. Nighttime control may take months — or years — longer. In the meantime, you may want to use disposable training pants when your child sleeps.
Know when to call it quits
If your child resists using the potty chair or toilet or simply doesn't get the hang of it, take a break. Chances are, your child simply isn't ready yet. Try it again in a few months.
Accidents will happen
You may breathe easier once your child learns how to use the toilet — but expect occasional accidents and near misses. Here's help handling — and preventing — wet pants.
Stay calm. Kids don't have accidents to irritate their parents. Don't add to the embarrassment by scolding or disciplining your child. You may say, "You forgot this time. Next time you'll get to the bathroom sooner."
Slow down. Remind your child to relax and take it slow. Completely emptying the bladder can help prevent accidents.
Offer reminders. Accidents often happen when kids are absorbed in activities that — for the moment — are more interesting than using the toilet. To fight this phenomenon, suggest regular bathroom trips — such as first thing in the morning, after each meal and snack, and before getting in the car or going to bed. Point out telltale signs of holding it, such as fidgeting or holding the genital area.
Be prepared. If your child has frequent accidents, absorbent underwear may be best. Keep a change of underwear and clothing handy — especially at school or in child care.
When to seek help
Occasional accidents are harmless — but they can lead to teasing, embarrassment and alienation from peers. If your potty-trained child reverts or loses ground — especially at age 4 or older — or you're concerned about your child's accidents, contact his or her doctor. Sometimes wetting problems indicate an underlying physical condition, such as a urinary tract infection or an overactive bladder. Prompt treatment can help your child become accident-free.
Potty training is a big deal for parents and kids alike. The secret to success? Patience. Perhaps more patience than you ever imagined.
Is it time?
Potty training success hinges on physical and emotional readiness — not a specific age.
Many kids show interest in potty training by age 2, but others may not be ready until age 2 1/2 or even older. And there's no rush. If you start too early, it may only take longer.
So how do you know when to start? Ask yourself these questions:
Does your child seem interested in the potty chair or toilet, or in wearing underwear?
Can your child understand and follow basic directions?
Can your child ask simple questions?
Does your child stay dry for periods of two hours or longer during the day? Does he or she wake from naps dry?
Does your child have fairly predictable bowel movements?
Does your child tell you when he or she needs to potty or poop?
Is your child uncomfortable in wet or dirty diapers?
Can your child pull down his or her pants and pull them up again?
If you answered mostly yes, your child may be ready for potty training. If you answered mostly no, you may want to wait awhile — especially if your child is about to face a major change, such as a move or the arrival of a new baby. A toddler who opposes potty training today may be open to the idea in a few months.
Ready, set, go!
When you decide it's time to begin potty training, set your child up for success.
Put on your happy face
Maintain a sense of humor and a positive attitude. Think of potty training as an adventure.
Start slowly
Place a potty chair in the bathroom. You may want to try a model with a removable top that can be placed directly on the toilet when your child is ready. Encourage your child to sit on the potty chair — with or without a diaper. Be cheerful and casual. Make sure your child's feet rest firmly on the floor or a stool.
As your child checks out the potty chair, help him or her learn how to talk about using the bathroom. Use simple, correct terms. Let your child see you and other family members using the toilet.
Schedule potty breaks
If your child is interested, have him or her sit on the potty chair or toilet without a diaper for a few minutes several times a day. Read a potty-training book or give your child a special toy to use while getting used to the potty chair or toilet.
Stay with your child when he or she is in the bathroom. Even if your child simply sits there, offer praise for trying — and remind your child that he or she can try again later.
Get there — fast!
When you notice signs that your child may need to use the toilet — such as squirming, squatting or holding the genital area — respond quickly. Help your child become familiar with these signals, stop what he or she is doing and head to the toilet. Praise your child for telling you when he or she has to go. When it's time to flush, let your child do the honors.
Also remember the importance of good hygiene. Teach girls to wipe carefully from front to back to prevent bringing germs from the rectum to the vagina or bladder. Make sure both boys and girls learn to wash their hands after using the toilet.
Consider incentives
Some kids respond to stickers or stars on a chart. For others, trips to the park or extra bedtime stories are effective. Experiment to find out what works best for your child. Reinforce your child's effort with verbal praise, such as, "How exciting! You're learning to use the toilet just like big kids do!"
Be consistent
Make sure all of your child's caregivers — including baby-sitters, child care providers and grandparents — follow your potty-training routine.
Graduate to training pants
After several weeks of successful potty breaks, your child may be ready to trade diapers for training pants. Take time to celebrate this transition. Go on a special "big kid" outing. Call close friends or loved ones and let your child spread the news.
Once your child is wearing training pants, be careful to avoid overalls, belts, leotards or other items that could hinder quick undressing.
Treat mistakes lightly
Accidents are inevitable — especially when your child is tired or upset. When it happens, stay calm. Simply say, "Uh-oh. You had an accident. Let's change you. Pretty soon you'll remember to use the potty chair or toilet every time you have to go."
Sleep soundly
Most children master daytime bladder control by age 3 or 4. Nighttime control may take months — or years — longer. In the meantime, you may want to use disposable training pants when your child sleeps.
Know when to call it quits
If your child resists using the potty chair or toilet or simply doesn't get the hang of it, take a break. Chances are, your child simply isn't ready yet. Try it again in a few months.
Accidents will happen
You may breathe easier once your child learns how to use the toilet — but expect occasional accidents and near misses. Here's help handling — and preventing — wet pants.
Stay calm. Kids don't have accidents to irritate their parents. Don't add to the embarrassment by scolding or disciplining your child. You may say, "You forgot this time. Next time you'll get to the bathroom sooner."
Slow down. Remind your child to relax and take it slow. Completely emptying the bladder can help prevent accidents.
Offer reminders. Accidents often happen when kids are absorbed in activities that — for the moment — are more interesting than using the toilet. To fight this phenomenon, suggest regular bathroom trips — such as first thing in the morning, after each meal and snack, and before getting in the car or going to bed. Point out telltale signs of holding it, such as fidgeting or holding the genital area.
Be prepared. If your child has frequent accidents, absorbent underwear may be best. Keep a change of underwear and clothing handy — especially at school or in child care.
When to seek help
Occasional accidents are harmless — but they can lead to teasing, embarrassment and alienation from peers. If your potty-trained child reverts or loses ground — especially at age 4 or older — or you're concerned about your child's accidents, contact his or her doctor. Sometimes wetting problems indicate an underlying physical condition, such as a urinary tract infection or an overactive bladder. Prompt treatment can help your child become accident-free.