I am so excited and honored to have Dr. D. Preston Smith founder of PottyMD and Pediatric Urologist with us today answering questions about potty training. Dr. Smith is board-certified and has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith's dedication to helping children with urologic problems inspired him to establish PottyMD.

1. First, I want to say thank you so much for doing this interview. It is such an honor to have you here with us today! Would you please tell us a little bit about yourself and PottyMD?

I am a practicing Pediatric Urologist in Knoxville TN. I have been practicing for almost 15 years and I started PottyMD and writing books on potty-related topics about 5 years ago. As a parent of 3 children and a pediatric urologist, I realized there was void of material available to parents about issues related to potty problems after potty training. So I wanted to reach parents during the potty training process to avoid problems after their child 'graduates' from diapers.

2. There seems to be a lot of discrepancy as to when to start potty training. Some people tell you to start when the child is still a baby and then others will tell you to wait until the child is ready (after 24 months usually). When is the right age to start potty training?

This is a parent's decision. There are no consistent reports that have shown when is the best time. With a loving approach ANY style may work and it may need to be tailored for your child and your parenting style. For example, a child as young as 1 year may train very well and easily and never grow up to have problems with holding and control issues in the future. On the reverse side, a child may be allowed to completely decide when to train--even as late as 4-5 years and progress normally throughout their 'potty life' without significant parental input.

3. How do parents begin potty training a child? What are the first steps?

The first step is for the parent to be ready. In other words, if your child can walk, talk and sit on a potty then he/she can probably be trained. The problems arise when the child is stubborn, confused, or simply not interested and the parent is not prepared for this response. Frustrations mount and unpleasant toilet training experiences can then develop. So it is important for parents to place their desires to train and their actions that may be needed to train on a level playing field. If these two factors are not equal then parental and child disappointments develop. For example, if a parent is very frustrated that their child is not trained, yet is unwilling to take the necessary actions to succeed, then tension mounts and the process becomes difficult for everyone. I like to call these--"child and parent signs of readiness".

4. My son is 20 months old and he is able to communicate to me that he has wet or dirtied his diaper, but when I put him on the potty-he refuses and starts to cry. How can parents help children get over their fear and/or resistance of the potty?

This may take a lot of work and introduction to the process of stooling on a commode. Even with appropriate techniques some children will not easily go on a potty. The parent must then make the difficult decision to force the issue or simply avoid the training and retry at a later time (probably several weeks later). There have been several techniques described, but none of these are easy or consistently work.

5. As a follow up to the previous question: I never scold my son, Lucas when he refuses to use the potty-I always pick him up and tell him that it’s ok. How should parents respond when their child refuses to use the potty?

I think your technique is fantastic since it is your son and your parenting style. I totally support your approach. However, another parent may wish to be more directive and enforce more toilet use. As long as inappropriate scolding does not occur then this is also OK. Usually with a magical mixture of love and enforcement, the toilet training process can be achieved during a reasonable time period under a parents' direction.

6. Are there any differences between potty training a boy versus a girl?

Well, boys do tend train at a slightly older age than girls. This does not mean that they should be trained later, or that very young boys do not train. So again, toilet training can occur at most any age once the child is walking and preferably prior to entering formal schooling. The techniques for training are similar for the sexes and I still believe that boys that sit to potty are more likely to develop better long-term toileting habits.

7. I’ve heard many parents say that their children will pee in the potty, but they won’t do a BM. Are there ways of resolving that?

There are no easy maneuvers. It is also true that some kids will poop on the potty but not pee on the potty. Children can have strange issues related to using the potty for poop or pee and it is very difficult to get into their heads and determine what is causing their actions. The best consistent advice I can offer parents with children who do preferential use of the potty is to make sure your child always goes on schedule (every 45 mins-11/2 hr) and sits for 3-5 minutes each time. In other words, the more often a child sits and relaxes on the potty the more chances the pee AND poop will come out. Also, children with poop hording/holding/issues commonly are constipated--even if mildly. So if you give them extra juices and beans, or even a low-dose laxative, the softer, easier and more often the BMs will occur. Hopefully these will come out in the potty. Then have a poop party!!

8. How should parents deal with potty training when they are out with their children?

Try to do the same consistent patterns as at home. Confusion enters the picture if children are receiving inconsistent messages from their parents when using and going to the potty. Try not to make the public restroom a hygiene nightmare. If children are afraid of public restrooms and going other places then the process can become very problematic.

9. Which, in your opinion, are the best types of products/tools parents should use when potty training their children?

The best thing for parents is to pick an approach and go with it. There are no best products or tools. Although I created the Potty Monkey to be the highest tech device with the most educational tools for parents, it still is a gizmo that many children may not need. So reach in your heart and touch your parenting style and then love your child and go with it. This is the best way I can tell parents to approach toilet training in a short and simple format.

10. Any last words of advice, tips, suggestions?

Do not make toilet training medical. It is a simple bodily function like brushing your teeth. Parents should not fear the process and they should take charge of a process and timing they like. I do beg of parents to make sure that once your child is trained STAY INVOLVED with your child's potty habits. Make sure they are going often,