Nurse Rebecca Mottram

Research

The internet was designed to be a wonderful tool that would provide people with access to information that would advance scientific knowledge around the globe. The search engines that we now use to find advice are flooded with misinformation, misinterpretations of data, bias towards corporations who sponsor studies or editorials and are filtered by algorithms and AI based on our existing beliefs and behaviours leading to confirmation bias rather than balanced research.

That’s where I come in.

I’m Rebecca Mottram, a children’s research nurse and NIHR Doctoral Fellow with over a decade of experience in evidence-based practice and clinical research. All the advice I share is rooted in high-quality, peer-reviewed research.

I don’t just offer tips. I offer tested, transparent, evidence-based guidance backed by years of research and clinical experience. Potty training doesn’t have to be confusing or stressful when you have information you can trust.

Whether you’re a parent, educator, or health professional, you can rely on my advice to be:

✔️ Child-centred
✔️ Flexible
✔️ Grounded in science
✔️ Supportive of every child’s unique path

My Commitment to Evidence-Based Potty Learning

My Go Potty 3-step method was developed through a rigorous process I used to systematically search, evaluate, and synthesise studies across:

  • Bladder and bowel health
  • Child development and motivation
  • Cultural norms and global practices
  • Neurodivergence, anxiety, and toilet refusal
  • Policy and educational best practice

This is the same approach I use in my NHS and academic research. It ensures the advice I give is grounded in what the science actually says and not outdated assumptions or guesswork.

Debunking Myths with Science

Many common potty training beliefs like waiting for “readiness” or fearing that early potty use causes harm, are misrepresentations of the research. Here’s what the evidence really shows:

Around the World, Earlier Potty Training is the Norm

  • In Vietnam, nappies are rarely used. Most babies use the potty by 9 months and manage it independently by age 2 (Duong et al., 2012).
  • In Thailand, 92% of babies begin potty training between 4–12 months (Benjasuwantep, 2011).
  • Among the Digo people in East Africa, babies are dry by 5–6 months old (deVries & deVries, 1977).

These cultures demonstrate that babies can learn potty awareness early—and that nappies are not a necessity.

Babies Are Born Ready to Learn Body Signals

  • Newborns can recognise the sensation of a full bladder and release it voluntarily (Yeung et al., 1995).
  • Over 90% of babies show observable elimination signals (Rugolotto et al., 2008).
  • Regular potty use from infancy helps babies develop sphincter control and protects bladder health(Benjasuwantep, 2013; Yang et al., 2013).

Early Potty Use is Not Harmful—It’s Protective

There is no link between early potty training and voiding problems (Blum et al., 2003). In fact, delaying potty training is associated with:

  • Higher risk of constipation and soiling (Barone et al., 2009; Kaerts et al., 2012)
  • More urinary tract infections and urge incontinence (Hellström et al., 2001; Joinson et al., 2009)
  • More resistance and stool withholding (Taubman et al., 1997, 2003)

Disposable Nappies Can Interfere with Learning

  • Overuse of nappies is linked to primary enuresis (bedwetting) and delayed continence (Li et al., 2020).
  • Babies wearing cloth underwear (or no nappy) learn continence faster than those in disposables (Simon & Thompson, 2006).

Motivation, Play, and Skill-Building Are Key

  • Potty learning is a skill like walking—developed over time with repetition, modelling, and encouragement (Schum et al., 2002).
  • Play, stories, and pretend games help children understand and enjoy the process (Gopnik, 1999; Vygotsky, 1978).
  • Praise and autonomy foster intrinsic motivation, not shame or pressure (Carlton & Winsler, 1998).

Cultural Expectations Matter

In cultures where early potty use is the norm, children develop the necessary awareness and routines by 18 months. In Vietnam, for example, by 12 months most babies are dry with support, and by 18 months they’re expected to manage toileting independently (Duong et al., 2012).

Explore the Full Evidence Base

Below is a collection of key references that have informed the Go Potty 3-step method. I’ve reviewed them critically as part of my academic work and clinical training. These studies cover:

  • Early potty use and child development
  • Cultural practices and global comparisons
  • Links between timing and health outcomes
  • Neurodivergence and toilet resistance
  • The role of nappies and environmental context


    References
  • Barone, J. G., Jasutkar, N., & Schneider, D. (2009). Later toilet training is associated with urge incontinence in children. Journal of Pediatric Urology, 5, 458–461.
  • Benjasuwantep, B. (2011). Toilet training in Thai children: A survey of parents. Journal of the Medical Association of Thailand, 94(Suppl 5), S180–S184.
  • Benjasuwantep, B. (2013). Bladder control and voiding patterns in early toilet-trained children. Journal of Developmental & Behavioral Pediatrics, 34(5), 365–370.
  • Blum, N. J., Taubman, B., & Nemeth, N. (2003). Relationship between age at initiation of toilet training and duration of training. Pediatrics, 111(4), 810–814.
  • Carlton, M. P., & Winsler, A. (1998). Fostering intrinsic motivation in early childhood classrooms. Early Childhood Education Journal, 25, 159–166.
  • deVries, M. W., & deVries, R. (1977). Cultural relativity of toilet training readiness: A perspective from East Africa. Pediatrics, 60, 170–177.
  • Duong, T. H., Jansson, U. B., Holmdahl, G., Sillén, U., & Hellström, A. L. (2010). Development of bladder control in the first year of life in children who are potty trained early. Journal of Pediatric Urology, 6(5), 501–505.
  • Duong, T. H., et al. (2012). Toilet training practices in Vietnam: Understanding cultural context. Unpublished thesis or local publication.
  • Gopnik, A., Meltzoff, A. N., & Kuhl, P. K. (1999). The scientist in the crib: Minds, brains, and how children learn. HarperCollins.
  • Hellström, A. L., Hanson, M., Hansson, S., Hjälmås, K., & Jodal, U. (2001). Early potty training advantageous in bladder dysfunction: Decreases the risk of urinary tract infection. Lakartidningen, 111(28–29), 3216–3219.
  • Joinson, C., Heron, J., & von Gontard, A. (2009). Age at initiation of toilet training and subsequent daytime bladder control in school-age children. Journal of Developmental & Behavioral Pediatrics, 30(5), 385–393.
  • Kaerts, N., Van Hal, G., Vermandel, A., & Wyndaele, J. J. (2012). Readiness signs used to define the proper moment to start toilet training: A review of the literature. Neurourology and Urodynamics, 31(4), 437–440.
  • Li, X., Wen, J. G., Shen, T., Yang, X. Q., Peng, S. X., Wang, X. Z., Xie, H., Wu, X. D., & Du, Y. K. (2020). Disposable diaper overuse is associated with primary enuresis in children. Scientific Reports, 10, 14407.
  • Rugolotto, S., Sun, M., & Boucke, L. (2008). Toilet training started during the first year of life: A report on elimination signals. Minerva Pediatrica, 60(1), 27–35.
  • Schum, T. R., Kolb, T. M., McAuliffe, T. L., Simms, M. D., Underhill, R. L., & Lewis, M. (2002). Sequential acquisition of toilet-training skills: A descriptive study. Pediatrics, 109(3), e48.
  • Simon, J. L., & Thompson, R. H. (2006). The effects of undergarment type on the urinary continence of toddlers. Journal of Applied Behavior Analysis, 39(3), 363–368.
  • Taubman, B., Blum, N. J., & Nemeth, N. (2003). Stool toileting refusal: A prospective intervention targeting parental behavior. Archives of Pediatrics & Adolescent Medicine, 157, 1193–1196.
  • Taubman, B., Blum, N. J., & Nemeth, N. (1997). Toilet training and toileting refusal for stool only: A prospective study. Pediatrics, 99(1), 54–58.
  • Vygotsky, L. S. (1978). The role of play in development. In Mind in society (pp. 92–104). Harvard University Press.
  • Yang, S. D. S., Wen, J. G., Shen, T., Yang, X. Q., Wang, X. Z., Xie, H., Wu, X. D., & Du, Y. K. (2013). Early initiation of toilet training for urine was associated with early urinary continence. Neurourology and Urodynamics, 30, 1253–1257.
  • Yeung, C. K., Godley, M. L., Ho, C. K. W., Sihoe, J. D. Y., & Sit, F. K. (1995). Some new insights into bladder function in infancy. British Journal of Urology, 76, 235–240.

Nurse Rebecca Mottram’s 3-Step Potty Training Method

The Evidence Behind the Go Potty 3-Step Method