Potty Training a Child on Chemo
By Allie Neenan, PhD, LP | Last updated 4/28/26
Potty training is one of the most hot-button topics in parenting. Should you use a one day method? A three day method? Is a "method" adding too much pressure? Perhaps you'll just introduce the toilet and then cheer every time a body fluid ends up in there. Oh wait, praising a bodily function is counterproductive! Every opinion has an equal and opposite opinion when it comes to ditching diapers. And if you ended up reading this blog, you are probably sifting through these ideas while navigating childhood cancer. What a recipe for confusion.
If you haven't been here before, welcome to Cancer Cushion! Every post on this website is written by licensed clinical psychologist, Allie Neenan. Cancer Cushion is my resource library for every age, role, and stage in the childhood cancer journey. While I wish websites like this weren't necessary, I'm glad you're here.
Back to potty training a child with cancer. First, I am so sorry that you are in this situation. Childhood cancer dials up the stress of "normal" parenting dilemmas to an extreme level. There are no obvious choices here. It will be hard, and it's not your fault. Please note that this article will be most relevant to children who were diagnosed with cancer prior to starting potty training. A separate article will explore potty training regressions and ways to navigate them.
If you haven't already, please consult with your child's oncology team about potty training. There are some key players whose insights will likely help:
Your Child's Oncologist - they will be able to describe the risks of exposure to body fluids, for you and your child. Laissez-faire potty training methods that make light of accidents are likely not a good fit for your situation due to the effects of chemotherapy on body fluids.
Occupational Therapy - they will have great ideas on environmental supports that can aid success. Think step stools, hand rails, timers, and charts to keep the process achievable and engaging.
Physical Therapy - your child may experience fine or gross motor challenges that complicate potty training, and you may not realize it until you start. PT can assess and intervene as early as possible to minimize complications.
Depending on the makeup of your child's medical team, there may be others who can provide guidance as you set up a potty training plan. Even and especially in the case of childhood cancer, potty training is not one size fits all.
All of the different potty training philosophies rest on different core values. Some elevate independence. Some prioritize the parent-child relationship. Some maximize stickers. All of these approaches get kids out of diapers. Parental preference truly is the magic ingredient in selecting the "right" approach. The two most common potty training methods are child-led potty training and behavioral (parent-led) potty training. Child-led potty training emphasizes monitoring for signs of interest and encouraging a child's natural desire to learn how to use the toilet. Parent-led potty training focuses on scheduled toilet sits and rewarding each success. There are elements of each approach that fit the unique needs of children with cancer. This blog post will outline a blended method that breaks down the skills of using a toilet to pee or poop ("void", for simplicity in the remainder of this post).
Skill #1: Sitting on a toilet
A toilet is a pretty strange thing, when you really think about it. It's sort of a chair, but it has no arms or legs and there's a giant hole in the middle. Filled with water! Some children are scared of it, and rightfully so. So the very first skill of potty training is getting comfortable with sitting on a toilet. You can place your child down or allow them to climb up, if possible. Keep expectations low. They may prefer to just look at first. If sitting doesn't start to go smoothly after a few days, it's ok to take a break and restart another time. Once they are happily practicing sitting 1-2 times per day for several days, you can move on to skill 2.
Skill #2: Sitting on a toilet without pants
Many children struggle with the transition to sitting on the toilet without clothing. Some may need to transition from pants to a diaper, then from a diaper to no diaper. Children with cancer are especially vulnerable to these challenges. Medical procedures can lead to an aversion of taking off clothes, even in non-medical settings. It's important to limit pressure as much as possible. This is a great skill to model with dolls, where children can act out the process in a controlled manner. Skill 2 really is the foundation of diaper freedom. It's ok for it to take a long time, and it naturally leads into skill 3.
Skill #3: "Accidental" voids
Wait, I thought we were trying to avoid accidents? Think again! The beauty of getting kids comfortable with sitting on the toilet, is that comfortable kids void. As us expert adult voiders know, the goal of toileting isn't really "trying" to void. It's just allowing the voiding process to naturally happen, without tensing up. Over time, the more comfortable your child is with skill 2, the more chances you'll have to capture the happy accidents of skill 3. Then, you'll add in some structure with skill 4.
Skill #4: Scheduled sit routine
What makes skill 4 unique is that it's not just one action, but a new daily routine. Depending on how easily your child has adapted to skills 1-3, begin introducing up to five scheduled sits per day from the following list:
just after waking after breakfast after lunch after dinner before bed.
Hopefully, you will start to notice your child's patterns and adjust the sit schedule to maximize the chance of successful voids. While it is possible that your child will begin to self-initiate during this stage, it can be helpful to assume that "ownership" remains with parents for longer than you'd expect. It's important to avoid asking children whether they need to use the toilet - asking creates an opportunity for them to say "no" and start a power struggle. Instead, gently direct them: "it's time to sit on the toilet now."
Skill 4 is a delicate time. It's the official transition from the toilet as an object to explore, to an expectation. Children with cancer face so many insults to their bodily autonomy. So many adults tell these kids what to do with their bodies so they can receive treatment. If your child flips out once yet another daily task is introduced, it. is. not. your. fault. Many parents of children without chronic health conditions work with pediatric psychologists to address hiccups in toilet training. At any point in this process, consult with your child's medical team if it feels like something is wrong. Collaboration with the team is especially critical during the final transition from skill 4 to skill 5.
Skill #5: Self-initiation
Skill 5 is the hallmark of "potty trained." It's when children can keep themselves dry without being reminded by adults. By its very nature, this is the most elusive potty training skill of all. You cannot make self-initiation happen in the moment because it's 100% the child's choice. Instead, you can use two kinds of interventions to increase the chance that the behavior will stick:
Antecedent interventions (before voiding):
encouraging handwashing throughout the day without explicitly mentioning the toilet, which provides regular exposure to the bathroom (and good hygiene) modeling self-monitoring and narrating sensory signals of your own need to void keeping special toys and books in the bathroom that are only available during toilet sits
Consequence interventions (after voiding):
verbal praise stickers, including sticker charts to earn a prize any other reward that you feel comfortable with