When I hear about toilet training, I wonder if I got the “right” toilet training when I was growing up in a small town in Tanzania. My parents did not have the books which modern mothers have to guide them. We did not have the public health care system to help young mothers at home.
By the time I was born, my mother already had five children. So I am sure she knew what to do. My role in toilet training my children was to listen to my wife and follow her advice. “Mother knows best” is my mantra when I don’t know what to do. When I have to rush to work or to golf course then, of course, “mother knows best” works quite well. Sometimes it can back fire.
Ok, let us not digress. My eyes lit up the other day when I looked at the recent issue of the Canadian Medical Association Journal (CMAJ March 20, 2012). There is commentary titled, “Toilet training children: when to start and how to train.” It is written by Dr. Darcie A. Kiddoo, who is with the Divisions of Pediatric Surgery and Urology, Department of Surgery, University of Alberta, Edmonton, Alta.
So I said to myself, here is something scientific to tell me how to toilet train my grandchildren.
Dr. Kiddoo says, “Toilet training is felt to be a natural process that occurs with development, yet very little scientific information is available for the physicians who care for children. In reality, toilet training is a complex process that can be affected by anatomic, physiologic and behavioural conditions.”
Over the last 100 years, there have been many ways of toilet training our children. This varies from passive and lacking in structure, to coercive and regimented, to child-oriented and semistructured, says the article.
In 1962 Brazelton developed a “child readiness” approach, which was child-focused and unregimented. The children started training at 18 months of age, and, daytime continence was achieved by a mean age of 28.5 months.
Spock discussed toilet training in Baby and Child Care, published in 1968. His approach was similar to Brazelton’s. He was opposed to absolute rules that could result in behavioural problems.
Since then many methods have been described. These are: structured and parent-oriented, the very early approach of assisted toilet training in infants when the infant is two to three weeks of age, then there are other approaches which involve both positive and negative reinforcements.
Many studies have been published but none providing any definitive answer to the question – What is the best way to toilet train your child?
Despite the lack of evidence, the American Academy of Pediatrics and the Canadian Paediatric Society recommend a child-oriented approach based on expert opinion. They advise starting when the child is 18 months of age and suggest that the child must be interested in the process, says the CMAJ article.
If you toilet train your child later (more than 18 months of age) then there is a higher incidence of incontinence and urinary tract infections. Some experts have concluded that toilet training at a younger age (18 to 26 months) was associated with a longer training interval but no adverse events. But have no fear or sense of guilt, because there isn’t a final word written on this subject.
Three things to remember:
-Toilet training should be started when both the child and parent are willing and able to participate.
-A positive, consistent approach to toilet training is unlikely to cause long-term harm.
-Mother knows best.
Well, I wish your children happy “pooping.”