Toilet training and potty training

The control of sphincters is something that is innate to human beings, just like holding one’s head or being able to sit without support. An article by pediatrician Joana Martins.

When asked for advice on the best time to potty train, my answer is invariably: “don’t do it”. I issue this opinion based largely on scientific evidence on the subject and much less on my personal experience as a mother. However, I am pleased to say that in this specific topic, what science says and what my children know how to do is quite coincidental.

So why do I strongly discourage diaper training?

For the simple reason that it is unnecessary! Sphincter control is something that is innate to human beings, just like holding one’s head or being able to sit without support. It will happen when there is organic/physical, cognitive and emotional maturity. By physical maturity, we obviously mean a greater capacity of the bladder and by first unconscious and finally conscious perception of the sphincter function. And notice that for a sphincter to relax, there is indeed a very important reflex component, but above all there is the ability to interpret the signals that precede both bladder emptying and rectal ampoule emptying. There must therefore be a sense of storage (the feeling of bladder and rectal ampoule filling), urgency (being in distress or on the verge of relaxing the sphincter) and mastery of motor order that allows sphincter relaxation.

However, these organic factors will be widely influenced by cognitive and emotional factors.

By cognitive factors we have the perception of the behavior itself (urinating or defecating), the social convention of going to the bathroom, the request to go to the bathroom, the use of the potty or reducer, undressing and dressing.

Emotionally, children have to say goodbye to the idea of making their eliminations in a diaper and having someone take care of them or, as strange as it may seem to us adults, being able to say goodbye to something they see as theirs. It is precisely in balancing these three orders of factors that potty training occurs, not a day before the child is actually prepared, no matter how much effort parents and caregivers put in or how intensive the training is. And these are indeed the great complications of intempestively early potty training, sometimes before 18 months, just because it’s summer or because school says so.

Most importantly of all is not forgetting that kids are actually responsible for sphincter control and not adults who “train” them!

Changing our view and accepting that the merit is entirely theirs instead of ours leads us to accept that every child has their own time to acquire a new ability. And no, it’s not the parents’ fault for “not training enough” or for the child “being difficult to train”.

What to do then?

Potty training happens more quickly and effectively if children are always invited to participate in hygiene care. Even as babies! The way we explain to our children what we are going to do and how we are going to do it is vital. It is very important not to convey harsh messages about body parts or even eliminations. Saying “you’re dirty” or “you smell bad” is different from saying “your diaper needs to be changed”. This level of respect is very important so that children do not feel ashamed of themselves while they cannot control their sphincters.

Because there is a reverse of training that cannot be neglected: the truth is that early training can result in abnormal retention behaviors. Urinary retention and subsequently urinary incontinence, as well as fecal retention and consequent constipation.

Never force a child to use a potty or toilet. In this chapter, it is really important not to make the use of the toilet the preferred ground for typical power struggles at these ages.

If the child shows signs that he wants to use the potty, try asking if he wants to do it and accept no as an answer. Think positively: if your child can already give signs that he has perception/cognition of the function of his sphincters, we are on the right track!

Always offer the choice of using diapers or underwear, accepting if the child prefers to keep using diapers.

And finally, trust. Trust that your child will be able to learn by himself, in his own time, without haste, when and how he wants.

An article by pediatrician Joana Martins. in lifestyle.sapo.pt