WebMD The Magazine - Feature
Roy Benaroch, MD
Getting ready to tackle potty training in your household? You’ve probably
read reams of information on the topic -- but you may not have come across
these seven little-known facts.
Despite all the articles on toilet training in the popular media, very few
scientific studies have addressed the issue of how best to potty train a child.
“Most of what parents read in the lay literature -- whether it’s about the
right age to potty train or the right approach to use -- isn’t backed up by
scientific evidence,” notes Timothy Schum, MD, an associate professor of
pediatrics at the Medical College of Wisconsin.
In the 1940s, the average age for potty training was 18 months. Averages
today, according to a 2001 study by Schum, show baby boys in the United States
give up diapers at 39 months and girls at 35 months.
Some experts have attributed the rising age of potty training to permissive
parenting (and overzealous marketing by diaper companies). But it could show
that “we’re learning that pressuring children to achieve potty training isn’t
constructive,” says Andrea McCoy, MD, an associate professor of pediatrics at
Temple University. “Two-year-olds are working to express their autonomy.
Engaging in power struggles with them is frustrating and fruitless.”
Just because your toddler can stay dry during a nap doesn’t mean he’s ready
to use the potty consistently. Your child also has to want to use the potty.
Signs of that readiness include being able to follow simple instructions
(“Don’t forget to pull your pants down!”), wanting dirty diapers to be changed,
and being interested in “big kid underwear.”
Babies don’t have the “ability to hold urine and stool until they’re at
least 12 to 18 months old,” McCoy says. So while they may learn to associate
the toilet with elimination, they’re not actually being toilet trained.
Dozens of studies have shown that, contrary to popular belief, the age of
potty training won’t turn someone into a compulsive cleaner, a slob, or any
other type of personality.
Kids have accidents at night long past the time they achieve daytime
dryness. Indeed, 22% of all children are still wetting the bed at night at age
3, and 10% are still wetting the bed by age 7. “Children can’t stay dry at
night until they start producing a hormone that signals their body to stop
making urine at night,” McCoy says. “That doesn’t happen until it happens.”
SOURCES:Andrea McCoy, MD, Section Chief, Pediatric Primary Care; associate professor
pediatrics, Temple University School of Medicine.Timothy Schum, MD, associate professor of pediatrics, Medical Center of
Wisconsin.Kiddoo, D., Evidence Report/Technology Assessment No. 147.The Effectiveness of Different Methods of Toilet Training for Bowel and
Bladder Control, (Prepared for Agency for Healthcare Research and Quality),
2006.Goode, Erika. “Two Experts Do Battle Over Toilet Training,” in The New
York Times, Jan. 12, 1999.Schum, T., Ambulatory Pediatrics, March-April 2001; vol 1, issue 2:
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