Juliette Rayner
CHIEF EXECUTIVE, ERIC, THE CHILDREN’S BOWEL & BLADDER CHARITY
Over the last century, the average age that children are being toilet trained has risen from 12-18 months to an average of around three or even four years today.
School staff are diverting 2.5 hours a day, on average, away from teaching and towards supporting children who are not toilet trained. This has a knock-on effect on pupils, who lose around a third of learning time each day.
It’s important that potty training is done early for the benefit of children and those around them, so why isn’t it happening in all cases?
Potty training can be more difficult now than in previous generations, due to many social and economic factors affecting families. This is compounded by a lack of local paediatric continence services and fewer health visitors, which means families who are experiencing problems are finding it more difficult to get advice.
Research shows it is better for your child’s bladder and bowel health to stop using nappies between 18 and 30 months.
Leaving potty training later can lead to longer-term bowel and bladder issues. For example, it can hide conditions such as constipation.
Potty training earlier makes parents’ lives easier too! The longer you leave potty training, the harder it can be for your child to learn this new skill, accept not having a nappy on any more and be introduced to a new place to wee and poo.
Many parents wait for ‘signs of readiness’. Many children, and particularly those with additional needs, will never give any signs that they are ready to potty or toilet train. Most children are ready to master potty independence and lead in many parts of the process from around 18 months.
Most parents find that a good time to start helping their child learn potty skills is from the time they can sit up, usually around six to nine months.
By starting the process early and gently, when the time comes to stop wearing nappies, children will already have some skills to make this transition easier and less daunting for all involved.
ERIC offers free support and guidance on potty training, As a charity, we rely on donations to fund our vital work. To ensure we can continue offering this support, please donate to our Christmas Appeal: https://eric.org.uk/eric-christmas-appeal-2024
Steve Hodges
PROFESSOR OF PAEDIATRIC UROLOGY, WAKE FOREST UNIVERSITY SCHOOL OF MEDICINE IN CAROLINA, USA; CO-FOUNDER OF BEDWETTINGANDACCIDENTS.COM; AND AUTHOR
As a paediatric urologist, I would submit that there is no sound evidence children are actually toilet training later these days, and many adults misunderstand why four-year-olds wear nappies.
In short, these children are toilet trained. But they also have chronic constipation, a condition that wreaks havoc on bladder control. Often, constipation stems from toilet training too early.
Based on my research and experience, I know children trained before age two have a significantly elevated risk of developing chronic constipation, enuresis (daytime or nighttime wetting) and encopresis (poo accidents).
Let’s revisit the notion that more children today are arriving at school in nappies. I’ve been hearing this for 20 years!
Based on unscientific surveys or anecdotal teacher reports, media declare a ‘concerning education trend’, blaming ‘lazy’ parents. Today, teachers still lack training on toileting dysfunction, parents still shoulder blame, and children still lack the treatment and support they deserve.
Toilet training is not a skill that gets locked in, like reading or bicycling. A toddler who uses the toilet beautifully can develop enuresis or encopresis at age five.
Sure, many babies can use the toilet. But this isn’t the same as possessing the maturity to heed your body’s signals promptly. It’s important that young children use the toilet when the urge strikes.
Humans have the capacity to override our bodies’ signals, and the praise toddlers receive for ‘staying dry’ motivates them to delay pooing and peeing.
So, stool accumulates in the rectum, forming a hard mass that makes pooing painful, prompting children to delay further. More stool piles up, and eventually the enlarged rectum encroaches upon the bladder nerves, triggering wee accidents. Holding urine for hours further aggravates the bladder.
What’s more, a stretched rectum loses tone and sensation, and stool may drop out of the child’s bottom without the child noticing.
Teachers consider the student ‘not toilet trained’. In reality, the child cannot feel or control the accidents.
I advise waiting until a child demonstrates the maturity to toilet train – when the child can dress without help, shows interest in using the toilet, and notices a wet or dirty nappy.
