Treinamento esfincteriano precoce: prevalência, características materna da criança e fatores associados numa coorte de nascimentos

Mota, Denise M.; Barros, Aluísio J D

doi:10.1590/s1519-38292008000100012

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…23 The same phenomenon is being observed in other places, with mean age of acquisition of bladder and bowel control being around 36 months of age. 4,24,25 On the other hand, early training (before 18 months) is still common in some cultures.…”

Section: Discussionsupporting

confidence: 59%

Aquisição do controle esfincteriano em uma coorte de nascimentos: situação aos 2 anos de idade

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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Objectives: Acquisition of bladder and bowel control is influenced by physiological, psychological and sociocultural factors. The objective of this study was to evaluate the prevalence of children out of diapers by 24 months of age and the factors associated with this finding.Methods: A total of 3,281 children born in Pelotas, RS, Brazil in 2004 were enrolled on a longitudinal study. At 24 months their mothers were visited at home and replied to a questionnaire containing questions about sociodemographic data and the characteristics of their children's urinary and intestinal evacuation habits, with special attention to toilet training. Multivariate analyses were carried out using Poisson regression.Results: From the total, 24.3% were out of diapers during the day, with the female sex predominating (27.8 vs.21.1%, p < 0.001) and 8.6% were out of diapers at night, also with the female sex predominating (10.6 vs. 6.8%, p < 0.001). The abilities needed to start toilet training were present in 85.5% of the children. Guidance was received from a pediatrician in 10% of cases, and more frequently among richer mothers than among poorer mothers (22.9 vs. 4.8%).Mothers who spent more years in education (13.2%) and were from higher social classes (14%) took their children out of diapers later; a greater number of children living at home (relative risk = 1.32) and being able to communicate the need to go to the toilet (relative risk = 11.74) both increased the probability of being out of diapers; previous unsuccessful attempts delayed removal of diapers (relative risk = 0.59). Conclusions:Although the abilities needed for acquisition of bladder and bowel control were already present at 24 months, indicating that toilet training could be started, the majority of children had not yet started this training.Better-informed mothers delayed training the most.J Pediatr (Rio J). 2008;84(5):455-462: Toilet training, children, bladder control, bowel control, voiding dysfunction.

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Section: Discussionsupporting

confidence: 59%

Aquisição do controle esfincteriano em uma coorte de nascimentos: situação aos 2 anos de idade

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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“…Para esta análise, foram utilizados os dados da visita dos 24 e 48 meses 6,11 . Durante os quatro primeiros anos de vida, houve 94 óbitos, 6,8% de perdas e 1,2% de recusas, sendo avaliadas aos 48 meses, um total de 3.799 crianças (92% da coorte original).…”

Section: Metodologiaunclassified

Longitudinal study of sphincter control in a cohort of Brazilian children

et al. 2010

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Objective: To analyze sphincter control acquisition in a birth cohort.Method: 4,231 children born in 2004 in Pelotas, Brazil, were included in a longitudinal study. During home visits at the ages of 12, 24 and 48 months, the mothers answered a questionnaire about sociodemographic questions and characteristics of their children's voiding and bowel habits, with special attention to toilet training. Results:At 48 months, most children were off diapers during the day (98.5%) and by night (83%), with no difference between sexes. The average age for starting toilet training was 22 months, with earlier initiation in girls. The training was, on average, 3.2 months long, showing no difference between sexes. Children with developmental delay had late voiding and bowel control; the higher the deviation from normality, the later the child was off diapers. Medical advice was given to 15.9% of mothers. The training initiated before the age of 24 months was inversely correlated with an older age of sphincter control and longer training. Premature and low birth weight children showed no significant difference in training time and age of acquisition of sphincter control. Conclusions:At the age of 48 months, most children, including premature and low birth weight ones, acquired sphincter control regardless of external factors and sex. The beginning of training (before 24 months) did not anticipate sphincter control, but only prolonged the duration of training. J Pediatr (Rio J). 2010;86(5):429-434:Toilet training, child, sphincter control, epidemiology. ResumoObjetivo: Avaliar a trajetória do controle esfincteriano em uma coorte de nascimento.Método: Quatro mil duzentos e trinta e uma crianças nascidas no ano de 2004, em Pelotas, RS, foram incluídas em um estudo longitudinal. Em visitas domiciliares realizadas aos 12, 24 e 48 meses, as mães responderam a um questionário com questões sociodemográficas, características dos hábitos miccionais e intestinais das crianças, com atenção ao treinamento esfincteriano.Resultados: Aos 48 meses, a maioria das crianças estava sem fraldas durante o dia (98,5%) e à noite (83%), sem diferença entre os sexos. A idade média de início de treinamento esfincteriano foi 22 meses, com início mais precoce nas meninas. A duração média do treinamento foi de 3,2 meses, sem diferença entre os sexos. Crianças com atraso de desenvolvimento apresentaram controle esfincteriano mais tardio, havendo relação direta entre a intensidade do desvio da normalidade e a idade da retirada de fraldas. A orientação médica foi fornecida a 15,9% das mães. O treinamento iniciado antes dos 24 meses esteve relacionado com uma maior idade de controle esfincteriano e maior duração do treinamento. Crianças prematuras ou com baixo peso não apresentaram diferença significativa no tempo de treinamento e idade de aquisição do controle esfincteriano. Conclusões:Até os quatro anos de idade, a maioria das crianças, inclusive prematuros e de baixo peso ao nascer, obtém controle esfincteriano independentemente de fatores externos e d...

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“…17 A recent study based on the 12-month home visits paid to the Pelotas 5.6% cited some type of ability acquired by the child as a parameter to indicate that toilet training should be initiated and 53% of mothers decided to take their children out of diapers based on the child's age. 18 Despite these expectations, when the same cohort was visited at 24 months, just 25% of children were out of diapers during the day and 9.5% at night (unpublished observation). It is important to bring this subject up with families, since the correct guidance can help prevent family conflicts between parents and child.…”

Section: Parents' Expectationsmentioning

confidence: 97%

“…6 The social context and aspects of the culture in which the child lives contribute to the way they are cared for, both by family members and daycare staff and by health professionals. 10,42 Poorer mothers who have spent less time in education start training earlier, 43 as do younger mothers, 18 basing the decision purely on the age of the child, without giving importance to their development. Knowledge on the subject is greater among mothers in more favorable economic situations.…”

Section: Factors That Can Affect Trainingmentioning

confidence: 99%

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

Mota¹,

Barros²

2008

J. Pediatr. (Rio J.)

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Objective: To review both the scientific literature and lay literature on toilet training, covering parents' expectations, the methods available for achieving bladder and bowel control and associated morbidities. Summary of the findings:Parents have unrealistic expectations about the age at which diapers can be withdrawn, not taking child development into account. Toilet training strategies have not changed over recent decades, and in the majority of countries the age at which children are trained has been postponed. Training methods are rarely used.Starting toilet training prematurely and stressful events during this period can extend the training process. Children who have not been trained correctly present with enuresis, urinary infection, voiding dysfunction, constipation, encopresis and refusal to go to the toilet more frequently. Literature intended for lay parents is both abundant and adequate, available in book form and on the Internet, but it is not widely available to the Brazilian population. Just three international pediatrics societies have published guidelines on toilet training. Conclusions:Toilet training is occurring later in the majority of countries. The training methods that exist are the same from decades ago and are rarely used by mothers and valued little by pediatricians; incorrect training can be a causative factor for bladder and bowel disorders, which in turn cause problems for children and their families.J Pediatr (Rio J). 2008;84(1):9-17: Toilet training, enuresis, child, urinary tract infection, elimination disorders.

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Treinamento esfincteriano precoce: prevalência, características materna da criança e fatores associados numa coorte de nascimentos

Cited by 7 publications

References 20 publications

Aquisição do controle esfincteriano em uma coorte de nascimentos: situação aos 2 anos de idade

Aquisição do controle esfincteriano em uma coorte de nascimentos: situação aos 2 anos de idade

Longitudinal study of sphincter control in a cohort of Brazilian children

Treinamento esfincteriano: métodos, expectativas dos pais e morbidades associadas

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