Personal and familial factors associated with toilet training

Abstract

Purpose: Toilet training (TT) is an important marker in a child's physical and psychosocial development. The present study aimed to evaluate aspects associated to delayed TT. Material and Methods: We interviewed 372 parents of children who had completed TT up to 48 months before the interview. The questionnaires were applied at school exits when parents went to pick their children up and at public parks. Questions included demographics, aspects related to TT, dysfunction voiding symptom score and evaluation of constipation. Results: The interviews were performed at a mean of 15.3±10.4 (0 to 47) months after the end of TT. Girls accounted for 53% of the sample. The mean age at fi nishing TT was 31.6±9.3 months and similar in both genders (p=0.77). TT occurred before school entry in 45.7% of the children and medical advice for TT was sought only by 4.8% of the parents. No association was observed of age at completing TT and presence of lower urinary tract symptoms (LUTS) (p=0.57) and/or constipation (p=0.98). In the univariate analysis, prematurity (OR=2.7 [95% CI 2.3-3.1], p <0.0001) and mothers who work outside their household (OR=1.8 [95% CI 1.4-2.3], p <0.0001) were associated to delayed TT. Conclusion: Children completed TT at a mean of 2 years and 7 months of age. The age of completing TT was not related to LUTS and/or constipation. Premature children and those whose mothers work outside the home fi nish TT later.

Mother's Support Related to Toilet Training in Toddlers 18-36 Months

“…Toilet Training is an important step to support children's ability to control micturition and defecation independently. Control of elimination was carried out by the cerebral cortex which is responsible for facilitating and inhibiting the micturition reflex (Griffiths, 2015;Netto et al, 2020). To be able to perform these abilities a child needs to go through a complex process that is influenced by anatomical, physiological, and cultural factors (Carvalho et al, 2022).…”

“…It can be seen that maternal support has a very important role in supporting the success of TT. Mothers who provide good support, children are able to fight anxiety, can increase self-confidence, and are not afraid to do new habits (Netto et al, 2020). The role of the mother in accompanying the child to successfully carry out TT can have good benefits for the child's physical, psychological, cognitive, and emotional health development, and conversely, the low support of the mother can cause problems related to the child's development in the future.…”

“…One of the solutions to prevent enuresis in children is to do toilet training. Toilet training is a training process for children to be able to independently control elimination from using diapers to going to the bathroom like adults (Netto et al, 2020). Toilet training was recommended to applied when the child is ready to perform micturition and defecation independently, namely at toddler age (1-3 years), because at this age the ability of the urethral sphincter to control the urge to urinate and the anal sphincter to control the urge to defecate begins to develop (Luxem et al, 1994;.…”

“…The factors that could affected success of TT include the age of the mother, the education level of the parents, the mother's employment status, the socioeconomic status of the family, single parenthood, and the gender of the child (Schum et al, 2002;Koc et al, 2008;Joinson et al, 2009;Netto et al, 2020). Parental support has a big role in the success of the TT process, but now parents have a shift in roles to carry out activities outside the home or work (Ito et al, 2022).…”

Evaluation of the effects of the toilet training process on the children's quality of life

“…26 Enuresis has been found to be three times more likely in children who start toilet training before the age of 18 to 24 months. 27 Murillo et al 28 found no relationship between the age of starting toilet training and lower urinary tract dysfunction or constipation. Carvalho et al 29 also found no difference between the groups regarding the onset age of toilet training and occurrence of nocturnal enuresis.…”