Report: Don't Rush to Toilet Train Tots
NEW YORK (Reuters Health) - Starting toilet training early may help children go diaper-free sooner than otherwise, but there can be such a thing as too early, researchers said Monday.
In fact, children whose parents started intensive toilet training -- defined as asking the child to use the toilet more than three times a day -- before they turned 27 months took longer to toilet train and did not complete the process at an earlier age than children who started training later.
So while the right time to toilet train may differ for every child, parents might want to postpone the process at least until the child is 27 months old, according to Dr. Nathan J. Blum and his colleagues at the University of Pennsylvania in Philadelphia.
"There doesn't seem to be much benefit to doing it for kids who are that young," Blum told Reuters Health.
"They don't toilet train any younger, and it takes a lot longer. You're going to be working at it a long time," he said.
But Blum added that the current findings apply to intensive toilet training, and do not suggest that parents ignore toilet training until their child reaches 27 months. Rather, he said that gentle introductions to the concept of abandoning diapers -- perhaps showing children a potty and describing how to use it -- could be helpful, even before 27 months of age.
"If your kid's really taking to (the potty) and wants to use it, I certainly wouldn't discourage that at any age," Blum noted.
Previous research has suggested that children who start toilet training at an early age finish at an earlier age than those who start later. However, other studies have suggested that starting kids on the road to full-time toilet-use can increase their risk of constipation and other troubles.
Blum and his colleagues obtained their findings by following 406 children between 17 and 19 months old as they went through the long process of toilet training.
To track their progress, the investigators phoned parents every two to three months, asking them if they had asked their children to sit on the toilet and how often their children had actually used the toilet when urinating or defecating.
Blum and his colleagues discovered that starting training early did enable children to complete the process at an earlier age than others -- except if parents initiated intensive training before children reached 27 months, that is.
In fact, starting toilet training before 27 months only lengthened the entire process, the authors report.
Despite the difficulties linked to early training, the authors did not find that early trainees were more likely than others to experience constipation or willful symptoms such as withholding stool or refusing to use the toilet.
In an interview, Blum explained that previous fears that early toilet training could cause problems in children stem from periods when experts were recommending that parents begin toilet training before children turned one.
None of the parents in the current study started the process of toilet training in children less than one, he noted, and the findings suggest that as long as training doesn't begin too soon, early onset will not pose a problem.
"Other than taking a long time, early toilet training wasn't associated with any problems," Blum said.
He added that judging when a child is ready to begin training can be very difficult for parents. Many experts have offered recommendations of signs that show the child is ready -- such as when he follows a parent into the bathroom, or generally wants to please -- but none has been "universally accepted" as proof of readiness, Blum said.
"If you find that you have to work (hard at toilet training before 27 months), wait until your kid's about somewhere between 27 and 33 months of age," Blum recommended.
"It still takes a while -- six months or so -- but it doesn't take a year, like it does if your kid's a lot younger," he said.
SOURCE: Pediatrics 2003;111:810-814.