Infant's toilet training

Perhaps more family quarrels have been precipitated by the problems of toilet training than by any other part of the baby's learning process. There is considerable disagreement as to the when and how of toilet training and young mothers may receive rather conflicting advice. Perhaps the importance of establishing regular habits early has been much over-stressed. Babies who are too soon and too strictly trained frequently relapse later. Normally, bowel control may be expected at about twenty-one months, and bladder control soon after two years of age. Differences will occur, depending in part on the baby's health, and set-backs must be expected when the baby is ill, or disturbed or frightened by any event.
 

The whole training process should be treated as unemotionally as teaching a child to fasten buttons or to learn any other skill, but it is difficult for many mothers to think about it in this way. It is a mistake to start too soon, and better to wait until the child has reached the stage when these three following conditions can be noted.

First the child should be able to sit on his potty without strain and have acquired sufficient muscular control for this, i.e. any time after six months. Secondly he should be able to indicate his need in some way and also to understand what is required of him, so that he can co-operate, intelligently and not just in an automatic and uncertain way. Thirdly, and most important of all, he should have been able to form a definite relationship with the adult responsible for his care, to feel affectionate towards her and to be eager to conform for her sake, and to win her approval. This stage is usually not reached until nearly a year old. When all these conditions have been satisfied, and after weaning has been safely achieved, no great difficulty should be found in helping the child to gain first bowel and then bladder control and abandon the wearing of napkins, at least during the day. The child will take pride in acquiring this skill just as in any other achievement.

Praise should be given for successful efforts, but no undue disgust or shame shown over mishaps—merely some indication of their nuisance value. The child should be able to feel that his mother is trying to help him gain control, to grow up. Treatment of cases of incontinence has shown that these bodily products possess an emotional significance to the child. He feels a certain sense of power and creativeness in regard to them, and incontinence later on may be an expression of aggressive feeling towards his parents, or his failure to achieve control may be one symptom of his need to remain dependent on them. A breakdown in toilet habits is a common occurrence under any particular stress even among quite old children. It is incorrect to regard bowel and bladder control as a type of conditioned reflex uninfluenced by emotional factors. The human element looms large ; the quality of the mother-child relationship is all important. Patient encouragement will help the child most, and standards should not be set too high or too early.

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