I am coming to think, second time around, that starting earlier with potty training might be better. This is based entirely on personal and circumstantial evidence – friends who started their kids young telling their stories with smiles versus friends (and myself) starting at the currently recommended age and having horror stories. Now that my daughter has been using her potty a couple times a day for nine months or so, I thought it might be time to do some actual reading on the subject. She’s almost two, so this isn’t really early start anymore. Still, we started as early as we could, given her personal circumstances. Time will tell, and of course the sample is small to tell the difference between method and personality. So far, though, I’m going to say that early start does seem to lead to more fun with the process. I picked this book to read scientifically because the title called out to me from the library. The only other potty training book I have read is The No-Cry Potty Training Solution, which is decidedly the modern late-start approach. If you have other favorites, please do let me know.
Diaper-Free before Three by Jill Lekovic This book was for me a strange mixture of my favorite and least favorite styles of parenting books. It started off with a history of toilet training over time. She looks at literature describing when children used to be trained, advice for mothers from the Victorian era on, and studies of toilet training practices and the ages of beginning and completion from the past century. In the early Victorian era, toilet training began at birth, and advice columns told mothers that with most babies, there shouldn’t be a need to have soiled diapers left to wash by six months. Things drifted a little later in the early years of the last century, but kindness and paying attention to the child’s needs were keys. In the 20s, things started getting really rigid, to the point of using a brush to make children poop on schedule. This rigidness, Lekovic theorizes, is what caused the extreme counter-reaction in the 1950s and 60s. Led by Brazelton and fed by Freudian theory, pediatricians theorized that early potty training could cause sexual difficulties down the road. It would be better to wait a little, and let potty training be more child-led. Brazelton wrote at a time when most children finished potty training at about 18 months, but he thought that his new methods wouldn’t lead to children finishing learning any later. Boy howdy, was he wrong! It’s now most common for children to finish potty training at 3 or 4, with night-time learning lagging even farther behind. What is fascinating is that Brazelton’s recommendations, based on his theories and never backed up with any studies at all, took over. Now parents have to look at fringe movements to find books that recommend starting toilet learning any earlier than 2. I had multiple health care professionals give me the possibly crazy mother look when I told them I was starting my daughter at 15 months. With the increased use of disposable diapers, their ever-increasing capacity and their ability to keep wetness from being felt, the age of finishing toilet training continues to go up, even over the last decade. Meanwhile, there have never been any studies showing any kind of mental or physical damage from earlier toilet learning, and Lekovic feels (though with more back-up from her pediatric practice than from studies) that modern delayed toilet learning increases difficulties with things like diaper rash, urinary tract infections and other bladder ailments, and chronic constipation.
The next parts of the book describe her toilet learning plan, with later sections covering adapting the method for older toddlers, and problems like bed wetting.
She makes the case that since toilet learning and baby rearing are both hands-on, intensive processes, they are best combined, rather than waiting to try to teach a child who’s old enough to want some freedom from the caregiver. She recommends starting at six months, when babies are starting solids and can usually sit relatively stably. She recommends just sitting them on the potty at the same regular intervals throughout the day: at diaper changes, after meals, and so on. When they are able to do this well, succeeding if not all the time, at least at predictable times and (I think) walking, they’re ready to switch to padded underpants. At this phase, they may start asking to go to the potty, but Lekovic thinks that learning to potty when it’s convenient, not just urgent, is important. When they’re mostly successful here, they can move on to regular underwear and more independent pottying. Lekovic stresses that it’s fine for children to need help with their clothing and some reminders – they are still managing their bodies mostly on their own. Her experience is that most children trained in this fashion will be done around two, though others will take until three. Evidence shows, though, that the earlier children start, the earlier they finish.
Her toilet training method looked straightforward, and her phase one of toilet training was exactly what we’d been doing so far. According to her, we could have moved on to phase two some months ago. However, this hands-on section was where I got the feeling that she was speaking more as a pediatrician than as a parent. For example, when talking about preschoolers resisting potty training, she says that no child will keep resisting for more than a couple of days if the parent is firm and consistent. Maybe she could come and tell that to my children? Her tone is brisk and assured, meant for parents to be able to read quickly, but it sometimes came off to be as arrogance. Also, she is clearly aiming at mainstream parents – she thinks that in spite of all the problems that disposable diapers cause, cloth is just way too hard even to consider. She mentions on one page breastfeeding working mothers as an example of the work parents will do if they see sufficient benefit for their child, but all the rest of the time, she talks about babies and bottles. This is problematic yes, because pediatricians should be encouraging breastfeeding, but also because the people that now do infant toilet training also cloth diaper and breastfeed and care deeply about these topics. In trying to reach her hypothetical mainstream audience, Lekovic is turning off her actual parenting audience.
Also, as one Amazon reviewer pointed out, she gives no reason for starting at six months rather than birth. I personally one felt that caring for a newborn was quite enough without trying to add toilet training in at that point, but the rest of her book is so well researched that this is a noticeable omission.
This is a concisely written book meant for parents in a hurry. I really loved the history of toilet training, but those less interested in the history could skip that and go straight for the methods, which are even briefer. Ignore the bits where she is very dismissive of other methods. You might want a more comprehensive book if you run into problems or want to start potty learning at a different age than she recommends, but overall, this is a book that makes a convincing argument for earlier toilet learning and provides a simple, manageable method for doing so.
Originally posted at http://library-mama.dreamwidth.org .