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Toilet Training

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Early Childhood

The child at the beginning of life, instinctively – unconsciously performs physiological needs by emptying the colon and the bladder. As it grows, it gradually becomes aware of this bodily function. At the same time, the ability to control and retain the stool and urine develops as well as the ability to signal the parents about the urge, that is, begins to completely control this physiological need. The child becomes capable and conscious of the realization of this physiological need only when its nervous system develops to a certain degree of maturity. This happens roughly in the period when the child walks on its own, that is, before the end of the first and the beginning of the second year of life.

It is completely pointless before the end of that period to require from them to learn to control themselves. Developing the ability to learn or acquire a certain skill, takes place alongside the overall development of the child’s organism. It is therefore impossible for the child to learn something new as long as its development does not allow it. It primarily establishes control of the stool and later on urination. The bladder as an organ is much more sensitive than the colon and is susceptible to psychic influences as factors for proper work. So, the child will be uncertain for urinating control for a long time.

The Control of the Colon and the Bladder in the Child

Both the colon and the bladder are closed by muscle rings called sphincters. As their work is initially uncontrolled and later consciously managed, it makes them difficult to control, especially during sleep. The child must have a fairly developed nervous system that can automatically control this need while sleeping. Automatic sphincter’s control during sleep, is at first established on the colon and later on the bladder. Only at the end of the second or third year we can expect that the child will have complete control over them. Some children are establishing this control at the end of the third year, and some when they are turning to the fourth.

Controlling the Urine in Children: Is It “Lazy” or “Mischievous”?

In the successful taking of control, parents should take into account the fact that there are individual differences in children. Both children at the age of 18 months and those who later manage to control the urge for urinating, in 36 months, are treated as completely healthy and equally developed. The slow development of this control while sleeping does not mean that the child is ill or defective, and even less that it is “lazy” or “mischievous”.

The Control over the Exertion of Physiological Needs

There is another thing that should not be forgotten. The control over the exercise of physiological needs cannot be omitted. Everything that the parents will undertake prematurely in order to get out of practice the child from the spontaneous exercise of physiological needs gives the opposite effect. By forcing control over the necessity, they are only prolonging the period of the natural process necessary for self-control. It is not uncommon for parents to use violent measures, which in turn leads to neurotic disorders of the work of the sphincters, primarily the bladder.

Adaptation to the New Potty: A Step toward a New Routine

When the child is able to sit alone, already at the age of 7th-– 8th months, parents can already begin to introduce the potty, with attempts at intervals of 2 to 3 hours. In this way, you will be unequivocally accustomed to the new practice of necessity. Any attempt should not take more than 5 to 10 minutes, and then the pot should be put away or even better the child should be asked to stand up by itself, irrespectively on whether he or she is done. The child should not be allowed to sit for a long time on a pot, play, or the act to become a party.

Some children are initially resisting to sit on the pot. They should not be forced. A distraction is needed, for example: playing with a toy, a short story or something fun that will associate the child to sit on the potty. With this approach, the parent allows the child to adapt in a pleasant way to the new routine for the urge.  With every next attempt, the duration of the fun before sitting down on the potty should be shortened with the ultimate goal – the child to sit down without conviction and with one word. Forceful and authoritative approach will cause fear and resistance.

If a child hasn’t done the call of nature, it should not be reproached. It simply cannot suddenly become accustomed to the new practice, because there is simply no concept for it. Only with patience and repetition, the parent can awaken the conditional reflex in the child to perform potty needs. This means that the child will begin to feel the urge at the very moment when it sees the potty. The act itself creates a prerequisite for starting the work of sphincters – the ring muscles and thus the emptying of the colon and bladder.

Until this practice is well established by the nervous system, the child will still need the diaper in many cases. In the entirety of adaptation, the parents shouldn’t rebut the child at any cost.

Strict or rude treatment will only prolong the adaptation period and cause neurosis of the physical functions, and thus defiance of the child towards the parents. If it is handled in a peaceful and pleasant way, the child will only gradually start to talk about the need for a physiological need and sitting on a pot. Every successful attempt to use the pot should be rewarded with the parents’ appreciation for the child’s sense of security.

Sphincter Control in Sleep

Sphincter control while the child sleeps can not be stimulated or improved with anything. The only way is – not to take any actions. Automated control of the bladder during sleep is a very complex function of the nervous system. Any external intervention on the formation of that function is a gross violation of the nature of the child and the consequences can be far-reaching.

The Child’s Self-Control over Urination during Sleep: Bedwetting

Sleep is a vital function, allowing the child to recover and regenerate its nervous system. If we are disturbed during sleep, we will only prevent certain functions from developing, such as bladder control or urination. Therefore, it is essential that the parents leave the child to sleep peacefully and wait for the naturally developed self-control for urination. Meanwhile, any reproach or nervousness towards the child due to bedwetting is counterproductive. And even when it starts to control the urination to a certain extent during sleep, sometimes it will happen that it does not work. It will take some time for complete control over the bladder, and until then, parents should not pay any attention to it. However, at a given moment, the child will establish complete control over the physiological need for urination both during daytime and nighttime.

Many parents feel that they should take action if their child has been wetting the bed for a long time and rarely decide to wait. In the evening the child is denied the opportunity to drink liquids and is warned before going to bed or it gets a reward if it does not wet itself in bed. Overnight it is woken up several times and sleepy like that, put on a pot. Some parents are raising up the lower part of the child’s bed, others carry the child to the doctor or take other unwanted measures, hoping the child will stop wetting itself during the night. When all this does not succeed, they rebut, humiliate them before other children, or disregard them. The degree of frustration among parents due to the lack of patience goes to the extent that there are cases when the child is beaten or publicly humiliated before its peers.

With these actions, uncontrolled wetting that lasts until the end of the third year turns into a neurotic disorder of the bladder function, that is, pathological urination in bed – enuresis. It can take many years, sometimes to puberty. Enuresis occurs when parents with a wrong action negatively affect the child’s psyche by incurring fear, insecurity, guilt and dissatisfaction with the child because of lack of control over the physiological need. The work of the sphincters is largely influenced by emotions. When emotions are negative they cause disturbance to the normal work of the bladder in the child.


Each child individually demonstrates and exploits the urge. Some earlier in the day, some later, some ample, some less, depending on the regime, the type and amount of the diet. The metabolism of each child is different. As a general recommendation, it is okay for the parents in the morning after getting out of bed to “remind” the child by suggesting, but without persuasion, calmly and patiently, to it to sit down on the pot in order to achieve a long-lasting practice of morning discharge of the organism, which is also the most natural. Every evident anomaly in the stool’s regularity and urinating (restraint) in the child should be carefully monitored. If the child does not have a need to empty the bladder or colon for a long time than usual, then a consultation with a doctor is mandatory.