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This question has been in the news this week, and not for the first time. Certainly teachers are reporting that more children are starting school in nappies than before, but is this a big problem, and is there any reason for it?
I've been teaching parents a Toddler Led approach to potty training for a few years, and now train other facilitators, and so I thought I would share my thoughts on the situation.
Disposable nappies?
People often point the finger at disposable nappies, and indeed they are very good at wicking away moisture, and potentially this can have the effect of children not realising they have done a wee or poo.
However, we do know that young babies will cry to have their nappy changed, so maybe that is not entirely the case. Also disposable nappies have been around for a long time now, and yet the annual school readiness report from Kindred Squared shows an increase in recent years, when, if anything, fewer children are using disposables.
Parents too busy or lazy?
Some have claimed, this week, that parents are ‘too busy’, or on their phones too much, to take the time to toilet train their children, but that isn’t my experience. Indeed the parenting book my mum bought in 1968, Baby and Child Care by Dr Benjamin Spock, had the same worries about parents being too busy, and children starting toileting later. I've been supporting families for a couple of decades and reports, newspaper articles, professionals, all seem ready to blame parents for whatever the issue is, without actually talking to parents.
Parents are more likely to be putting it off because they are worried about it. Potty training has a reputation for taking a long time, and being difficult. While potty training can mean extra work, for a short while, it doesn't need to be onerous. But parents don't have the support or guidance to help them, so they turn to the internet.
The information on the internet is usually promoting approaches that encourage parents to start before two, and to follow methods that may cause tension and stress, and parents share stories of how difficult it was, and how long it took. Or there are books that promise to get it done in three days, but this involves an intensive, and time consuming, behavourist approach, more akin to training an animal than supporting a human being through a developmental stage.
Lack of support and guidance?
When my children were small I had a long lasting relationship with their health visitors, who I turned to for advice frequently. The health visitors had time for extra home visits but they also attended toddler groups on occasion, and ran drop in sessions, and extra support. In the late noughties and early 2010s, you could often find the health visiting 0-19 team at Sure Start children's centres, and could also get parenting support from the centre's family workers. A report out last year showed that health visitor numbers in the UK had fallen by 40% since 2015.
During my time as manager of a Sure Start children's centre I saw the workload of health visitors change, as their safeguarding caseload increased. Continued underfunding of social workers, health visiting teams, and children's centres, has reduced the sparse universal services further.
One of the findings from the Kindred Squared report that the press and public seemed most shocked about was that 40% of parents felt that getting their child toilet trained was not solely their responsibility. Yet most parents are not solely responsible for their children's care; they share it with grandparents, nursery, childminder. They also need wider support. So much of the problems parents face is because we are expected to do a job alone, that for thousands of years has been a communal undertaking. We need our village. How did I know what to do? I was one of the eldest of 25 cousins, in a big, close, child-centred family.
Pandemic?
The children who started school last September were one year old at the beginning of the pandemic. Their parents and carers missed out on support for the next two years, not only from professionals, but also from other parents. There is research to show that children born in the pandemic were slower to meet developmental milestones than babies born before. It is not just the lack of support that is likely to have impacted children, but the stress of the pandemic on children and adults. We experienced a worldwide traumatic event, which we are still healing from.
Social media and perfectionism
All parents, including myself, suffer from imposter syndrome. Everyone else seems to be able to do this parenting lark easier. Their homes are cleaner. Their children are better turned out. They do more fun activities. Social media fans those flames.
Potty training is an unknown. It challenges us. It messes up our homes. It assails us with bodily fluids. It is no wonder that many parents would like to get through potty training without any wee or poo on the floor, and perhaps delay starting in the hope that if they wait till their child asks for the potty then they can miss out on that.
Body confidence
Part of the anxiety around supporting children through starting toileting can also come from a lack of body confidence in parents. Many parents were themselves brought up to see their own bodily functions as dirty, disgusting and shameful. They may carry negativity about their body, what it does, and what it looks like. Potty training raises all these traumas.
Lack of a push?
One of the big changes that happened with potty training, in the recent-ish past, was the 2010 Equalities Act in the UK. This made it illegal for any setting, such as schools, pre-schools, playgroups, and educational nurseries, to exclude children who were in nappies.
Before then most pre-schools, playgroups and educational nurseries, who tended to take children from age two and a half, had the requirement that children were out of nappies before starting. That pushed parents to get their children using a potty or a toilet by the start.
My eldest four children were all in that situation. One of my sons was not fully dry during the day, but I worked out that if I got him to go to the loo when he arrived at pre-school, then he could generally last the two and a bit hours till I picked him up. I think a lot of us did the same. But we now know that some children are ready by two and a half, many children are not ready until three years or older. How many children missed out on early education because they were not dry during the day?
Without that push to start toileting, parents have relaxed and are able to follow their children better.
It does however leave parents without direction, amid a flurry of mixed messages, conflating old ideas, handed down generation to generation, and modern pressures from social media and other parents.
Toddler led toileting
I have found that parents want to be more child led. I started my Toddler Led Toileting workshops because clients who had done Baby Led Weaning were asking me for something similar for potty training. A child centred approach is often associated with starting toileting 'later'.
In a report about the timing of starting toileting, ERIC, the children’s bowel and bladder charity, said,
“Parents today are more likely to feel that they should wait until their child is ready to be potty trained but aren’t always sure exactly when this should be. They worry that they could be doing harm to their child by taking nappies away too early.
A child-led approach worked well when children were wearing washable nappies, but it isn’t always as effective with disposables. There isn’t the same motivation for children to want to stop wearing them.”
As Sarah Ockwell-Smith points out in her book ‘Gentle Potty Training’, it is not as simple as this, parents now are aware of the benefits of having a child-led approach to bringing up children, backed up by research on neuroscience. Antenatal classes teach about infant brain development and the importance of responsiveness. We understand more about the impact on the brain of early experiences and many want to be less authoritarian and behavourist in our parenting.
It is not hard to argue either, that a child's motivation to move out of nappies lies not just the sensory issue of being wet, but also because they want to develop their skills, change and grow.
Starting toileting is not just down to motivation either, there needs to be physical, cognitive, and social developmental change, which they will all do at different times, and mostly between 2 and 3 years old. Even Spock in the 1960, who was advocating starting before 18 months, conceded that most children started self-toileting between two and three years. So yes, children may have started potty training earlier, but it just took longer before they were actually doing it!
Individual needs
Parents are also more aware of individual developmental and neurological differences, such as autistic spectrum conditions. Children who come under the neurodiverse umbrella (autistic, adhd etc) are more likely to be independently toileting later, not just because of sensory issues, balance, motor skills, but also because of a lowered sense of interoception (awareness of needing the loo, among other things).
Many of these children will not have a diagnosis, and indeed many parents may not be aware of this, but they do know that they want to follow their child's lead, and respond to their unique little human being.
When is the right time?
Research has shown:
Most children achieve the physiologic, cognitive, and emotional development necessary for toilet training by 18 to 36 months of age.
Markers of readiness for toilet training include being able to walk, put on and remove clothing, and follow parental instruction; expressive language; awareness of a full bladder or rectum; and demonstrated dissatisfaction with a soiled diaper.
Other readiness cues include imitating toileting behaviour, expressing desire to toilet, and demonstrating bladder or bowel control (staying dry through a nap or through the night).
Research has shown that starting toileting early can simply mean that it takes longer. For, as Spock knew in 1968, and we know now, the physiological, cognitive, and psychological developmental time for children to start independent toileting is between two and three years, because that is the biology. Obviously some children may be ready earlier, and some later than that.
So what should parents do?
As you can see, there are many factors affecting the timing of potty training. Obviously, it is easy to blame parents for being too busy or lazy, because that is what society always does.
Parents, search out communities. Trust yourself. Follow your child. Take the plunge. Allow yourself and your child to experiment, make mistakes, and try again. Relax. You will get there.
I have created a toileting readiness checklist which I hope will help you. Feel free to message or email me with your questions.
Further references
Spock, B, ‘Baby and Child Care 1968
ERIC press release ‘Rise in children starting school in nappies’
Ockwell-Smith, S ‘The gentle potty training book’, 2017
Sunderland, M ‘What every parent needs to know’ 2006
Gerhardt, S ‘Why love matters’ 2015
Harvard Centre for the Developing Child www.developingchild.harvard.edu
Association for Infant Mental Health www.aimh.org.uk
Baird, D et al Toilet training: common questions and answers American Family Physician Journal 2019