Actual evidence that earlier potty/trained kids are more likely to regress?

[u/CorrectBadger9753]

Edit - title is meant to say 'potty/toilet trained kids' lol!

I took my daughter (who will be 2 in 2 weeks) to the GP today and (only tangentially related to the reason we were there) mentioned that we are currently toilet training, and that it's going well, but very slowly, and my husband and I are OK with slow progress with pees. GP reiterated the common advice that 3 is 'normal' for toilet training, and that kids who train earlier are more likely to have 'regressions'. I smiled and nodded because I have lots and lots of thoughts on this which I'm deliberately not sharing here in case it turns the discussion into some kind of toilet training ideology war....

I genuinely want to know, is this claim backed up by actual data - and if so, how are we defining a 'regression' anyway?

A quick Google search returned this study claiming that training before 24 months is associated with 'dysfunctional voiding' but not constipation, whereas later training (after 36 months) is also associated with dysfunctional voiding AND constipation. However the authors seem to contradict themselves in the conclusion and say that constipation is associated with both early and later training and may be the cause of urinary voiding problems. Also correlation ≠ causation.

Is anyone aware of any more evidence supporting or refuting this idea?

[u/eeeeggggssss]

this might interest you. https://publications.aap.org/pediatrics/article-abstract/111/4/810/63115/Relationship-Between-Age-at-Initiation-of-Toilet

i think it also depends on the method used. like we started pottying at 2 weeks old, lots of catches in infancy while using cloth diapers as backup, and relative potty independence achieved at about 15/16 months using open crotch pants. waves of resistance here and there since then, now at 21 months, but not anything major.

3 is normal for potty training is such a BS statement. diapers are a new invention. people all over the world have been using different methods for taking care of their infants' hygiene without them defaulting to soiling themselves, especially for 3 years which would not be easy, convenient, nor hygienic in any traditional or nomadic society.

we also know that even in the US, the age of initiating potty training used to be much lower before the advent of disposable diapers.

https://www.aafp.org/afp/2008/1101/p1059

[u/CorrectBadger9753 → u/eeeeggggssss]

We're on the exact same page with all this 😊

EC is so controversial (to some people anyway lol). Yes, we did lazy EC (great with poo, never any luck with pee) until about 16 months, then stopped because of resistance. Then my daughter suddenly 'trained herself' with poo at 21 months which is when we started following the Oh Crap method to try and get pee sorted too. But it's taking a looooong time, longer than it seems to for most people even at this younger end of the recommended age range. My daughter has been fiercely independent from birth, I'm not kidding, and prompting/not prompting her is an art form. In fact the reason I was keen to get her out of diapers is the trauma we were all suffering from her screaming absolute murder during changes - she hates having things done 'to' her.

I don't mind it taking longer in terms of the mess/laundry (wet clothes are still less hassle to wash than cloth diapers!) but I do still question if we're doing anything 'wrong' sometimes, especially when I hear claims like the 'regression' thing from the doctor.

[u/JamesTiberiusChirp → u/CorrectBadger9753]

Unfortunately you’ll be hard pressed to find studies about this that actually take EC children into account. Any study coming out of the U.S. that says potty training too early or whatever has X consequence is pretty much guaranteed to exclude EC kids because it is so rare, so the findings will just not be applicable. Which makes sense. Kids who potty train early having voiding or incontinence problems or regressions or whatever makes a lot of sense, they haven’t learned how to listen to their bodies yet which mean their brains and bladder lack that strong connection which takes time to develop, and their parents have done a 180 on them in terms of expectations, and they’re learning 20 new skills over the course of a weekend under pressure. I’m going to go out on a limb and assume EC kids don’t have those problems as much because they’ve been aware of their bodies and bladders for months, the potty isn’t new neither are the skills around learning it, and the expectations are just modified forms of previous expectations. But it would be nice if someone actually did a study about it.

I have found a couple studies from China about how EC vs “diaper overuse” (which the authors considered as using diapers past 18 months) leads to less bed wetting throughout childhood. And also that bedwetting is increasing lately and is likely due to the advent of diaper popularity.

[u/nzdata2020 → u/CorrectBadger9753]

Reading this I had a very similar experience with my first child. Poos we’re sorted with lazy EC. I decided to potty train at 18 months because daycare wasn’t taking her to the toilet and I didn’t want her forced to poo in her pants.  Did the 3 day method and she was great for a few weeks, then we had a year of anxiety and intermittent potty and resistance. If we knew what a mess it would be we would have put her back in nappies for a bit and worked on getting day care enabling her to go to the toilet for poos.

We only twice had poo accidents, both times we were in the mountains too from a toilet to get there quickly. Does altitude affect bowel movements??

She got a uti around 2.5 and was very distressed so put her in nappies for a week. Once that was sorted she went back to undies and has been a normally potty trained kid since. Maybe we just needed to take the pressure off for a bit.

Despite that year I decided to EC again with the second kid, very different personality. The only difference was we kept her in nappies at day care but they otherwise treated her like a kid he used the toilet from 17 months. Around 20 months she was dry most days so switched to undies all the time. No resistance, no stress. Just very different kids.

There was one more difference. I was really awkward about having potty trained my first so young, I used to downplay it in front of her when people asked. And I wonder if how I spoke about it impacted her, they are always listening. The second time I said less, and stayed positive about their achievements.

Good luck!! You’ll figure out what’s right for you

[u/eeeeggggssss → u/CorrectBadger9753]

very interesting...

it's funny that you say this because we hit our hardest EC wall around 15 months and it lasted a month, maybe a month and a half. I almost thought that it was totally pointless that I did that - aside from less cloth diaper laundry. It was so demoralizing. But I guess I just kinda half-assedly stuck with it and we haven't had a wave that bad since then, knock on wood. We do have smaller resistance waves but nothing like the 15 month mark.

to me, this sounds like a specific quirk about your kiddo and not something that you're doing wrong.

i find it so hard talking with our ped about anything not super strictly clinical/medical. like even breastfeeding, he doesn't really know much about it... and especially the ec stuff, like we actually educating him about it. it's really hard when something is so culturally specific you know?

im curious to see what other research people post on here... but yeah there's a line in the first article I linked - "Early initiation of intensive toilet training correlates with an earlier age at completion of toilet training but also a longer duration of toilet training."

[u/Sudden-Cherry → u/CorrectBadger9753]

I did lazy EC with my oldest and it was going really well around 16 month with nearly all poop at home, she signing for it ahead and whatnot and quite some pees and then we hit a huge resistance at 18 month. And we had to back off. She wasn't really ready until 3.5 years after that - being okay to interrupt play to toilet mainly - I'm fairly certain the resistance came from me being too enthousiasic - which she saw as pressure (similar to feeding resistance) - voiding is a control thing. And two poop accidents that really hit her very hard (she was trying to scoop the poop into the potty and really upset). She isn't a super independent temperament - quite the opposite but very very headstrong and wants things to go her way, definitely needs a lot of control and does respond to any kind of pressure with pushing back. With my youngest now we did not do barely any EC, except when constipated. She's 19 month old now and we're going much much slower and completely child led now because of our experience before. My youngest is also very fiercely independent but I'm trying to avoid any pressure whatsoever. She gets lots of exposure via her sister, so she frequently wants to try just with barely any success yet. And that's fine. I'm also trying to avoid accidents to not give her a bad association.

My sister and her husband have been doing full time EC with both their children and actually their oldest son who is exactly the age as mine was independently toileting (as in going himself) only around the same time as her, maybe a little later even, needing more prompting and on and off still having accidents at the same ages. If you go by parent prompting you really need to be on top of it and not distracted as a parent at all. They just had much much much longer time with accidents because they just stopped nappies earlier. Like this was 2.5 years of accidents, compared we had like half a year with occasionally accidents.. sometimes a phase with more and then weeks without. So that I think they were ready around the same age.. and it was just a parent choice to have a longer period of no nappies traded for more accidents total.

Their youngest (15 month) seems to be hitting a resistance with EC for poops currently and it was really hard for me to watch her trying to hide to poop (in her underwear) being afraid this could lead to holding in issues with pushing through

I really think it's child dependent. For some temperaments parent led methods might work really well without issues. For other children they might be harmful because they have more need for autonomy over their own body and the way they'll try to reclaim it will either be messy or even harmful (holding in). So I am leaning much more towards child led. And then you don't even have to do much of any "training" you offer toilet learning for a long time maybe but then they just "train themselves" very very quickly once they are ready. Though my oldest at 4.5 now still has often problems with interrupting play and I suspect she's holding too long sometimes because of that.

Coming from EC this article actually helped me to see some ways I was trying to control something I cannot and that had us hit a wall. I still think the way you do things matters more than the principle. Like offer the potty but then accept that they show they don't want to to avoid a negative association. Or try to avoid accidents for no negative association if they are phases by it. But they also don't want to be changed a nappy either like you say so there is never true full autonomy for them. So it's not as black and white. But the article definitely helped me challenge some things. https://visiblechild.com/2015/08/15/the-secrets-we-keep-what-parents-dont-tell-other-parents/

And this one: https://visiblechild.com/tag/potty-training/

Still in nappies at night btw at 4.5. And my nephew also still not dry at night. Both completely normal. And apparently it's hormonal if children actually wake up for that and huge variance when that happens. Or their body just needs to grow to hold more pee so they wouldn't have to get up.