tag:theconversation.com,2011:/us/topics/toilet-training-32426/articlesToilet training – The Conversation2023-09-18T12:19:01Ztag:theconversation.com,2011:article/2047892023-09-18T12:19:01Z2023-09-18T12:19:01ZWhat happens if you need to pee while you’re asleep?<figure><img src="https://images.theconversation.com/files/536919/original/file-20230711-19-qt6put.jpg?ixlib=rb-1.1.0&rect=703%2C209%2C4288%2C2597&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Your bladder can signal the brain when it's full, even while you're asleep.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/toilet-bowl-in-the-restroom-dramatic-lighting-copy-royalty-free-image/1303857822?adppopup=true">Happyphoton/iStock via Getty Images</a></span></figcaption></figure><p><em><a href="https://theconversation.com/us/topics/curious-kids-us-74795">Curious Kids</a> is a series for children of all ages. If you have a question you’d like an expert to answer, send it to <a href="mailto:curiouskidsus@theconversation.com">curiouskidsus@theconversation.com</a>.</em></p>
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<p><strong>What happens if you have to go to the bathroom in your sleep? – Calleigh H., age 11, Oklahoma</strong></p>
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<p>As you drink water during the day, your body turns extra liquid it doesn’t need into pee. Your bladder stores the urine and eventually alerts you when it’s time to take a trip to the toilet.</p>
<p>But what about at night? How does your body know not to pee while you’re asleep?</p>
<p>Just because you’re snoozing doesn’t mean your body is totally offline – continuous processes like breathing, digestion and, yes, making pee, still happen while you’re asleep. Your bladder and your brain work together to know what to do with that big glass of water you drank before bed.</p>
<p>Using the bathroom every day is routine for many people, so it’s something you might not pay much attention to. But as a <a href="https://www.seattlechildrens.org/directory/jennifer-jihyun-ahn/">pediatric urologist</a>, understanding how the brain and bladder work together – and sometimes miscommunicate – is an important part of my job. </p>
<h2>The bladder and the brain</h2>
<p>The bladder has two main jobs: to safely store urine and to empty it out. While it seems simple, these two tasks take <a href="https://www.mea.elsevierhealth.com/campbell-walsh-wein-urology-9780323546423.html">a lot of complex coordination</a> of muscles and nerves – that’s the brain’s job.</p>
<p>For babies and young kids, the bladder has reflexes, meaning it automatically knows when to squeeze the muscles to empty the urine. Since babies can’t control this consciously, they typically wear diapers. But <a href="https://www.seattlechildrens.org/health-safety/keeping-kids-healthy/development/toliet-potty-training/">as kids grow</a>, the bladder muscles and nerves also grow, which gives a youngster more control over their bladder. </p>
<p>During <a href="https://pubmed.ncbi.nlm.nih.gov/31613577/">toilet training</a>, which usually happens by the age of 3 or 4 in the U.S., kids learn how to use the toilet voluntarily. This means that they can feel when the bladder is getting full and their brain can receive and understand that signal. The brain can then tell the bladder to “hold it” until they’ve made it to the toilet and it’s safe to pee.</p>
<h2>What happens in sleep mode?</h2>
<p>Most children first learn how to use the toilet during the day. Using the bathroom overnight <a href="https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Bedwetting.aspx">can be more difficult</a> because the sleeping brain doesn’t receive signals in the same way as when awake. </p>
<p>While awake, if there’s a loud noise or a bright light, the body senses it and reacts. But during sleep, the body may not hear that noise or see that light because the brain is in <a href="https://doi.org/10.1016/j.smrv.2019.101228">sleep mode</a>. Imagine sleeping through an overnight thunderstorm that you didn’t realize happened until you hear people talking about it in the morning. Your brain didn’t process the loud noises because it was focusing on sleep.</p>
<p>The same thing can happen with bladder signals. The bladder fills with urine 24 hours a day, even while you’re snoozing, and it sends signals to the brain when it’s full. In order to help you get enough sleep, your brain will tell your bladder to hold it until morning.</p>
<p>Sometimes, if you really need to go, your brain will tell your body to wake up so you can go empty your full bladder. While it’s normal to wake up to pee sometimes – especially if you drank a big cup of hot chocolate right before bed – most older kids can usually sleep through the night without needing to use the toilet.</p>
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<p>When the brain and bladder are working together well, your bladder gradually fills up overnight and hangs on til morning when you stumble into the bathroom to empty it.</p>
<h2>Nighttime accidents</h2>
<p>But there are many ways the communication between the brain and the bladder can break down. For one, the brain may not get the bladder’s message that it’s time to go. Even if the brain gets the message, it may not be able to tell the bladder to hold on. Or, when the bladder can’t wait, the brain might not tell your body to wake up. If the signals and messages aren’t sent, or are received incorrectly, the bladder will go into <a href="https://doi.org/10.1016/j.smrv.2019.101228">reflex mode</a> – it squeezes to empty itself of pee, even though you’re fast asleep in bed.</p>
<p>Wetting the bed at night, which doctors call nocturnal <a href="https://www.britannica.com/science/enuresis">enuresis</a>, is more common than you might think. <a href="https://www.healthychildren.org/English/ages-stages/toddler/toilet-training/Pages/Bedwetting.aspx">About 15%</a> of kids between ages 5 and 7 wet the bed sometimes. Even some teenagers experience it. It’s more common in boys, and often there’s a family history, meaning parents or relatives may have dealt with nighttime accidents too.</p>
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<a href="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A child's legs, wearing pajama pants, against a grey floor. A wet stain is visible on their bottom and on the ground behind them." src="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/536921/original/file-20230711-19-pfnduo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Many children wet the bed at night.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/unrecognizable-child-legs-on-wet-bed-incontinence-royalty-free-image/1398170112?adppopup=true">Olga Rolenko/Moment via Getty Images</a></span>
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<p>There are a few reasons why nighttime wetting happens. Since kids’ brains are growing and developing, nighttime communication between the brain and bladder can take longer. </p>
<p>Some bodies make more pee at night, making it more likely the bladder will get full during sleep. Some people have smaller bladders that fill up fast. Sometimes having difficulties with sleep or being a deep sleeper <a href="https://doi.org/10.1016/j.smrv.2019.101228">can make it harder</a> to wake up at night if you really need to pee.</p>
<p>Most kids who wet the bed at night outgrow it as their brains and bodies continue to develop. At that point, they can sleep through the night without needing to pee, or their bodies are able to wake up at night to use the bathroom when they need to. </p>
<p>If wetting the bed is an issue, there are <a href="https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Nocturnal-Enuresis-in-Teens.aspx">some things that can help</a>, like drinking less liquid in the evening or using the bathroom right before you go to bed. These precautions make it less likely that the bladder will be too full during sleep. There are also bedwetting alarms that can help train the body to wake up when the bladder needs to be emptied. If there are concerns about nighttime accidents, or if accidents start happening in older children, I recommend consulting a doctor. </p>
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<p class="fine-print"><em><span>Jennifer Ahn does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A pediatric urologist explains how the bladder and the brain communicate to wake you up when you need to ‘go’ – and how that communication might break down.Jennifer Ahn, Assistant Professor of Urology, School of Medicine, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1676282021-09-20T05:51:48Z2021-09-20T05:51:48ZWhy you shouldn’t make a habit of doing a ‘just in case’ wee — and don’t tell your kids to either<figure><img src="https://images.theconversation.com/files/420190/original/file-20210909-25-123ez87.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C6000%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>We’ve all done done a quick “just in case” wee before heading out or because we’re passing the bathroom. If you’re a parent, you might have also told the kids to “do a wee now so we don’t have to find a toilet later.”</p>
<p>Doing a “just in case” wee isn’t a problem if it’s just occasional and if you have normal bladder function.</p>
<p>But doing it too often, making a lifetime habit of it, can kick off a vicious cycle. You can end up training your bladder to “think” it needs to go when it’s only slightly full. And the problem can worsen over time.</p>
<p>If you’re always ducking to the loo to wee at even the slightest tingling sensation, have a go at resisting that first urge — and consider seeing your GP or a pelvic floor physiotherapist about it.</p>
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Read more:
<a href="https://theconversation.com/curious-kids-why-is-urine-yellow-117747">Curious Kids: why is urine yellow?</a>
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<h2>Your bladder can probably hold more than you think</h2>
<p>Most bladders are actually capable of holding quite a lot of fluid. </p>
<p>For those with normal bladders (that is, you haven’t been diagnosed as having an overactive or irritable bladder), every day capacity is between 400–600 mls. It should take about two hours for the water you drink to make its way to the bladder. </p>
<p>So if you drink a 600ml bottle of water, it would be perfectly reasonable not to actually need to go to the toilet until a couple of hours later. In reality, however, I know of people who say they drink just a small amount and head off to the bathroom shortly after.</p>
<h2>What happens if you get into the ‘just in case’ habit?</h2>
<p>To pass urine easily, we need the bladder muscle to contract and the muscles around the urethra and pelvic floor to relax. </p>
<p>This nice, coordinated pattern does not occur nearly as well if there is no real urge to void. You’ll probably be able to squeeze some urine out, but it’s not how the muscles are supposed to work.</p>
<p>The bladder’s response is to spasm and contract more aggressively and inappropriately.</p>
<p>The bladder gets used to holding a certain amount and if you are always emptying at that amount, it gets harder to hold more. The bladder “thinks” it is at capacity, when it is not. You end up with a pattern of uncoordinated emptying.</p>
<p>The good news is most people with a normal bladder can train themselves out of this habit. It’s about learning to recognise the signs and differentiate between a small urge and a real <em>need</em>. </p>
<p>You don’t need to run off at the first urge — have a go at resisting it and see what happens.</p>
<p>Of course, nobody is saying you should hold on until you feel absolutely tortured. If ignoring the first urge is causing real distress, you should talk to your GP or a pelvic floor physiotherapist.</p>
<h2>Let your kids go to the toilet when they actually need to</h2>
<p>Everyone remembers the kids who wet their pants at school or those who were always in trouble “because they should have gone to the toilet at recess”.</p>
<p>In fact, it’s better just to let kids go to the toilet when they need to, instead of berating them about not having gone at recess or “before we left”. </p>
<p>You can cause more damage (physical and psychological) in the long run if you give kids a hard time about toileting, load it with emotion, or train them into the habit of always going “just in case”. Don’t always prompt them to go to the toilet.</p>
<p>(In some situations, such as with people with dementia, it can be appropriate to prompt people to go to the toilet. But this is done after a reasonable number of hours when there should be a good amount of urine in the bladder. And it is a compromise arrangement where we try to minimise incontinence episodes and patient distress.) </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A parent talks to her child." src="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/422028/original/file-20210920-48420-1mq1yne.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">It’s better just to let kids go to the toilet when they need to, instead of berating them about not having gone at recess or ‘before we left’.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<h2>Not everyone has a ‘normal’ bladder</h2>
<p>The aim with toilet training is to learn to recognise the sensation of bladder filling and gradually develop the ability to resist bladder emptying until convenient and socially appropriate. </p>
<p>But for some people this is never completely or consistently achieved.</p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/21256571/">Many people</a> – perhaps <a href="https://pubmed.ncbi.nlm.nih.gov/17049716/">30% of adults</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/11412210/">large numbers of children</a> – do not have a normal bladder. Rather, they have an overactive or irritable bladder.</p>
<p>This can make people want to go all the time or cause sudden urgency. They may not always make it to the toilet quickly enough. It can be impossible to prevent bladder leakage. Some people cope by limiting fluids or forever going “just in case”. </p>
<p>As with all bladder problems, it’s more common for women than men and tends to become more troublesome as we age.</p>
<p>Overactive bladders are unlikely to spontaneously improve. A good place to start would be to talk with your GP, a continence nurse or a specialist physiotherapist. These bladders need to be retrained using techniques learned from a specialist physio. Medication can sometimes help. </p>
<p>For most of us, though, overly frequent visits to the loo, or going “just in case” is a habit worth quitting. </p>
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Read more:
<a href="https://theconversation.com/health-check-how-do-i-tell-if-im-dehydrated-107437">Health Check: how do I tell if I'm dehydrated?</a>
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<img src="https://counter.theconversation.com/content/167628/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer King is the chair of the Education Committee of the International Urogynecology Association and state chair of the NSW Continence Foundation. The positions are unpaid.
</span></em></p>Doing a ‘just in case’ wee too often, making a lifetime habit of it, can kick off a vicious cycle. You can end up training your bladder to ‘think’ it needs to go when it’s only slightly full.Jennifer King, Honorary Clinical Lecturer, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1146042019-07-04T19:46:54Z2019-07-04T19:46:54ZWhat other countries can teach us about ditching disposable nappies<figure><img src="https://images.theconversation.com/files/282604/original/file-20190704-126340-13f38tz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Look familiar? Don't fret, there are better ways.</span> <span class="attribution"><span class="source">Shutterstock.com</span></span></figcaption></figure><p>This year, the small Pacific Island nation of Vanuatu announced a plan to <a href="https://www.theguardian.com/environment/2019/jun/22/vanuatu-to-ban-disposable-nappies-in-plastics-crackdown-we-had-no-choice">ban disposable nappies</a>, as well as other throwaway items such as plastic bags. While some commentators praised the move, others worried about what the alternatives might be, and how this might affect household workloads, particularly for women.</p>
<p>While Vanuatu is the first nation to take such a bold step, it is not the first nation to recognise the environmental problems disposable nappies pose. Although most <a href="https://theconversation.com/explainer-how-much-landfill-does-australia-have-78404">landfill waste in Australia</a> and <a href="https://www.mfe.govt.nz/sites/default/files/media/Waste/National%20Waste%20Disposal%20Survey%20Final%20Report.pdf">New Zealand</a> consists of building waste, disposable nappies make up a significant percentage of household waste entering landfill – Australia uses an estimated <a href="https://www.abc.net.au/news/2019-03-22/vanuatu-to-ban-disposable-nappies/10924586">3.75 million of them every day</a>. </p>
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Read more:
<a href="https://theconversation.com/does-becoming-a-mother-make-women-greener-19390">Does becoming a mother make women ‘greener’?</a>
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<p>Many urban parents find that a week’s worth of nappies barely fits into their kerbside bin, especially for families with two children in nappies. I’ve certainly met these parents stalking the streets on the evening before bin day, searching for half-empty bins to dump their surplus dirty nappies. </p>
<p>But this is not the only problem: nappies are a significant source of contamination in the waste stream. Infant faeces are a source of <a href="https://www.ncbi.nlm.nih.gov/pubmed/21477676">live vaccine</a>, <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1348-0421.1984.tb00754.x">bacteria such as <em>E. coli</em></a>, and many other hazardous contaminants. The correct procedure is to scrape faeces into the toilet before disposing of the nappy. But let’s be honest – the whole attractiveness of disposable nappies is not having to do this, especially while out and about.</p>
<h2>Lessons from a bygone age</h2>
<p>So what is the alternative? Obviously, before disposable nappies, parents had to use cloth nappies. In Australia, the standard was the fluffy terry cloth folded into a triangle; in New Zealand, the flat flannelette folded differently for boys and girls. </p>
<p>Traditional cloth nappies were much less absorbent, and therefore had to be changed about 15 times per day, before being washed, dried, and folded for next time. It’s no coincidence that this practice dates to an era when households typically featured a stay-at-home mother.</p>
<p>In recent years, modern cloth nappies have emerged, with more absorbent designs that require less frequent changing. They use modern materials such as microfibre, microfleece, polyurethane laminate, and fabrics derived from bamboo. These nappies may be snug in design, pleasing to the eye, and less prone to leaks. They also require less water for laundry, because they can be put straight into a washing machine rather than being soaked as traditional nappies were. </p>
<p>Yet, <a href="https://www.abc.net.au/news/2019-03-22/vanuatu-to-ban-disposable-nappies/10924586">as Ni-Vanuatu commentators have already pointed out</a>, these designs are not necessarily suitable for tropical climates or warmer weather due to the use of non-breathable fabrics. These fabrics might also encourage nappy rash and other related problems for babies’ delicate skin.</p>
<h2>Lessening the load</h2>
<p>The search for alternatives does not need to be limited to Oceania, however. My <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/apv.12078">research</a> with families with young infants in northwestern China examined a practice known as <em>ba niao</em>, or “holding out to urinate”. This method of infant hygiene involves very limited use of nappies, meaning laundry can feasibly be done by hand. </p>
<p>Briefly, it involves learning the signals and timing of a baby’s patterns of poop and pee, then holding them out over a basin, toilet or potty for them to release, nappy-free. Caregivers <a href="https://www.sciencedirect.com/science/article/abs/pii/S1755458616300494">look for signs</a> such as squirming, pushing, fussing, stillness, and other forms of more direct communication that precede an “elimination”. As babies get older and begin to walk, they can be taught to urinate in Chinese-style squat toilets or other appropriate places, with the help of pants with a hole cut out of the crotch.</p>
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<a href="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=159&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=159&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=159&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=200&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=200&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282601/original/file-20190704-126350-fess8h.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=200&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Items used for <em>ba niao</em> in northwestern China.</span>
<span class="attribution"><span class="source">Kelly Dombroski</span>, <span class="license">Author provided</span></span>
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</figure>
<p>In colder parts of China, this is done by using several layers of pants, each with a hole, so babies do not have to be undressed. Caregivers tuck nappy-cloths made from old sheets or other soft rags up into the waistband of the pants, to be quickly and easily removed when a baby seems ready to “go”. If the caregiver misses the signal, the small, light cloth can be easily handwashed and dried on a balcony or radiator. If the caregiver is not near a toilet, the baby may even be held out over the ground or tiles, and urine cleaned up with a mop.</p>
<p>For faeces, babies are encouraged into a regular routine through a large morning feed of milk, and patient “holding out” until the morning elimination is done. If the baby’s bowel movements are less predictable, perhaps due to illness, some families use disposable nappy pads, tucked in the same way as the traditional nappies, but more as a backup for missing a signal rather than relying on it.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=613&fit=crop&dpr=1 600w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=613&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=613&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=771&fit=crop&dpr=1 754w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=771&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/282553/original/file-20190703-126345-1dnavf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=771&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">‘Holding out’ over a basin as part of traditional hygiene practices.</span>
<span class="attribution"><span class="source">Kelly Dombroski</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>Households without indoor toilets also use this method, including families who live in their shop and rely on public showers and toilets for hygiene. </p>
<p>This method is used by rich and poor families alike. Research <a href="https://www.cbsnews.com/news/how-pg-brought-the-diaper-revolution-to-china/">by disposable nappy producers Proctor & Gamble</a> estimated that Chinese consumers of disposable nappies use only one per day – or more accurately, per night. Even those who can afford disposable nappies tend to eschew them in favour of <em>ba niao</em> during daylight hours. Besides a lot less laundry, the reported benefits include less nappy rash, earlier toilet independence, and less crying and fussing.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/toilet-training-from-birth-it-is-possible-67064">Toilet training from birth? It is possible</a>
</strong>
</em>
</p>
<hr>
<p>Is this a realistic practice for countries seeking to quit disposable nappies? It may seem far from westernised norms, but my research has also <a href="https://www.emeraldinsight.com/doi/abs/10.1108/IJSSP-12-2015-0150">analysed the content</a> of Australian and New Zealand-based web forums and Facebook groups, with collectively around 2,000 members. These caregivers, mostly mums, are trying to work out the best way to introduce a similar practice to everyday life here, too.</p>
<p>They are inspired by the fact that this is possible in other parts of the world, and may indeed be a key to reducing the laundry load. And if they’re not quite ready to quit disposable nappies altogether, they might at least give up the weekly raid on the neighbours’ rubbish bins.</p><img src="https://counter.theconversation.com/content/114604/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kelly Dombroski does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Vanuatu has banned them outright, while many Chinese families use just one every 24 hours. So why are Australians still sending millions of dirty nappies to landfill every single day?Kelly Dombroski, Senior Lecturer in Human Geography, University of CanterburyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/837522017-11-20T02:25:59Z2017-11-20T02:25:59ZDiapers, potties and split pants: Understanding toilet training around the world may help parents relax<figure><img src="https://images.theconversation.com/files/195246/original/file-20171117-19245-1c14v0z.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Chill: There's no one right way.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/david_martin_foto/24073729359">David D</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Are two-year-olds too young to start toilet training?</p>
<p>For many children, yes. Especially boys. At least, that’s what American pediatricians would likely say. Nowadays, only <a href="http://www.aafp.org/afp/2008/1101/p1059.html">around half of children in the U.S.</a> are fully toilet-trained by age three.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=860&fit=crop&dpr=1 600w, https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=860&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=860&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1081&fit=crop&dpr=1 754w, https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1081&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/195240/original/file-20171117-19320-ipdm73.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1081&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Split pants let a Chinese boy go when he needs to.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Chinese_boy_with_open_rear_pants_closeup.jpg">Daniel Case</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Chinese grandmothers would be appalled. They’d likely point out that with “split pants,” most kids are trained by age two. This traditional wardrobe item features an opening along the crotch seam, allowing children to urinate and defecate freely without soiling their clothes. These garments remain the pants style of choice for toddlers living in the Chinese countryside.</p>
<p>Parenting advice about divergent toilet-training methods (not to mention plenty of other child-rearing questions) is typically dished out as if it were the only reasonable, reliable option. Nowadays, parents are confronted with guidance claimed to be scientifically founded, and presented as relevant to all children, even when different strategies are in direct conflict with each other. With over 2,000 parenting advice books in print in English – and, along with so many parenting blogs, there’s even a <a href="https://www.mcsweeneys.net/articles/great-parenting-blogs-through-the-ages">parody of the genre</a> – it’s easy to see why many modern parents feel confused about how to raise their children.</p>
<p>As an anthropologist, I’ve been studying child-rearing practices around the world for 25 years. Living with my husband (writer Philip Graham) in small villages in the rainforest of West Africa for extended periods convinced me that we humans are a resilient species, able to thrive in so many distinctive settings. Discovering the incredible diversity of ways to raise children inspired us to rethink and change some of our own family’s child-rearing practices (around bed-sharing, independence and household tasks, for instance).</p>
<p>There’s no one-size-fits-all model of child-rearing advice for all the world’s parents. To spread this message, my colleagues and I collaborated on the book “<a href="https://doi.org/10.1017/CBO9781316480625">A World of Babies: Imagined Childcare Guides for Eight Societies</a>,” based on our own and others’ long-term ethnographic fieldwork in places ranging from Israel and the Palestinian territories to China, Portugal, Peru, Denmark, Côte d'Ivoire and a Somali-American community in Minneapolis. By presenting multiple solutions to the commonest challenges facing parents, we hope to provide a bit of a tonic for parents, to assure them that there’s more than one path to raising a well-adjusted child.</p>
<h2>Toilet training from birth?</h2>
<p>So, why do parents choose a given child-rearing practice? Often, it comes down to money and availability. Let’s revisit that question about toilet training.</p>
<p>In Côte d'Ivoire, Beng mothers begin training their infants’ bowels a few days after birth. They administer enemas twice daily, beginning the day a newborn’s dried-out umbilical cord stump drops off. By the time the little one is a few months old, caregivers shouldn’t have to worry about him pooping during the day at all.</p>
<p>What could account for such a seemingly extreme practice? For one thing, disposable diapers are unavailable in Beng villages – and throughout much of the global south. Moreover, even if they were sold in local markets, few subsistence-farming families could afford them. (And the planet can’t afford them, either. Environmentalists calculate that “disposable” diapers constitute the <a href="http://realdiapers.org/diaper-facts">third-largest single consumer item in landfills</a>, and their <a href="http://www.peggyomara.com/2014/01/16/a-tale-of-two-diapers/">production requires some 7 billion gallons of oil each year</a>.)</p>
<p>But availability and affordability tell only part of the story. The structure of labor plus deep-seated values also shape parents’ choices.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=924&fit=crop&dpr=1 600w, https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=924&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=924&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1161&fit=crop&dpr=1 754w, https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1161&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/195254/original/file-20171117-19320-u89aa5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1161&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A Beng babysitter carrying a young charge.</span>
<span class="attribution"><span class="source">Alma Gottlieb</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>In Côte d'Ivoire (as elsewhere across sub-Saharan Africa), Beng babies spend most of their days attached to someone’s back. Often, that someone is not the mother – who is working in her fields, producing crops to feed her large family. Beng society (unlike traditional Chinese society) also rates all feces (including those of babies) as disgusting, and the thought of a baby pooping on someone’s back produces revulsion.</p>
<p>Given the local attitude toward feces, no potential babysitter would take care of a child likely to poop on her back while being carried. Hence, starting potty-training from birth aims to help a mother get her farmwork done. In that sense, early toilet-training promotes an adequate food supply for a mother’s family.</p>
<p>A Western observer might shrink in horror from this practice, imagining long-lasting emotional maladjustments from early trauma. But, discounting the ravages of poverty that challenge health and deny educational and economic opportunity, these very early toilet-trained babies appear to grow into just as happy and well-adjusted adults as diaper-wearing children might become.</p>
<h2>Context counts for what works</h2>
<p>In motivation, this practice may not even be as exotic as it might appear to a non-Beng reader. In the U.S., women’s labor needs may also dictate potty-training schedules, albeit with a later timeline. Many daycare centers accept only children who are fully potty-trained. If a working mother lacks both in-home daycare options and babysitting relatives, she may work frantically to potty-train her toddler as soon as possible, so she may return to full-time paid work.</p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=634&fit=crop&dpr=1 600w, https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=634&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=634&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=797&fit=crop&dpr=1 754w, https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=797&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/195256/original/file-20171117-19305-3ohgzc.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=797&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">This Palestinian girl cares for her baby brother as part of the extended ‘hamula’ family who raise children collectively whenever possible.</span>
<span class="attribution"><span class="source">Bree Akesson</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>For stay-at-home moms, or working moms who have nearby relatives to care for their child, different life situations may dictate toilet-training decisions. In the Palestinian territories, for instance, many women start toilet-training around 14 or 15 months. They’re able to start early because they aren’t working outside the home, so they have the time. On the other hand, a Palestininan working woman may start toilet-training later, maybe around age two. In this case, women in the extended family (“hamula”) would care for the child while the mother worked, so no daycare rule compels early toilet-training.</p>
<p>Once we explore the local context of people’s daily lives, seemingly exotic or even abusive practices – split pants, infant enemas – suddenly seem far less so. Opening the minds of worried new parents to “other” ways of raising children may assuage fears that if they fail to “do the right thing,” their children will be doomed. Through exploring comparative commode customs, along with many other parenting practices, it’s clear there are many “right ways” to raise a child.</p><img src="https://counter.theconversation.com/content/83752/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alma Gottlieb is a Professor Emerita of Anthropology at the University of Illinois at Urbana-Champaign, and a Visiting Scholar in Anthropology at Brown University. She is on the advisory boards for the following organizations: Cape Verdean-American Community Development (Pawtucket, RI); World Affairs Council of Rhode Island; Cape Verdean-Jewish Annual Seder (Boston); and IndivisibleRI. She is on the Editorial Board of the following scholarly journals: AnthropoChildren: Perspectives Ethnographiques sur les Enfants & l'Enfance/Ethnographic Perspectives in Children & Childhood; Anthropology and Education Quarterly; Anthropology Today; and Mande Studies. Since 1979, she has received funding from the following agencies: Jacobs Foundation (Zurich), European Commission/U.S. Department of Education, National Endowment for the Humanities, John Simon Guggenheim Memorial Foundation, Wenner-Gren Foundation for Anthropological Research, Woodrow Wilson National Fellowship Foundation, American Association of University Women, and Social Science Research Council. She is co-founder and co-director (with Philip Graham) of the Beng Community Fund, a non-profit, 501 (c) (3) organization to benefit the Beng community of Côte d’Ivoire.</span></em></p>Opening the minds of worried new parents to other ways of raising children may assuage fears that if they fail to ‘do the right thing,’ their children will be doomed.Alma Gottlieb, Professor Emerita of Anthropology, African Studies, and Gender and Women's Studies, University of Illinois at Urbana-ChampaignLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/722582017-02-02T11:10:36Z2017-02-02T11:10:36ZWhy children find ‘poo’ so hilarious – and how adults should tackle it<figure><img src="https://images.theconversation.com/files/155166/original/image-20170201-12678-1ydilh4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Look! I can make an even bigger one.</span> <span class="attribution"><span class="source">petereleven/Shutterstock</span></span></figcaption></figure><p>A boy meets a man carrying a load of cow manure and asks him what he is going to do with it all. The man tells the little boy: “I’m taking it home to put on my strawberries.” The boy looks up at the man and says: “I don’t know where you come from, but where I come from we put cream and sugar on our strawberries.”</p>
<p>While most of us can appreciate a joke about excrement, preschoolers and children often find it hilarious on a completely different level. Just running around the house saying the word “poo” out loud can often unleash hysterical laughter. But why is this? </p>
<p>Perhaps most famously, Sigmund Freud argued that at this age, the child is going through an “<a href="https://www.verywell.com/freuds-stages-of-psychosexual-development-2795962#step3">anal stage</a>” when he or she gets immense psychosexual pleasure from the development of anal control through toilet training. While it is true that there are usually tensions around learning the toileting process for children at this age, such theories no longer have much bearing on our thinking. </p>
<h2>Stages of humour development</h2>
<p>Modern research focuses more on such behaviour as an important part of <a href="https://archive.org/details/psychologyofhumo00martrich">the development of humour</a> in children. Humour is after all a universal aspect of human behaviour. Anywhere you find people, you will find laughter. Laughter of a sort is <a href="https://www.ncbi.nlm.nih.gov/pubmed/19500987">also seen among non-human primates</a>, occurring during playful social interactions and laughing together is an important part of social bonding.</p>
<p>Research in children shows that the subject of the humour <a href="http://www.sciencedirect.com/science/book/9780123725646">changes as they develop</a>. In very young children, a game of peek-a-boo is the subject of much amusement. In the preschool years, we see a fascination with jokes about excrement and toilets. Then jokes about social and gender roles come to be funny. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/155167/original/image-20170201-12675-1jd7s4g.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Guys, are you not a bit old for that kind of joke?</span>
<span class="attribution"><span class="source">Jason Salmon/Shutterstock</span></span>
</figcaption>
</figure>
<p>Two patterns emerge from these studies. One is that children find things funny when they are stretching their cognitive abilities. Incongruity is a key quality of amusement and that has to be pitched at the right level and in the right context for the recipient to be tickled. Evidence shows that once the cognitive level has been passed, the subject loses its potency. </p>
<p>The other key quality is the social tension that gives rise to humour. For infants, the game of peek-a-boo may be a lot of fun because it is playing with both the threat of separation, and the concept of “object permanence” (when the young child is still learning that when something is out of sight it can be hidden rather than being no longer there). But if the child has separation anxiety, is scared of the stranger playing the game, or is long past the stage of understanding the concept of object permanency, the game of peek-a-boo is no longer funny. </p>
<p>Humour can thereby be understood as a critical aspect of social play. As well as its role in social bonding, play is something that we all must do in order to practise a range of skills, which will be required for survival and reproductive success. And social interaction skills <a href="http://onlinelibrary.wiley.com/doi/10.1002/(SICI)1520-6505(1996)5:5%3C172::AID-EVAN6%3E3.0.CO;2-H/full">are a very important part of this</a>. We play with funny faces, gestures and language, using the same words in different ways to make them mean different things. Sometimes, we use the words in different contexts to see what effects they have. When we play games, it is important to make sure all the players know it is a game, and so we have laughter to give a clear signal.</p>
<p><audio preload="metadata" controls="controls" data-duration="668" data-image="" data-title="Extract from The Anthill 16 podcast: Humour Me, on children's toilet humour." data-size="7576763" data-source="The Conversation" data-source-url="https://theconversation.com/anthill-16-humour-me-82845" data-license="CC BY-ND" data-license-url="http://creativecommons.org/licenses/by-nd/4.0/">
<source src="https://cdn.theconversation.com/audio/880/childrens-toilet-humour.mp3" type="audio/mpeg">
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<div class="audio-player-caption">
Extract from The Anthill 16 podcast: Humour Me, on children’s toilet humour.
<span class="attribution"><a class="source" rel="nofollow" href="https://theconversation.com/anthill-16-humour-me-82845">The Conversation</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a><span class="download"><span>7.23 MB</span> <a target="_blank" href="https://cdn.theconversation.com/audio/880/childrens-toilet-humour.mp3">(download)</a></span></span>
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<p>Between the age of two and three, children’s learning explodes as they develop the cognitive capacity to create <a href="https://www.ncbi.nlm.nih.gov/pubmed/11548971">“secondary” mental representations</a> of the world that are distinct from primary representations of reality. This means they are becoming self-aware, learning about pretence and learning that words can stand for objects. </p>
<p>The three-year-old running round the house saying “poo” or pretending to go to the toilet is arguably appreciating the incongruity of being able to use the word liberally. They are also playing with the action of toileting, the social conventions around it and the possible shameful consequences of incontinence. Toilet humour is therefore a natural part of their development. </p>
<p>Toilet humour tends to fade with age but usually sticks around in everyone to some extent, though not everyone finds it funny to begin with. Some children with a fear of germs, a heightened sensory aversion, problems with incontinence or a fear of public exposure, may just find the whole business too worrying or unpleasant to laugh about. In their case, their worries need to be acknowledged and their privacy respected. </p>
<h2>The role of parents</h2>
<p>Nowadays, most of us are fortunate to live in a world where the value of levity and laughter is appreciated. We appreciate the value of play and the right to play is <a href="https://www.unicef.org.uk/what-we-do/un-convention-child-rights/">enshrined in the human rights convention</a> on the rights of the child. This is actually a very recent cultural development in Western society. For many centuries, from the Greek scholars to the 20th century, humour was seen by philosophers <a href="https://plato.stanford.edu/entries/humor/">as a rather debased form of intellectual activity</a>. The bible also has little place for humour and the Christian tradition would frown on laughter as exemplified in many strict protestant traditions.</p>
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<img alt="" src="https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/155165/original/image-20170201-12669-dd3gf5.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Look what teddy’s doing!</span>
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<p>It was the advent of cognitive psychology that brought <a href="https://plato.stanford.edu/entries/humor/">new ways of thinking about the mind</a>, with relief theory suggesting that laughter was a way of releasing pent up energy, and <a href="http://www.richardwiseman.com/LaughLab/incon.html">incongruity theory</a> recognising that jokes play with cognitive incongruity. Now, most developmental psychologists appreciate the critical role of humour, levity and laughter in healthy social development and something to be utilised by good parenting and education. </p>
<p>So, for parents whose toddlers find excrement very funny, it is probably a sign of healthy development if they are also learning to use the potty in an appropriate way. It shows they are thinking about and reflecting on what they are learning, and upon the social rules that surround it. And for parents to be able to have a little laugh with their toddler about this learning process, shows them that it is an okay subject for discourse. This limits the shame and embarrassment that occurs during the inevitable accidents, helps develop the social bond and fosters that open channel of communication between parent and child that is so important in the long run.</p><img src="https://counter.theconversation.com/content/72258/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Justin H G Williams receives funding from the Northwood Trust.</span></em></p>The serious science of toilet humour.Justin H G Williams, Senior Clinical Lecturer in Child Psychiatry, University of AberdeenLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/670642016-10-24T19:06:53Z2016-10-24T19:06:53ZToilet training from birth? It is possible<figure><img src="https://images.theconversation.com/files/142467/original/image-20161020-8865-5gsyn8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Elimination Communication is a method of toilet training that starts from birth and follows a child's cues.</span> <span class="attribution"><span class="source">from www.shutterstock.com</span></span></figcaption></figure><p>It can often be pretty difficult to convince a determined two year old to quit nappies. </p>
<p>To avoid this conflict, many families are adopting a different approach to toilet training, one that is more commonly used in <a href="http://schindlermd.com/toilet%20training.pdf">other parts of the world</a>, including China, parts of Africa, India, and South and Central America.</p>
<p>This method, called Elimination Communication (EC or assisted infant toilet training), is becoming <a href="http://europepmc.org/abstract/med/19320136">increasingly popular</a> in the West. </p>
<p>It involves starting toilet training from birth by following the child’s cues. </p>
<h2>Toilet training from birth</h2>
<p>Instead of using nappies, children learn to go in an appropriate receptacle from two weeks old. Babies are placed on the toilet or some other suitable place (such as a cup, a potty, a bucket or even the ground) after a meal or when they show signs of wanting to eliminate. If the baby does this right, it is rewarded with food or affection.</p>
<p>As far back as 1977, <a href="https://www.researchgate.net/publication/22268273_Cultural_relativity_of_toilet_training_readiness_A_perspective_from_East_Africa">researchers</a> suggested, </p>
<blockquote>
<p>sociocultural factors are more important determinants of toilet training readiness than is currently thought.</p>
</blockquote>
<p>Research shows this process can help babies <a href="https://www.researchgate.net/profile/Leith_Pugmire2/publication/277142311_Infant_Toileting_A_Mother's_Perspective_on_Natural_Infant_Hygiene/links/5563992b08ae86c06b695795.pdf">quickly learn to eliminate</a> in a convenient place. </p>
<p><a href="http://www.goodreads.com/book/show/1132111.Diaper_Free">It works</a> through <a href="http://www.naturalchild.org/guest/ingrid_bauer.html">two way communication</a> between the caregiver and the infant. Caregivers follow the infant’s cues and can also signal to the baby to eliminate.</p>
<h2>How effective is it?</h2>
<p><a href="https://books.google.com.au/books?hl=en&lr=&id=78h2dnL00isC&oi=fnd&pg=PT8&dq=elimination+communication+infant&ots=owgQOq2NIp&sig=IFFGdUwaIdhRAXbrrlAlNvcNg4Q#v=onepage&q=elimination%20communication%20infant&f=false">Some</a> argue, based on this cultural difference, that babies are aware of their need to eliminate from birth. <a href="http://sarahbuckley.com/mothering-mindfulness-and-a-babys-bottom-an-introduction-to-elimination-communication">Others suggest</a> that infants prefer to be dry and would rather not be left in a dirty nappy. It is this preference that makes elimination communication easy.</p>
<p><a href="http://journals.lww.com/jrnldbp/Abstract/2004/04000/Assisted_Infant_Toilet_Training_in_a_Western.4.aspx">One study found</a> that children who used this method (from 33 days) were toilet trained by five months of age. </p>
<p>In this study, the parents noted the child’s signal to eliminate and held the infant’s back to the caregiver’s chest while sitting over a toilet. </p>
<p>While the baby eliminated, the caregiver used vocal signals to reinforce the behaviour. </p>
<p>Usually these signals are a “psss” sound for urine and a different sound for faeces (we’re trialling this method and using a “plop” sound).</p>
<h2>Cultural and social differences around nappy use</h2>
<p>Parents in western countries generally use nappies to manage babies’ and young children’s waste. </p>
<p>Some parents prefer disposable nappies, which are said to <a href="http://onlinelibrary.wiley.com/doi/10.1111/pde.12501/full">reduce nappy rash</a> – a red and <a href="http://www.babycenter.com/0_diaper-rash_81.bc">inflamed rash</a> around the nappy area, caused principally by wetness and bacteria or yeast – and other skin conditions including eczema.</p>
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<img alt="" src="https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/142599/original/image-20161021-8849-gie6nv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Some parents prefer to use reusable nappies.</span>
<span class="attribution"><span class="source">from www.shutterstock.com</span></span>
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<p>For others, <a href="http://link.springer.com/article/10.1007/BF02830834">environmental concerns</a> mean reusable nappies are preferred. Reusable nappies are usually made of cotton. </p>
<p>There are <a href="http://www.babycenter.com.au/a559767/buying-reusable-nappies">two types</a>: two-part nappies that often have an insert and an outer, waterproof, layer; and all-in-one nappies that combine the inner absorbent layer with the waterproof outer layer. Parents also need nappy liners. But cloth might not be as environmentally responsible as <a href="http://pediatrics.aappublications.org/content/89/3/523.1.short">many parents believe</a>. </p>
<p>There is evidence of major <a href="https://www.washingtonpost.com/opinions/why-cloth-diapers-might-not-be-the-greener-choice-after-all/2015/05/08/32b2d8dc-f43a-11e4-bcc4-e8141e5eb0c9_story.html?utm_term=.ddf8d68a35f3">environmental issues</a> including the water and pesticides used in cotton farming, the principal ingredient in reusable nappies. </p>
<p>The need for cleaning products, hot water and constant washing may also be environmentally damaging. Cloth nappies generally soak through more quickly than disposables and need to be changed more often.</p>
<p>What’s more, the care-giver’s labour is not cost neutral and may not be factored into the evaluation of cost and benefits of reusables. </p>
<h2>Western families increasing age of toilet training</h2>
<p>Toilet readiness is usually considered a developmental milestone, where <a href="https://www.ncbi.nlm.nih.gov/pubmed/10048607">bladder and bowel control</a> is linked to maturation. </p>
<p>For toilet training <a href="http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572008000100004&lng=en&nrm=iso&tlng=en">to be successful</a>, children must be able to walk to the toilet after recognising the need to eliminate, manage clothing, eliminate fully, clean, manage clothing again and flush. </p>
<p>Over the last 80 years, Western families have been <a href="http://schindlermd.com/toilet%20training.pdf">increasing the age</a> at which they toilet train, from less than 18 months 40 years ago, to between 21 and 36 months today. </p>
<p>Starting toilet training at 18 months may be related to <a href="http://europepmc.org/abstract/med/19320136">medical advice</a>. </p>
<p>Thinking about when to start toilet training has shifted since the early 20th century. </p>
<p>In the 1920s, for instance, 12 months was considered suitable. By the 1960s, the advice was later than 18 months. <a href="http://onlinelibrary.wiley.com/doi/10.1046/j.1464-410x.2000.00737.x/full">Researchers suggest</a> changes may be due to parents’ work schedules, convenient disposables and a more liberal approach to parenting.</p>
<p>Children with <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2788.2010.01286.x/full">special needs</a> may take longer learning to use the toilet.</p>
<p>The relationship between caregivers and babies is complex. It may be that, with <a href="http://search.proquest.com/openview/f53628394f2bda0cb5d861286e67dffa/1?pq-origsite=gscholar">careful observation</a> of infants’ cues, parents can learn to understand their child’s needs. </p>
<p>We are certainly hoping so in our family to avoid buying nappies for three more years and cleaning up after inevitable misses.</p><img src="https://counter.theconversation.com/content/67064/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebecca English does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An increasing number of parents are choosing to toilet train their children from birth, without using nappies. But how effective is this?Rebecca English, Lecturer in Education, Queensland University of TechnologyLicensed as Creative Commons – attribution, no derivatives.