When we talk about nappies all sorts of other topics come up, like Mooncups and Cloth Sanitary Products (CSP), even recycling and composting. Washing nappies in an eco-friendly way comes up a lot as you’d imagine.  And also stuff to do with health like breastfeeding, baby-led weaning, nappy rash and potty training – that comes up a lot. We’re asked questions and then we do some research and talk to health professionals.

Something we’ve come across lately is a worrying increase in urinary tract infections (UTIs) and constipation amongst children. Some health professionals are attributing this trend to infrequent nappy changes, others to current toilet training methods. Our refined diet plays a part too.

At the moment the findings are anecdotal and there is no hard research published on which to base health policy interventions. At Real Nappies for London we believe in sharing knowledge so that parents are aware of the risks and can make up their own mind about what to do.

In the French nappy documentary, Couchorama a toileting anthropologist (yes, really – he’s very interesting) describes western style nappy habits as ‘hospitalisation’. We wrap the child in a nappy and just change the baby/patient as a routine. This is in contrast to what happens in most parts of the world where the parent/carer looks for cues from the baby that s/he wants to pee or poo and the child is held over a pot or in a convenient position and place for the baby to ‘eliminate’.

A study by a Swedish paediatrician of toileting habits in Vietnam found babies were releasing the bladder ‘on demand’ at 9 months, starting independence at 12 months and in control of the bladder by 18 months. We are meeting more and more parents who are doing this with their babies or at least giving their child the opportunity to ‘eliminate’ on a pot/toilet at changing time.

This is in direct contrast to mainstream Western style toilet training where we often delay offering the potty or toilet until the child is two or perhaps even older. But there is a growing body of research indicating that chldren develop the ability to control their bladders and bowels through the process of toilet training. This suggests the earlier the child has the opportunity to do this the better.

However there are also continence experts who believe children are at more risk of constipation and UTIs if potty training starts early. The influential article By Dr Steve Hodges in the Huffington Post says that children have a greater tendancy to ‘hold’ if they’ve been potty trained early. So what should a parent do?

Any baby/toddler is at risk of ‘holding’ on to urine or poo. It’s important therefore to be observant about how regularly your child eliminates. You should notice the colour of the pee. It should be pale yellow. If it is dark yellow ensure your child drinks more water.

It’s also important to be aware of how quickly food moves through the bowels. This will enable you to look out for constipation. It’s true that a child may poo regularly but still be constipated. However there are certain highly coloured foods and foods that are only partially digested by young intestines that help you see how quickly food passes through your child’s gut eg beetroot, spinach, prunes, peas.

Anecdotally it looks like parents are putting off potty/toilet training until later and later. It also seems to be perceived as something really quite stressful for the parent and child. Fitted carpets don’t help!

Our advice is gather the information and decide what’s right for you and your child.

For further reading see Are Potty Training Methods in the West

If you’re looking for toilet training advice see New thoughts on Potty Training

Check out EC simplified.