Related Experiment Video
Updated: Jun 25, 2026
Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
Published on: August 22, 2012
Bowel habits and toilet training in a diverse population of children
Ellen R Wald1, Carlo Di Lorenzo, Lynne Cipriani
1Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Insights
This study on children aged 5-8 found toilet training completion by 32.5 months, with earlier completion in girls and African American children. About 10% experienced functional constipation.
Area of Science:
- Pediatric Gastroenterology
- Child Development
Background:
- Understanding typical bowel habits and toilet training milestones is crucial for pediatric health.
- Variations in toilet training timelines and bowel behaviors exist across different demographics.
Purpose of the Study:
- To collect data on bowel habits and toilet training in typically developing children aged 5 to 8 years.
- To identify patterns and potential risk factors for constipation in this age group.
Main Methods:
- Anonymous parent-completed questionnaires were distributed across 9 pediatric practices.
- Data collected included age, race, sex, toilet training onset/completion, stooling frequency/quality, and defecation behaviors.
Main Results:
- Toilet training began at a mean of 27.2 months and completed at 32.5 months, earlier in girls and African American children.
- 95% of children had daily or every-other-day bowel movements; 10% met criteria for functional constipation.
- Differences in stooling behaviors (e.g., straining, large movements) were noted between sexes.
Conclusions:
- Most children aged 5-8 exhibit regular bowel movements without significant issues.
- While African American children toilet train earlier, their bowel habits are similar to white children.
- A notable percentage of children present with constipation symptoms, highlighting a need for clinical attention.
Objectives:
To gather data concerning bowel habits and toilet training of developmentally normal children ages 5 to 8 years.
Methods:
A questionnaire containing information on age, race, and sex was completed anonymously by a parent in 9 pediatric practices. Recall information was elicited about onset and completion of toilet training, frequency and quality of stooling, size of bowel movements, and behavioral components of defecation.
Results:
Questionnaires were completed for 1142 children. When all of the children were considered together, toilet training started at a mean of 27.2 months and was completed at a mean of 32.5 months. It began and was completed nearly 3 months earlier for girls than for boys (P<0.001). African American children started and completed toilet training at least 6 months earlier than white children (P<0.001). Of the children, 95% defecated either daily or every other day. Straining at defecation and infrequent stooling were reported significantly more often for girls, whereas staining of underclothes and passage of large bowel movements were reported more often in boys. Approximately 10% of children fulfilled criteria for functional constipation.
Conclusions:
Most of the children between 5 and 8 years of age have a medium-size bowel movement daily or every other day without straining or withholding. Although African American children toilet train at an earlier age than do white children, bowel habits appear to be similar. A sizeable subgroup of children presenting to primary care providers have a history that is consistent with constipation.
Related Concept Videos
01:26Psychosexual Stages of Personality: Anal
01:30Development of Human Microbiota
01:25Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...