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Longitudinal study of sphincter control in a cohort of Brazilian children
Denise M Mota1, Aluisio J D Barros, Alicia Matijasevich
1Universidade Federal de Pelotas, Pelotas, RS, Brazil. denisemmota@gmail.com
Insights
Most children achieve sphincter control by age four, regardless of sex or birth weight. Early toilet training does not speed up control acquisition but may prolong the process.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Sphincter control acquisition is a key developmental milestone.
- Understanding factors influencing toilet training is crucial for child development and parental guidance.
Purpose of the Study:
- To analyze the acquisition of sphincter control in a Brazilian birth cohort.
- To investigate the impact of early toilet training on the age and duration of sphincter control.
Main Methods:
- Longitudinal study of 4,231 children born in Pelotas, Brazil, in 2004.
- Data collected through home visits at 12, 24, and 48 months, using maternal questionnaires on voiding, bowel habits, and toilet training.
- Analysis focused on age of onset, duration of training, and factors influencing control acquisition.
Main Results:
- By 48 months, 98.5% of children were diaper-free during the day and 83% at night.
- Average toilet training initiation was at 22 months, with earlier initiation in girls.
- Children with developmental delays exhibited later sphincter control; earlier training (before 24 months) correlated with delayed control and longer training duration.
- Premature and low birth weight children showed no significant differences in training outcomes.
Conclusions:
- The majority of children achieve sphincter control by 48 months, irrespective of sex or birth weight.
- Initiating toilet training before 24 months did not accelerate sphincter control acquisition but extended its duration.
- Developmental status significantly impacts the timing of sphincter control.
Objectives:
To analyze sphincter control acquisition in a birth cohort.
Method:
4,231 children born in 2004 in Pelotas, Brazil, were included in a longitudinal study. During home visits at the ages of 12, 24 and 48 months, the mothers answered a questionnaire about sociodemographic questions and characteristics of their children's voiding and bowel habits, with special attention to toilet training.
Results:
At 48 months, most children were off diapers during the day (98.5%) and by night (83%), with no difference between sexes. The average age for starting toilet training was 22 months, with earlier initiation in girls. The training was, on average, 3.2 months long, showing no difference between sexes. Children with developmental delay had late voiding and bowel control; the higher the deviation from normality, the later the child was off diapers. Medical advice was given to 15.9% of mothers. The training initiated before the age of 24 months was inversely correlated with an older age of sphincter control and longer training. Premature and low birth weight children showed no significant difference in training time and age of acquisition of sphincter control.
Conclusions:
At the age of 48 months, most children, including premature and low birth weight ones, acquired sphincter control regardless of external factors and sex. The beginning of training (before 24 months) did not anticipate sphincter control, but only prolonged the duration of training.
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