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A Longitudinal Study of Assisted Infant Toilet Training During the First Year of Life
Jeffrey M Bender1,2, Yelim Lee3, Ji Hoon Ryoo4
1Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA.
Insights
Assisted Infant Toilet Training (AITT) is a viable diaper alternative for Western families. High caregiver satisfaction was linked to infant dryness and understanding, despite challenges like potty refusal.
Area of Science:
- Pediatrics
- Developmental Psychology
- Family Health
Background:
- Previous research on Assisted Infant Toilet Training (AITT) focused on elimination signals, refusal rates, and completion age.
- AITT is a practice aimed at toilet training infants from an early age.
Purpose of the Study:
- To describe the practice of AITT in a Western setting during an infant's first year of life.
- To assess caregiver satisfaction with AITT.
Main Methods:
- A longitudinal cohort study involving families who began AITT before 4 months of age.
- Standardized caregiver interviews conducted at 1- to 2-month intervals, with data analyzed using a linear mixed-effect model.
- Data analyzed in 2-month blocks from 3-4 months to 11-12 months.
Main Results:
- 87 children started AITT at a mean age of 2.5 months, with 88%-94% of caregivers identifying elimination signals.
- Toileting attempts decreased, and while many practiced AITT part-time, daytime dryness was 12%-14%.
- Caregiver satisfaction was high, positively correlated with infant dryness and caregiver understanding, despite some potty refusal.
Conclusions:
- Assisted Infant Toilet Training (AITT) is a practical alternative to diapers in Western contexts.
- Improved understanding of AITT can help meet infants' basic needs more effectively.
- AITT offers a valuable approach for early infant toilet learning.
Objective:
Previous retrospective studies have examined elimination signals, stool toileting refusal, and completion age in Assisted Infant Toilet Training (AITT). The aim of this longitudinal cohort study was to describe the practice of AITT and caregiver satisfaction in a primarily Western setting during the first year of life.
Methods:
Families who started AITT before 4 months of age were recruited. Standardized interviews of caregivers were conducted at 1- to 2-month intervals. To identify trends over time, data were fitted to a linear mixed-effect model. Data were analyzed according to five 2-month blocks, starting at 3 to 4 months.
Results:
Of 85 participating families, 87 children started AITT at a mean age of 2.5 months. At all age intervals, 88% to 94% of caregivers could identify elimination signals. Toileting attempts decreased from 10/day at 3 to 4 months to 7/day at 11 to 12 months (p < 0.001). Many families (45%-53%) practiced AITT on a part-time basis. Daytime dryness was noted in 12% to 14% of infants throughout the first year. Although more than 63% of families used cloth or disposable diapers throughout this study, use of trainers and underwear increased significantly by 2- to 3-fold (p < 0.01 for both). Caregiver satisfaction was high overall. Although negatively associated with potty refusal, it was positively associated with daytime and nighttime dryness, perceived elimination signals, and a better understanding of their infant's needs (p < 0.001 for all).
Conclusion:
This study demonstrates that AITT is a worthy viable alternative to the use of diapers even in Western settings. Better understanding of AITT provides a new perspective to properly meet infants' basic needs.
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