The overall purpose is to assess whether assisted infant toilet training during the first year of life can prevent functional gastrointestinal and urinary tract disorders up to 4 year of age. Healthy Swedish children will be randomized to start assisted infant toilet training at 0-2 months of age or at 10-11 months of age. The toilet training process will be described including mother-to-infant attachment and parental stress.
The mastery of toilet training is an important developmental milestone for children and parents. The age at which children start toilet training has increased during the last decades in the Western world. 50 years ago most children were out of nappies by 1,5 years of age. Today, wearing nappies by 3-4 years of age is considered normal. Meanwhile an increase in functional gastrointestinal and urinary tract disorders and toileting problems is reported by health care professionals. A randomized multicenter intervention study is conducted at Child Health Care Centers in Sweden to investigate whether assisted infant toilet training initiated during the first year of life can prevent functional bowel and bladder disorders.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
293
The parents learn to sensitively respond to the child's routines and signals of elimination needs.The child's ability to convey the need for bowel and bladder evacuation is enhanced through responsive interaction so that a kind of assisted dryness is developed. The infant is held "squatting" over a potty or basin, while older children sit on the potty.
Unicare vårdcentral Borlänge
Borlänge, Dalarna County, Sweden
Vårdcentral Kvarnsveden
Borlänge, Dalarna County, Sweden
Elsborgs Familjecentral
Falun, Dalarna County, Sweden
Falu Vårdcentral
Falun, Dalarna County, Sweden
Prevalence of functional constipation
Functional constipation, measured with validated questionnaires according to the ROME IV criteria
Time frame: Up to 9 months of age
Prevalence of infant dyschezia
Infant dyschezia, measured with validated questionnaires according to the ROME IV criteria
Time frame: Up to 9 months of age
Prevalence of infant colic
Infant colic measured with validated questionnaires according to the ROME IV criteria, including a prospective 24h infant behavioral diary when infant colic is suspected
Time frame: Up to 5 months of age
Prevalence of functional constipation
Functional constipation, measured with validated questionnaires according to the ROME IV criteria.
Time frame: Up to 4 years of age
Prevalence of gastrointestinal symptoms
Gastrointestinal symptoms, measured with Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module (PedsQL Gastro)
Time frame: At 4 years of age
Prevalence of stool toileting refusal
Stool toileting refusal, measured with validated questionnaire
Time frame: At 4 years of age
Prevalence of bladder dysfunction
Bladder dysfunction, measured with validated questionnaires according to International Childrens Continence Society (ICCS) definitions.
Time frame: Up to 4 years of age.
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Familjecentralen Bönan
Leksand, Dalarna County, Sweden
Barnavårdscentral Mora
Mora, Dalarna County, Sweden