• Logo
  • SBMUJournals

The Differences Between Preterm and Term Birth Affecting Initiation and Completion of Toilet Training Among Children: A Retrospective Case-Control Study

Dilek Yildiz, Derya Suluhan, Berna Eren Fidanci, Merve Mert, Turan Tunc, Bulent Altunkaynak



Purpose: This study seeks to investigate the possibility the existence of a difference in terms of start and end dates of toilet training between term and preterm children as well as the possible determining factors.

Materials and Methods: This study was conducted as a 5-year retrospective case (children born preterm-(32 to <37 weeks) – and control (children born at term (>37 weeks + 1 day)) study. The data were collected with a form consisted of questions about demographic data (12 questions) and toilet traning features (10 questions) through face-to-face interviews with the mothers. A chi-square test and logistic regression analysis were conducted to examine the data. Odds ratio was used as a measure of the relation between levels of the dependent variable. p< .01 and p< .05 values were assumed to be statistically significant.

Results: The study examined a total of 133 children including 59 preterm children and 74 children born at term including 60 (45.1%) boys and 73 (54.9%) girls. The possibility of starting toilet training at or before 24 months was found to be 6.4 times greater in full-term children than preterm children (OR=6.493). The logistic regression analysis, which aimed at identifying any variables that might affect end date of toilet training, found that despite the tendency to consider preterm   birth as a factor prolonging the duration of toilet training, the difference was not found to be statistically significant (p= .07).

Conclusion: This study compared full-term and preterm children in terms of start and end dates of toilet training and found that preterm children start toilet training later than full-term children. Based on the results of the study, it is possible to say that preterm birth, gender and birth order affect start date of toilet training. However there is no difference between term and preterm babies on the end date of toilet training.


Van Aggelpoel T, De Wachter S, Van Hal G, Van der Cruyssen K, Neels H, Vermandel A. Parents' views on toilet training: a cross-sectional study in Flanders. Nurs Child Young People. 2018 May 11;30(3):30-35.

Brazelton TB, Christophersen ER, Frauman AC, et al. Instruction, timeliness, and medical influences affecting toilet training. Pediatrics. 1999;103 (Supplement 3):1353-8.

Mota DM, Barros AJ. Toilet training: methods, parental expectations and associated dysfunctions. J Pediatr (Rio J). 2008;Jan-Feb;84(1):9-17.

Vermandel A, Van Kampen M, Van Gorp C, Wyndaele JJ. How to Toilet Train Healthy Children? A Review of the Literature. Neurourol Urodyn. 2008;27(3):162-6.

Bakker E, Van Gool J, Van Sprundel M, Van Der Auwera C, Wyndaele J. Results of a questionnaire evaluating the effects of different methods of toilet training on achieving bladder control. BJU Int. 2002 Sep;90(4):456-61.

Klassen TP, Kiddoo D, Lang ME, Friesen C, Russell K, Spooner C, Vandermeer B. The effectiveness of different methods of toilet training for bowel and bladder control. Evid Rep Technol Assess (Full Rep). 2006 Dec;(147):1-57.

Schum TR, McAuliffe TL, Simms MD, Walter JA, Lewis M, Pupp R. Factors associated with toilet training in the 1990s. Ambulatory Pediatrics. 2001;1:79-86.

Largo R, Molinari L, Von Siebenthal K, Wolfensberger U. Development of bladder and bowel control: significance of prematurity, perinatal risk factors, psychomotor development and gender. European Journal of Pediatrics. 1999;158:115-22.

Drillien CM. A longitudinal study of the growth and development of prematurely and maturely born children. Arch Dis Child. 1961 Oct;36:515-25.

Toilet Training Guidelines: Parents—The Role of the Parents in Toilet Training. Pediatrics. 1999 Jun;103(6 Pt 2):1362-1363.

Clifford T, Gorodzinsky F. Toilet learning: anticipatory guidance with a child-oriented approach. Paediatr Child Health. 2000 Sep;5:333-44.

Stadtler AC, Gorski PA, Brazelton TB. Toilet training methods, clinical interventions, and recommendations. Pediatrics. 1999;103(Supplement 3):1359-61.

Blum NJ, Taubman B, Nemeth N. Relationship between age at initiation of toilet training and duration of training: a prospective study. Pediatrics. 2003;111:810-4.

Gorodzinsky F. Toilet learning: Anticipatory guidance with a child-oriented approach. Paediatrics & Child Health. 2000;5:333-5.

Kaerts N, Vermandel A, Van Hal G, Wyndaele JJ. Toilet training in healthy children: Results of a questionnaire study involving parents who make use of day‐care at least once a week. Neurourology and Urodynamics. 2014;33:316-23.

Joinson C, Heron J, Von Gontard A, Butler U, Emond A, Golding J. A prospective study of age at initiation of toilet training and subsequent daytime bladder control in school-age children. Journal of Developmental & Behavioral Pediatrics. 2009;30:385-93.

Horn IB, Brenner R, Rao M, Cheng TL. Beliefs about the appropriate age for initiating toilet training: are there racial and socioeconomic differences? The Journal of Pediatrics. 2006;149:165-8.

Koc I, Camurdan A, Beyazova U, Ilhan M, Sahin F. Toilet training in Turkey: the factors that affect timing and duration in different sociocultural groups. Child: Care, Health And Development. 2008;34:475-81.

Bloom DA, Seeley WW, Ritchey ML, McGuire E. Toilet habits and continence in children: an opportunity sampling in search of normal parameters. The Journal of Urology. 1993;149:1087-90.

Taubman B. Toilet training and toileting refusal for stool only: a prospective study. Pediatrics. 1997;99:54-8.

DOI: http://dx.doi.org/10.22037/uj.v0i0.4820


  • There are currently no refbacks.