Understandably, all parents look forward to the day when their child is toilet trained - partly because nobody enjoys dealing with dirty nappies, and partly because it really does seem to signal the end of babyhood. So the day when your child first steps out in a smart pair of pants or knickers (and is still wearing the same pair at the end of the day!) is just as big a milestone as when he learns to walk or to talk. Just like those other developmental milestones, there is a wide variation in the age range at which children achieve bowel and bladder control.

Mothers used to spend hours holding their tiny babies over potties. If the baby was regular in passing a bowel motion the mother hoped to strike lucky by providing the potty at the right time and saving a dirty nappy, though of course this did not mean that the child was able to control bladder and bowel movements. There are still some parents who want to start training their babies in the first year by trying to catch regular bowel motions, for example, by potting after meals. If a baby is regular, this may condition him to open his bowels when he sits on the potty, although he still does not have conscious control. The danger of this approach is that when he does learn to understand and control what is happening, in his second and third year, he may decide not to co-operate and you have to start training him all over again. Nowadays, with disposable nappies designed for toddlers making life much easier, most parents prefer to wait until their children show some signs of becoming ready to use the pot or lavatory. But before we embark on the whole subject of how your child learns control, it is useful to know a few of the basic biological facts.

Body Waste

The food that healthy people eat is automatically processed by their digestive system. We eat fats, sugars, proteins, carbohydrates, vitamins, minerals, and we drink liquids. These are distributed through the bloodstream to fuel growth and to give us energy to function. But there is some waste matter that the body does not need and this has to be passed out at regular intervals. Liquid waste, urine, is produced by the kidneys and stored in the bladder until a feeling of fullness signals a need to pass urine. It is then passed out through the urinary tract. Solid food is passed from the stomach through the small and the large intestines which are responsible for extracting what the body needs and which then push out the waste through the rectum and its external opening called the anus. Normal people vary in the number of times they need to pass this waste - most urinate several times a day and have a bowel motion from once or twice a day up to every few days. Obviously these functions vary according to what and how much you eat and drink. This may vary depending on the weather (when it is hot you may drink more and excrete more fluid, or if you do not drink, you will sweat more and pass less urine), or on your state of mind (when you are nervous your digestive system becomes more active), or of course when you are ill.

Newborn babies produce and pass this waste automatically and indeed have started doing so in the womb. Although they often seem to know what they are doing - they usually go very quiet or red in the face when passing a motion - they actually have no conscious control over the process. Conscious control means being able to recognise the signs of wanting to empty bowels or bladder, and then waiting until you are in the right place to do so - lavatory or potty - which only comes with age and maturity. It happens because both the parts of the brain and the nervous system supplying the bowel and bladder become more mature. The rate at which this happens is under control of the genes, so it is not surprising that delay in gaining bladder control tends to run in families. Most children are able to achieve this conscious control at some time between eighteen months and three years with a few exceptions either side. Bed wetting at night goes on longer in most children, although a few whose bladders can hold urine for long periods are dry earlier. Wetting at night isn't abnormal in children under five years, although if a child has been dry and then starts wetting again you need to check there is nothing wrong physically or emotionally.