Historial Perspective #3 The twentieth century

A gentler approach – The Twentieth Century

As the Twentieth Century progressed, this new kind of psychological understanding of children’s development influenced the way experts thought about toilet training. The use of enemas and soap-sticks – once utterly widespread for both adults and children, was now regarded as interfering, with a good chance of causing dependency.[1]

In Frederic Bartlett’s 1934 childcare guide, he provides a comprehensive guide to both bowel and bladder training.

“In his second month you may start to train him to have a regular bowel movement. Towards the end of his first year, you start to train him in bladder control… In training young babies, the power of suggestion may be used by the mother’s grunting to indicate to the baby what is expected of him. Of course, these suggestions are unnecessary for mothers who have had several children, but they may be news to the mother with her first baby.”

It shows how far we have come that Bartlett thought that this method would be self-evident to more experienced mothers. His bladder training programme will also sound familiar to those following the practices in this book:

“It is a good plan to begin at 6 or 8 months to put the baby on the chamber as often and as regularly as possible, when he wakes up in the morning, before and after meals and naps and at least once during the night, in spite of the fact that he may have already wet his diapers…

Whether trained or not, most children should go without diapers in the daytime from 18 months. I know that practically speaking this may mean wet shoes and floors for mothers to face. On the other hand, if you keep your baby in diapers too long, his training in the matter of wetting will surely be delayed.”

Bartlett reveals himself to be compassionate and insightful in his summary of the process and is refreshingly relaxed about further advice:

“Punishments are not of the slightest value in training a child to have a regular bowel movement or to control his urination. Rewards are sometimes helpful. Unfortunately I can give you no more specific advice about the method of training your child in this control. You will have to exercise your patience and your ingenuity.” [2]

Bartlett shows how early potty training does not have to be synonymous with conflict and control. His account suggests that mothers need only follow babies’ natural stages of development to achieve timely potty training. It is interesting that his instructions are very similar to those I have given in my book – with the notable exception, however, of the use of babies’ signals as a means to work out when to offer the potty. There is no discussion of the joys of communication and feedback that, to me, is the biggest advantage of the method. (Though of course, Bartlett was writing in an age when saving laundry was the primary factor in toilet training; modern parents are more interested in other gains.)

In 1938, the doctor and wife team, Charles and Mary Aldrich, argued against the use of artificial methods to produce a bowel movement. Their method of bowel training was respectful:

“The developmental formula for true training is simple and efficient. After a few weeks, automatic evacuations gradually become less frequent so that only one or two occur daily. Their time and number vary in different children but the tendency for them to come at definite periods in each day is steadily more pronounced. As soon as it is possible to discover the exact moment at which the mass movement takes place, it is reasonable to put the baby on a chamber pot or toilet seat and relieve his mother of the irksome task of diaper-washing. When he is placed on the toilet seat at his right time, his brain naturally develops the necessary association between the mass movement, the toilet seat and his own, satisfying effort. Our co-operation in this growth process is merely to observe the baby’s own rhythm, in selecting the times of day for a bowel movement. Such synchrony leads to training at a reasonably early date and does not subtract from the baby’s innate capabilities. When this is done, real, permanent training becomes a fact, and his future health is protected, even though the period of diaper-washing may be prolonged for a few weeks.”[3]

Again we can see similarities between the Aldriches’ method, and the method I advocate here. Both rely on a gentle, respectful partnership between parent and baby. The main difference I see is that the Aldriches advise mothers to wait until their baby is voiding at a regular time. I would argue that by offering before then (even from birth) we can assist baby in their voiding, and help encourage them to fully empty their bowels. It seems to me that this process is the same whether they are voiding many times a day or only once. Anecdotal evidence from mothers I know suggest that babies who are offered the potty move towards more regular stools more quickly than those who are not.

None of this advice takes into account the fact that we can often recognise a baby’s immediate need to defecate or urinate. This understanding arises from a strong bond between parents and babies – a bond built on empathy and careful watching. Instead of directing them to pass a bowel movement or urinate at a certain time, we respond to the needs of the baby – we observe them to find out how regularly they go, and at what usual times, and offer accordingly; or we wait until they display the symptoms of a full bladder or bowel and offer them a chance to go. This subtle interaction – the dance of trial and error – of communication in both directions, this is what makes BLPT such a joyful explorative experience.

Did mothers in the Nineteenth and early Twentieth Centuries also experience this wonderful bond – at least at times? Surely they did! The earlier ‘expert guides’ were written by male doctors – often for the benefit of the nurses that looked after the babies. So the guides (and presumably the lives of the babies) were much more detached and precise. The Twentieth Century sees more female authors – and tellingly, the advice is much more gentle and sensitive.

The responsive aspect of BLPT relies on closeness, and careful watching and interpreting of baby’s signals. It’s hard to know whether this was absent (or discouraged) in a culture that embraced the cot and the pram, or whether experts simply did not acknowledge the complex interactions between mother and child. (Though Bartlett seems to hint at this with his words: “You will have to exercise your patience and your ingenuity.”) Inevitably, childcare manuals were aimed at the higher, educated social classes, who could afford wet nurses and nannies for their offspring. It would be nice to think that the lower classes, who were forced to raise their children themselves, had a stronger bond with them.

The delayers

In 1949 the child psychoanalyst Edith Buxbaum argued that a delayed start to bowel training was more effective. In her book she complains mothers start too early with first children, get impatient and show disapproval.

“The first child had to “educate” the parents so subsequent children in the family were usually not so rigorously attended to and bowel training was started when they were about ten to fifteen months of age, when they could cooperate in the process and know what it was about. Training would then be perhaps only a few weeks duration with everyone happy.”[4]

The key childcare manual, however, came in 1955, when the American Dr Benjamin Spock published Baby and Child Care. This book became a great success on both sides of the Atlantic, and was probably the most influential childcare guide of the century. Although Spock’s ideas seem somewhat old fashioned nowadays (for example with his four hour feeding schedules), at the time he revolutionised childcare through his baby-friendly, respectful, and flexible approach. He advocated a gentle, more relaxed approach to toilet training. Though his summary may still come as a surprise:

“It has been the style, lately, to try to ‘train’ the baby to move his bowels at a very early age…. This isn’t exactly training, because the baby doesn’t really know what he’s doing. It’s the mother who’s trained. Many times the baby rebels against these efforts when he is old enough to realize what is happening to him. Some psychologists think that early training is harmful, in certain cases at least, whether the baby rebels later or not. It seems sensible to give the baby the benefit of the doubt, and leave him in peace until he is old enough to know a little of what it’s all about. I would wait until he can at least sit up steadily alone, which will be around 7 to 9 months.”

Spock is refreshingly flexible about the timing of bowel training. He says that his preferred method is “to leave bowel training almost entirely to your baby.” He suggests that around the latter part of the second year a baby will make some kind of signal that he needs to go, and the mother can lead him to the potty. However, he sees no harm in a mother “lending a hand earlier [from 7 months], if she does it tactfully, takes baby’s readiness into account and, doesn’t make an issue of it.” He argues “whether you start bowel training early or late, the most important thing is how you go about it during the second year.” He notes that many children get rebellious at this time, even when the mother has been ‘pretty polite and reasonable’ about it. He suggests mothers “shrug [their] shoulders and let him move them in his own way for a few weeks, or even months if necessary, until he feels more co-operative. All you can work with is his willingness; you can never really beat him in a battle. Wait until he is settled down again and willing and predictable enough to do his part.”

As for urine training, Spock is more specific. He recommends waiting until the child can stay dry for two hours. He advises sitting them on the pot if their nappy has been dry for two hours. He suggests that this will happen gradually as mothers will only find a dry nappy every few days. He suggests that for most children this will occur around 15 months, some as early as 10 months, and others as late as 20 months. When the child has been dry more regularly, this is the practical time to switch to training pants. He suggests they will complete urine training between 1 ½ and 2 ½ years.[5]

Part 4: the 60s to the present day

There was also Part 1 (Ancient Greece – C17th) and Part 2 (Victorians and Freud)

[1] Langdon, Grace. Home Guidance for Young Children. New York: John Day, 1938.

[2] Bartlett, Frederic, Infants and Children: Their feeding and growth (London: Cassell, 1934) p. 225.

[3] Aldrich, Charles Anderson and Aldrich, Mary M, Babies are human beings: an interpretation of growth (New York: The Macmillan company, 1938).

[4] Buxbaum, Edith, Your Child Makes Sense. (London: Allen and Unwin1951) p.23.

[5] Spock, Bejamin, Baby and Childcare (London 1955: The Bodley Head) pp.177 – 187.