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The Germy Side of Toilet Training

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Each and every day in homes worldwide natural disasters are occurring; and the culprit isn't the weather. These unfortunate incidents are human-made and the result of a process every family must experience. For a child, it is the transformation from home-bound infant to a functional member of society; for his or her parents, it could be best described as torture.

For everyone else, it's simply known as toilet training.

The process of convincing a 18- to 36-month-old child to give up the freedom of a diaper and learn to use the strangely shaped porcelain bathroom furniture is not for the faint of heart. Accidents end up wetting and soiling anything below two feet off the ground including the carpet, mislaid purses and even the toddler crib.

Despite the best evidence to help make the process as simple and effective as possible, it seems that nothing can stop the chance of a temporary décor change that incorporates a few puddles of yellow or streaks of brown.

While the problems may seem humourous to many, including parents who have already gone through the nightmare, there are potentially germy consequences that need to be considered. By the time a child is ready for training, the gastrointestinal tract is filled with a diverse population of microbes many of which can be pathogenic. The child is at risk for urinary tract infections as well as the spread of gastrointestinal problems associated with a lack of proper handwashing. Moreover, the potential for infection spread within the house or any other population increases as proper hygiene is less likely to be adhered.

To get a better idea of the germy nature of toilet training, I decided to reach out to a fellow microbiology buff, Wendy Jozsi, who has since left the lab to become a business leader at the global biotechnology firm, Life Technologies. Her experience suggests that when it comes to raising children, it's not a matter of ignoring of germs but rather acclimatizing to them.

"My training is microbiology, so the concept of sterility/contamination and how quickly noxious beasties can spread is pretty sensitized and the pre-kid me prided myself on being on top of that. But when my cute little infant became increasingly mobile, all of a sudden my house became a microbiologist's nightmare of thrown food, diaper accidents and sticky fingerprints. I went from working with petri dishes to living in one!"

While germs apparently took over the family's way of life, it was nothing compared to the problems that were to be encountered when it came time to train their son Jackson, 3. Whereas the germs were stabilized in one spot (i.e. the diaper), with the advent of the toilet, the germs became incredibly mobile.

"I was terrified and not just for the health of my kids. I felt that the experience could take down my husband or me with every post-poop hug." The petri dish became in Wendy's words, a nightmare. "Imagine a soccer goalkeeper on a really muddy pitch. You end up diving to catch anything knowing full well you are about to be covered in brown sludge that can and most likely will affect your health."

Wendy's experience is understandable as preparing for the potty can be a highly involved process requiring a combination of psychological, physiological and even sociocultural factors. There are many steps necessary to achieve a perfect visit including i) recognition of the toilet; ii) gaining comfort while sitting on the toilet; iii) learning how to aim properly; iv) wiping; v) flushing; and vi) washing hands.

A child needs to have not only functional motor capacity but also has to have control of their sensory, neurological and etiquette skills. Then there is the temperament of the child who simply may not be ready to explore the more adult world of the toilet or have little to no interest in "holding it in."

But perhaps there is a solution to the problems associated with potty training that might save the health of the home's inhabitants and the welfare of the furnishings and accoutrements. If one asks certain pediatricians such as Dr. Steve Hodges, a pediatric urologist at Wake Forest University in Winston-Salem, NC, the answer may simply be to wait a little longer before starting the process.

In February of this year, Hodges released a book called, It's No Accident in which he points out that maybe toilet training is doing more harm than good and that germs could be a major problem.

His argument flies in the face of 50 years of dogma that states children should be relieved of their diaper duty around the age of two with a final success being reached within three to six months. This protocol of bringing about bowel and bladder control has been followed by parents worldwide without much deviation.

But according to Hodges, children shouldn't be asked to withhold nature's natural waste removal process until at the least three years of age and that the process should be gradual with children first learning how to control their voiding before even attempting to go unprotected.

From a microbiologist perspective, waiting may offer a better chance to minimize or even prevent accidents. By the age of three, the child's actual toilet training process can be cut nearly in half. This reduction may be associated with improved muscle control, improved cognizance and a greater understanding of the environment. In addition, an older child has a much better capacity to perform the entire toilet experience from knowing when to venture to the bathroom to washing their hands afterwards.

But even with increased age, the fact is that the experience will still tax upon the nerves of parents and possibly their immune systems. From the exposure to fecal matter from the wiping process to the requirement of a clean up, the chances are high that mild infections will be a part of their lives. As Wendy puts it, "My son now knows he only gets the chocolate post-potty treat after he's washed his hands. But I'm pretty certain my house wouldn't be getting a restaurant "A" grade these days. It'll be a while before we are fully germ safe."

Even in light of the germy nature of toilet training, the value of watching a little one grow up into a 'big kid now' is worth the possible upset tummies, involuntary retching and occasional gastrointestinal event. As the pop icon Alicia Keys said to People Magazine, it's part military and part consistency but it's also a great deal of love and support.

Not to mention it makes for some great war stories to tell your children when they become parents.