Sphincter control is not trained

When Brenda’s son was about to turn 2, she and her husband embarked on a “race” to get the child out of diapers. The following March he went into the garden and there he was told he had to go in and check his sphincters. When they enrolled him, they thought it was possible because in their oldest nephew’s case it had happened: he had left his diapers just at the age of two. But there were two weeks left before his admission and the boy continued to pee his clothes every time.

Anxiety and despair overwhelmed the family. “One day, I remember I was in the middle of a Zoom meeting, sitting in the dining room of the house. I was advised to have my son sit in the bathroom every hour, but the meeting dragged on. Suddenly I saw that he squatted down in the corner and immediately pee started flowing down his leg. I shouted, unaware that the microphone was on. “I died of shame, I had to apologize at the meeting, but worst of all, my son was so scared by the scream and the way he saw me upset, that he started crying and didn’t stop several minutes later, “remember. She also says she will never forget her son’s scared face, which made her think something was wrong with this process.

Just as it happened to Brenda, for many mothers and fathers the step of giving up the diaper is difficult and, in some cases, very stressful and frustrating. For Constanza Olivares, nurse specializing in pediatric incontinence (on Instagram @happypopopis), this finds its origin in the social pressure . In fact, he says, the majority of patients who consult do so at the moment when they have to leave their core, which is surely home: when they go to school, when they go to the garden and they are told that ‘they need to be checked.

In January 2018, the Ministry of Education issued a circular which clearly establishes that entry to kindergarten cannot be refused or conditioned on a boy or girl abandoning diapers. Nor is it appropriate to send him back to a daycare center, reduce his working hours or resort to any other measure of arbitrary discrimination. But it’s recent and that’s why beyond the norm, the standardization of sphincter control has become a cultural issue. Just do a quick internet search for “how to leave the diaper” and recipes appear such as: “eight tips for removing baby’s diaper”, “how to leave the diaper in three days” or “the best training for leaving layer”. layer’ .

However, Constanza Olivares insists that “Sphincter control cannot be trained, it develops according to the maturity of each child.” And since it is a maturation process, the logic is that we let them be the protagonists. “We are used to stimulating children; It’s us, the adults, who move the toy for them, we sit them down – lots of cushions so they don’t go sideways – we stop them when they’re about to turn a year old because someone told us at that time. when they have to walk, etc. But none of this is necessary because when a baby is in an environment in which he feels safe, cared for, respected and in which he has the space to show himself, he can make decisions, like what object to take or how. move.”, explains kinesiologist Camila Puschmann, in another article.

The same thing happens with bathroom trips, says Olivares. “At one point they told us that we had to take the diaper off at two years old and we kept it like that for a long time, then it became normal and all the parents and even the preschools understood that it was the case. Children had to be trained to reach this milestone “on time”. But advances in medicine have shown that, for example, there are children who do not crawl, who skip this step and walk directly. It used to seem strange, but today we have become a little more open to the developmental flexibilities of boys and girls.

And it’s not that certain standards shouldn’t exist – in the case of peeing, it’s normal for a boy or girl to do it until the age of 5 – because you have to have a reference and be attentive, adds the specialist. . “The problem is that The rigidity of these standards means that, although we all say that each child has his own rhythm, if the boy or girl deviates from this line for two weeks, we start with interventions. For her, it is necessary that this be considered from the perspective of respectful parenting: “I understand this as the possibility of giving the boy or girl the space to express, to the extent of their abilities, how to move forward in the stages of its development,” says.

Constanza says there are times when children are afraid to go to the bathroom because of their parents’ behavior, because their parents get frustrated and challenge them when they sit wet or when they don’t not according to the schedule they have established. According to his experience, When we focus on what the child is doing, not just what they are not doing, we begin to really see what they need.

And, as with any other stage of development, it is important to see the signs that the boy or girl gives. “For example, when the diaper with pee makes them uncomfortable, or when they start to warn each other. There you have to see how often he warns, how wet the diaper comes out, because these are signs that he is already doing a bathing routine. It is also good to adapt the bathroom, put a stool so that your feet do not float. All this, more than training, creates the conditions for them to develop their own approach,” explains the nurse.

He adds that the method of punishment and reward – so used in these training sessions – is also not good because it generates conditioned learning: doing it in the bathroom only when it is going to be done pleasure. Constanza points out that this can be reinforced with applause or happy faces, but there can’t be sad faces, because they haven’t done anything wrong, they’re just learning. “I understand that parents are sometimes overwhelmed by the process because it can be exhausting to do it everywhere, especially outside the home, but that’s why I always recommend that they come prepared, with a change of clothes, so that the process is not stressful and does not limit the family’s social life,” he says.

The other thing, this is what the specialist points out, is This idea that childhood incontinence is always associated with a psychological problem: The boy is cunning, we just moved, a little brother was born. “Even though there are stages that can have an impact, like separation from parents or something else that affects their daily life, we tend to think that everything comes from a psychological problem and this is not necessarily the case. There may be something at the physiological or maturational level.

Although sphincter control is a natural process of human development, it is a topic of conversation behind closed doors; No one wants to talk about what happens in their bathroom. “Many couples don’t talk about, for example, pooping until their child is born. This happened to me the other day at a conference with adults, I said something like “you have gas” and everyone laughed, even though it’s something so normal. The problem is that misinformation abounds and any “anomaly” is treated as a private issue,” says Constanza, adding: “If a boy or girl pees at school, they try not to let it show, they call the parents silently, and all this generates the feeling that it is something bad and therefore a reason for ridicule for the others.” Like a vicious circle. When everyone should understand that peeing during this developmental period can be normal.

According to the specialist, there is an urgent need for cultural change. “It often happens to me that incontinent girls come to tell me that their mother always tells them to hold on when they are not at home because the toilets are dirty. Bad there. Because in these cases, you have to be prepared, carry disinfectant wipes. Boys and girls must be educated so that they dare to say, wherever they are, that they want to pee or poop, and not that they are ashamed. And for that, we need to talk about this issue.