What is true about the fact that summer is the best time to leave the diaper?

BarcelonaMost children stop using daytime diapers between the ages of two and four, although nighttime training can be more difficult and may not be completed until around five or six years of age. For Alejandra Pérez, supervisor of pediatrics and neonatology at Sant Pau Campus Salut Barcelona, it is key to understand that sphincter control is not a habit learned through repetition, "but rather a maturational milestone acquired when the child's body is physiologically, cognitively, and emotionally ready." Neurologically, Pérez continues, "it involves a transition from an involuntary reflex action (where the bladder empties automatically) to a voluntary and conscious act under cortical control." Forcing this process prematurely, therefore, "is ineffective and can generate frustration, anxiety, and unnecessary conflicts, as each child has their own pace of nervous system maturation."

Are there signs that indicate our son or daughter is ready to take the step?

The child is ready to give up diapers when several maturational factors converge, which manifest through clear signals. On the one hand, Dr. Pérez highlights that the child must have the ability to communicate, as they need to have enough language to verbally express the need to go to the bathroom or, at least, make gestures to indicate to adults that they are wet or dirty. Regarding their physical autonomy, “it is necessary that they can pull their underwear up and down by themselves and that they have the ability to sit quietly on the potty or toilet for a couple of minutes”. The coordinator of pediatrics and neonatology points out that their body awareness plays a key role: “The child must be able to recognize their own body's signals and realize when the diaper is dirty. They may show behaviors such as bringing their hands to the genital area or looking for a place to hide to evacuate”. Finally, from a physiological point of view, an unequivocal sign of maturity is that the diaper remains dry for prolonged periods, of at least an hour and a half, “which shows that their system already has the necessary retention capacity”. Should families accompany or encourage this process?

Pérez underlines that families “must adopt a role of guides and companions on this path towards personal autonomy, always prioritizing the fostering of the child's confidence in their own abilities”. To achieve this, he recommends using positive reinforcement through praise, kisses, or small immediate rewards each time a milestone is reached. At the same time, he adds, “you have to arm yourself with patience and avoid rushing, try to create a fun and natural environment in which the process is experienced without pressure, as well as dressing children in comfortable and easy-to-handle clothing”. Pérez also urges parents to avoid comparing the child with siblings or friends, as these comparisons “are very counterproductive, as they generate anxiety, can damage the child's self-esteem and image, and often cause a regression in the progress made”. Why is summer considered the optimal time to carry out this process?

Pérez clarifies that summer is usually considered the optimal time mainly for practical reasons, “not because the body is more prepared for the heat”. At this time, he points out, children wear less clothing (which facilitates their autonomy) and “accidents” are not as uncomfortable or cold. However, he insists, “the process should not be started just because it is summer if the child does not show the necessary signs of maturity”. Should this be done before children start I3 in September?

As Pérez points out, historically, September marked an administrative deadline, but the decision, she insists once again, "must be based on the child's socio-emotional and psychological maturity and not on calendar dates". To get rid of this pressure, for the doctor, "the collaboration between family and school is essential, as well as understanding that forcing the process for a fixed date can hinder long-term learning".

How should we act if a regression occurs during the process?

Accidents and regressions should be understood as a normal and absolutely expected part of this learning process, which, explains Pérez, "is not linear, but often presents advances and setbacks." In his opinion, when an accident occurs, it is essential that adults "act with naturalness and calm, avoiding scolding, humiliating, or punishing the child, as punitive attitudes or power struggles can damage their self-image and hinder progress." For Pérez, one strategy can be to allow the child to feel the discomfort of being wet for a few moments so that they become aware of the situation, and then immediately change them with a neutral attitude.