title: Bowel habits and toilet training in a diverse population of children.
abstract: OBJECTIVE
  To gather data concerning bowel habits and toilet training of developmentally normal children ages 5 to 8 years.
  
  
  METHODS
  A questionnaire containing information on age, race, and sex was completed anonymously by a parent in 9 pediatric practices. Recall information was elicited about onset and completion of toilet training, frequency and quality of stooling, size of bowel movements, and behavioral components of defecation.
  
  
  RESULTS
  Questionnaires were completed for 1142 children. When all of the children were considered together, toilet training started at a mean of 27.2 months and was completed at a mean of 32.5 months. It began and was completed nearly 3 months earlier for girls than for boys (P<0.001). African American children started and completed toilet training at least 6 months earlier than white children (P<0.001). Of the children, 95% defecated either daily or every other day. Straining at defecation and infrequent stooling were reported significantly more often for girls, whereas staining of underclothes and passage of large bowel movements were reported more often in boys. Approximately 10% of children fulfilled criteria for functional constipation.
  
  
  CONCLUSIONS
  Most of the children between 5 and 8 years of age have a medium-size bowel movement daily or every other day without straining or withholding. Although African American children toilet train at an earlier age than do white children, bowel habits appear to be similar. A sizeable subgroup of children presenting to primary care providers have a history that is consistent with constipation.
authors.affiliation: Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, USA.
authors.forename: Ellen R
authors.initials: ER
authors.lastname: Wald
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: Lynne
authors.initials: L
authors.lastname: Cipriani
authors.forename: D Kathleen
authors.initials: DK
authors.lastname: Colborn
authors.forename: Rosa
authors.initials: R
authors.lastname: Burgers
authors.forename: Arnold
authors.initials: A
authors.lastname: Wald
mesh_terms: D001741:Black or African American; D002648:Child; D003248:Constipation / Q000453:epidemiology* / Q000208:ethnology; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D010414:Pennsylvania / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014039:Toilet Training; D044465:White People