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Bowel And Bladder Function in Infant Toilet Training

Not Applicable
Active, not recruiting
Conditions
Infantile Colic
Bladder Dysfunction
Toilet Training
Constipation - Functional
Interventions
Behavioral: Assisted Infant Toilet Training
Registration Number
NCT04082689
Lead Sponsor
Dalarna County Council, Sweden
Brief Summary

The overall purpose is to assess whether assisted infant toilet training during the first year of life can prevent functional gastrointestinal and urinary tract disorders up to 4 year of age. Healthy Swedish children will be randomized to start assisted infant toilet training at 0-2 months of age or at 10-11 months of age.

The toilet training process will be described including mother-to-infant attachment and parental stress.

Detailed Description

The mastery of toilet training is an important developmental milestone for children and parents. The age at which children start toilet training has increased during the last decades in the Western world. 50 years ago most children were out of nappies by 1,5 years of age. Today, wearing nappies by 3-4 years of age is considered normal. Meanwhile an increase in functional gastrointestinal and urinary tract disorders and toileting problems is reported by health care professionals.

A randomized multicenter intervention study is conducted at Child Health Care Centers in Sweden to investigate whether assisted infant toilet training initiated during the first year of life can prevent functional bowel and bladder disorders.

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
293
Inclusion Criteria
  • Full-term infant (born at gestational week 37+0 to 41+6)
Exclusion Criteria
  • Infants with malformations or disorders that may affect the gastrointestinal or urinary tract in any relevant way
  • Infants born small for gestational age (SGA), < - 2 standard deviation
  • Parents with insufficient understanding of the Swedish language
  • Infants older than 2 months, 1 week and 6 days at inclusion

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Assisted Infant Toilet Training- Group BAssisted Infant Toilet TrainingParents to Children randomized to group B will be instructed in how infant toilet training is performed by the co-workers doing the ultrasound measure of rectal diameter at 9 months. They receive a book in Swedish concerning infant toilet training and a brief summary of it made by the investigators. They start infant toilet training at the age of 10-11 months. The definition of adherence to the intervention is to perform at least one attempt a day of infant toilet training (without the requirement of a successful outcome) on at least 5 out of 7 days per week.
Assisted Infant Toilet Training-Group AAssisted Infant Toilet TrainingParents to Children randomized to group A will be instructed in how infant toilet training is performed by the investigators. They receive a book in Swedish concerning infant toilet training and a brief summary of the book made by the investigators. The parents are encouraged to begin infant toilet training as early as possible, 0-2 months of age The definition of adherence to the intervention is to perform at least one attempt a day of infant toilet training (without the requirement of a successful outcome) on at least 5 out of 7 days per week.
Primary Outcome Measures
NameTimeMethod
Prevalence of infant colicUp to 5 months of age

Infant colic measured with validated questionnaires according to the ROME IV criteria, including a prospective 24h infant behavioral diary when infant colic is suspected

Prevalence of infant dyscheziaUp to 9 months of age

Infant dyschezia, measured with validated questionnaires according to the ROME IV criteria

Prevalence of functional constipationUp to 9 months of age

Functional constipation, measured with validated questionnaires according to the ROME IV criteria

Secondary Outcome Measures
NameTimeMethod
Prevalence of stool toileting refusalAt 4 years of age

Stool toileting refusal, measured with validated questionnaire

Prevalence of functional constipationUp to 4 years of age

Functional constipation, measured with validated questionnaires according to the ROME IV criteria.

Prevalence of gastrointestinal symptomsAt 4 years of age

Gastrointestinal symptoms, measured with Pediatric Quality of Life Inventory Gastrointestinal Symptoms Module (PedsQL Gastro)

Prevalence of bladder dysfunctionUp to 4 years of age.

Bladder dysfunction, measured with validated questionnaires according to International Childrens Continence Society (ICCS) definitions.

Trial Locations

Locations (6)

Unicare vårdcentral Borlänge

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Borlänge, Dalarna, Sweden

Barnavårdscentral Mora

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Mora, Dalarna, Sweden

Familjecentralen Bönan

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Leksand, Dalarna, Sweden

Vårdcentral Kvarnsveden

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Borlänge, Dalarna, Sweden

Falu Vårdcentral

🇸🇪

Falun, Dalarna, Sweden

Elsborgs Familjecentral

🇸🇪

Falun, Dalarna, Sweden

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