War of the Diapers

With all the unsettled issues dominating the news lately, from the Middle East peace process to the Clinton impeachment to Saddam Hussein's defiance, Americans hardly need something new to worry about. Yet that's just what they got on Page One of the New York Times last week. Under the headline TWO EXPERTS DO BATTLE OVER POTTY TRAINING came the unwelcome assertion that baby-boom parents may be taking exactly the wrong approach to this crucial milestone in child rearing.

That, at least, is the view of psychologist and child-care guru John Rosemond, who laid out his complaints in a series of columns published in more than 100 newspapers last month. And superficially at least, his arguments seem to make sense. For more than a generation, observes Rosemond, experts like Dr. T. Berry Brazelton have advised parents to let kids decide for themselves when to make the transition from diapers to potty. As a result, the age of toilet training has risen dramatically--as has the incidence of constipation, bladder-control problems and other potty-related ills.

Just as bad, argues Rosemond, is the psychological damage inflicted by wishy-washy parents. "The issue," he says, "is the mother's ability to give up the role of caretaker and become an authority figure." If that transition is delayed much beyond the age of two, says Rosemond, the child won't mature properly and will probably develop behavior problems later in life.

What makes the whole thing so silly, he says, is that toilet training can be a snap if you use the technique he calls "naked and $75." You remove the diaper, put a portable potty within reach of your two-year-old and wait for the inevitable accident. "Kids that age hate to have 'it' running down their legs," Rosemond explains. "So they stop the flow, and you lead them to the seat. The $75 is for cleaning the carpet." Within a few days, he says, the child is trained--and knows who's boss. "This technique is not my idea," says Rosemond. "This is the way grandma trained her children."

Well, yeah, says Brazelton, professor emeritus at Harvard Medical School and chairman of the Pampers Parenting Institute. That's the trouble. Back in the early '60s, Brazelton was distressed by the amount of bed-wetting and deliberate fecal retention he was seeing in his patients. So he asked mothers to try something new: let kids decide for themselves when to take the potty plunge.

"By giving the child a sense of autonomy," says Brazelton, "we reduced the incidence of problems from the national average of 8% to about 1%." Brazelton's results, reported in the journal Pediatrics, transformed the way most parents do toilet training. Even the term was recast as the kinder, gentler "toilet teaching."

Brazelton agrees that the incidence of potty-related problems has been rising lately, but he ascribes it to a return to the old ways, not reliance on the new. "Working parents don't have a lot of time for a leisurely approach to toilet teaching," he says, and observes that many day-care centers insist that children be out of diapers by age three. Under this sort of pressure, he suspects, many are resorting to just the sort of rigid timetables Rosemond advocates. Like Brazelton, psychologist and child-care expert Penelope Leach dismisses the notion that laid-back parenting has caused problems. She too believes kids who are forced to use the toilet before they're ready "are more likely to rebel and develop anal retention that can cause severe constipation or blockages."

Leach does side with Rosemond on one point: Brazelton's affiliation with Pampers, which is pushing a supersize disposable diaper for children 35 lbs. or larger, stinks. Is Brazelton's pediatric judgment being influenced by Pampers' desire to sell more diapers? It certainly might be taken that way, even though Leach and Rosemond acknowledge that Brazelton was giving the same advice long before he and Pampers hooked up. "I agree there's a danger," admits Brazelton. "But I honestly believe in what the company does."

For moms and dads on the front lines, such concerns are academic. They want to get their kids over the potty hump with as little disruption as possible. And despite Rosemond's contention that they're going about it all wrong, his "back-to-grandma" movement hasn't yet attracted much support. Says Becky Tamblyn Pence of Crystal Lake, Ill., mother of Emily, 5, and Michael, 3: "There are so many things to fight about just to get through the day. At least let them have control over this."