Assisted Infant Toilet Training and Bladder and Bowel Health: A Global Integrative Review

BACKGROUND: Toilet training practices vary across cultures and time. Assisted Infant Toilet Training (AITT) is commonly used in low- and middle-income countries.

OBJECTIVES: To synthesise the literature on AITT, including timing of initiation and completion, infant elimination signalling, and associations with bladder and bowel dysfunction.

METHODS: An integrative review methodology was employed. Comprehensive searches of Scopus, Medline, CINAHL, Web of Science, PsycINFO, and Google Scholar identified relevant studies. Two reviewers independently screened and appraised studies using GRADE and JBI tools.

RESULTS: Of 2,069 studies identified, 21 met inclusion criteria. Six observational studies reported reduced rates of bladder and bowel dysfunction when AITT was practised.

DISCUSSION: AITT is widely practised in low-income, non-English speaking countries. While observational studies suggest a potential protective effect on bladder and bowel health, the evidence is at serious risk of bias. Further prospective research in high-income contexts is warranted.