Stories & News Blog 11 common unhelpful things people say when your child has a wee or poo problem Everyone's got their own advice about toileting, but it's not all accurate! In the course of many of our conversations on the ERIC helpline, callers often say the same thing “I just don’t know what to do …we keep being told different things by different people!” After a particularly moving call with an exasperated mum last week who was being bombarded by very well meaning (but not quite accurate!) advice from her friends, mother-in-law and the staff at her little girl’s nursery, we decided to list the 11 most common unhelpful things you might be told when your child has a wee or poo problem…and how you can respond. 1.”Your child will tell you when they’re ready to potty train and there’s no point trying until they do” There are some little ones who wake up one morning and decide for themselves ‘that’s it no more nappies thank you very much’ and take to the potty like a duck to water. However, if you are waiting for your son or daughter to be that child you could be waiting some time! Take a look at our information about potty training for help with spotting the signs of readiness. 2. “Some children soil or wet their pants on purpose – they’re just being lazy/ naughty/looking for attention” Wee and poo accidents can sometimes have a behavioural or developmental aspect to them. For example, it’s very common for children to get so engrossed in what they’re doing that they ignore the fact that they’re bursting for a wee and it ends up in a puddle on the floor. Changes in routine such as starting school and the arrival of a new sibling can also lead to regression with potty training. However, all wee and poo accidents should be investigated for underlying physical causes. It may seem as though your 5-year-old who’s having one of those difficult days pooed themselves on purpose, but they could be constipated and genuinely didn’t feel it happening. Your teenage daughter may be hiding wet bedding in her wardrobe not because she’s in denial or being lazy but because she feels ashamed about wetting the bed and doesn’t know how to talk about it. Teenagers can get help to understand why accidents happen via our teen pages and parents can read with younger children what wee and poo say about keeping your bladder and bowel healthy in the kids area. 3. Nursery/pre-school staff to parent or carer: “If your child is still in nappies we can’t offer them a place” Lots of parents worry about trying to get their children toilet trained in time for nursery, but legally no child care setting can deny a place to a child who has delayed continence. This can constitute discrimination. ERIC has best practice guidelines to help all childcare settings support children with toilet training and wee or poo problems. Rather than putting unfair pressure on parents and carers, all nursery and school staff should support and work with parents. 4.“Can you leave work to pick up your child who’s just soiled their pants at school?” Calling parents in to clean up their child after an accident is considered unacceptable practice according to the Children and Families Act 2014. No child should be knowingly left in wet or dirty pants as this can constitute neglect. Again, at ERIC we encourage families and school staff to work together for the good of the child. See ERIC’s guidance for schools for help with getting a care plan in place to support your child if they have an accident at school. 5.“Trying to toilet train children with additional needs is very difficult – it’s better to wait until they’re older” Toilet training children with additional physical or behavioural needs can be very challenging and require huge amounts of patience and perseverance, but delaying the process of getting clean and dry can cause more problems in the long run. It’s really important to assess their physical signs of readiness and get any constipation or daytime wetting issues treated first before deciding if the time is right for the family as a whole. There’s lots of support out there for helping children with special needs to get toilet trained, for instance try: ERIC’s helpline and resources Bladder and Bowel UK (formerly PromoCon) The National Autistic Society (NAS) 6.”If you want to avoid bedwetting, don’t drink too much in the day” In fact, the complete opposite is true! To help their bladders stretch and hold during the day and at night, all children, whether they wet the bed or not, should have 6-8 drinks of water-based fluid throughout the day. They should try to have their last drink an hour before bed if this fits in with family life and is easier to do when you’ve kept well hydrated during the day. Children who restrict fluids during the day are at risk of getting urinary tract infections and will have a lower bladder capacity than those that drink well and wee at regular intervals. Take a look at our daytime wetting pages for more information on keeping your bladder healthy. 7.”If you let a child wear pull-ups at night they’ll never learn to be dry” Having a trial of a few days without nappies or pull-ups at night is a good way to see if a child is ready to be dry as there are some kids who will never by dry whilst they stay in them. Waking in a wet bed can help some children to learn to hold on to their wee or wake up before they’ve started wetting. However, for others taking away the pull ups makes no difference to their wetting whatsoever. At ERIC we support families to make the right choice for them – if taking away the pull-ups is causing more stress for everyone then they may choose to keep their child wearing them whilst seeking treatment and working on other good bladder habits that can help reduce bedwetting. Read our pages about night time wetting (aka bedwetting) for more help. 8. “Don’t let them have a nappy on to do a poo, you’re just giving in” At the toilet training stage, some little ones get really nervous about doing a poo without the security of their nappy and they hold on to stop their poo from coming. There are also those children who will happily wee on the potty or toilet but will only ever poo in a nappy. For some children going cold turkey on nappies will just mean they hold on to their poo and risk getting constipated. For those that are already full of poo, they’re likely to get even more bunged up and the vicious cycle of withholding and constipation is harder to break. So at ERIC we suggest that parents try a softly softly approach – doing things like keeping the nappies in the bathroom area and encouraging their child to sit on the potty or toilet wearing their nappy just to get used to it before moving on to the next step. Take a look at our tips for helping children who will only poo in a nappy. 9. “If they ate more fruit and veg they wouldn’t get constipated” It is important (but not always easy, we know!) to try and encourage children to eat their greens, but some kids have an amazingly varied diet and they still have a poo problem. By the time a child has become constipated just getting more fruit and veg in them won’t sort it out by itself. As the NICE Guideline on Constipation in Children and Young People recommend, macrogol laxatives are the first line treatment to clear a poo blockage and help to produce an ideally daily soft sausage-shaped poo. Plenty of water based fluids and a well-balanced diet will also help to keep them regular. 10. “But hold on, laxatives will make your bowel lazy! Try to wean your child off them as soon as you can” Sorry Granny and Mrs Smith at No 9 but this is a complete myth! The latest research on constipation shows that laxatives don’t make the bowel sluggish – but holding on to poo does! Macrogol laxatives like Movicol and CosmoCol work by delivering water to the bowel and soften poo, whilst stimulant laxatives such as sodium pico sulphate help the ‘push action’ of the child’s muscles. If they’re given consistently and at the right level, laxatives will stop constipation building up again and help a child to get back into the routine of pooing every day. If they are stopped too quickly or reduced too fast, then the child risks getting bunged up again. For more help with this see our information about children's bowel problems. Which leads neatly on to something at least one parent a day tells us they’ve been told (even by their GP)… 11.”Don’t worry they’ll grow out of it” This seems to be a universal bit of well-meant wisdom that’s imparted by everyone from your great aunt to the doctor you’ve already seen three or four times. As children grow and develop it’s possible that a large number of them will learn how to manage wee and poo accidents and eventually they’ll stop. It’s also true that the percentage of children who wet the bed falls to just 1% by the age of 16 years. However, all bladder and bowel problems need to be assessed as it’s so sad to think of children and families suffering for months or years because they didn’t think treatment was available. Even if children do eventually grow out of a wee or poo problem, just think of how many everyday activities such as camps and sleepovers they may have missed and the effect this could have on their self-esteem. All children with constipation and/or daytime wetting should have a physical examination by a GP to rule out underlying causes and treatment for bedwetting is available from five years old now. See the NICE Guideline on Bedwetting in under 19s for more information on this. For more help with any of the scenarios above please contact the ERIC helpline on 0845 370 8008 Monday to Thursday 10am to 2pm (9.6p per minute plus the service provider charge) or email [email protected].