Families Bladder and bowel issues at school Healthy bladders and bowels at school In the UK an estimated 900,000, or 1 in 12, 5-19 year olds suffer with a continence problem* Bowel and bladder issues such as daytime bladder problems, bedwetting, constipation and soiling can have a devastating impact on a child’s learning, development and well-being. For many sufferers their continence problem will be 'chronic' - meaning it could persist for many years or keep recurring. It's an issue that will therefore commonly affect not just younger children, but also teenagers. Continence issues are often poorly managed in schools and education settings. A lack of awareness amongst health and education professionals, along with the stigma that still surrounds wee and poo is affecting many children and teenagers' school experience. These children are at high risk of bullying and withdrawing from social situations. *NHS Modernisation Agency (2003) Good practice in paediatric continence services - benchmarking in action, Department of Health. Toilet access Some children struggle with a bladder condition which means they need to wee urgently and frequently, others may have a bowel condition such as constipation. When these children need to wee or poo, they have to go and shouldn't be told to 'hold on'. If they’re afraid to ask to go to the toilet or the toilets aren't a pleasant place to be, this can make their continence problem worse and reduce their ability to manage or overcome it. For small children it may negatively affect their ability to learn to use the loo. Health risks Banning toilet breaks during lessons can aggravate continence problems when children are forced to hold on or stop drinking and/or eating to avoid the urge to use the toilet. Not only does this risk wetting or soiling accidents, but it can also lead to more serious problems with their bladder and bowel such as urinary tract infections (UTIs) and constipation. Holding back the urge to wee or poo can result in children being distracted and unable to focus in class. Reduced drinking can also lead to dehydration which can negatively affect their concentration and energy levels. Find out how schools can improve their policies on school toilets. Read our suggestions of what to do to get your school to re-open the toilets during lessons. Improving school experiences By raising awareness amongst school staff of continence conditions, we want to improve the school experience of children and teenagers. We also want schools and education settings to realise the importance of providing high quality and accessible toilets. Good school toilet facilities go hand in hand with improvements in care for pupils with bowel and bladder problems and avoiding issues arising. Our free resources and information can be used by schools to improve their policies to avoid discriminating children with bowel and bladder conditions and to ensure pupils with continence problems are fully supported. It can also be used by pupils and parents to encourage schools to improve their policies and their toilet facilities. 'Toilet pass' Since the passing of the Children and Families Act in 2014, education settings have a statutory duty to support children with health conditions, including bowel and bladder problems. If a pupil has an identified continence issue that the school is aware of, they should be given a 'toilet card' or similar that allows them to go to the toilet when they need to. The school may ask for a signed letter from a health professional requesting that a child has a condition which means they need a 'toilet pass'. Download our sample toilet pass Read our blog about schools and medical conditions. In schools where the toilets are locked, these pupils have to get a key before they can use the facilities. Although on paper this sounds like a reasonable compromise, for a child with urgency problems, this is not a feasible solution. This policy also singles out pupils with bowel and bladder conditions – when they may want to keep their condition private - as they are the only pupils allowed to use the toilet during lessons. Individual Healthcare Plan for pupils with continence conditions An Individual Healthcare Plan (IHP) is essential to ensure a child’s needs are sensitively and effectively met in education settings and that all people responsible for the child understand their needs. ERIC has produced a template IHP with input from Dr Eve Fleming, a community paediatrician and Brenda Cheer, a Paediatric Continence Specialist Nurse. The plan was reviewed by a school nurse, a paediatrician, and two families of school-age children with continence problems. Download the template Individual Healthcare Plan here. Advocacy support for parents The ERIC helpline can help you improve the support your child receives at school. Our helpline staff give rights-based information that you can use to press for better care and/or better school toilets. Get answers to questions we are frequently asked about legislation relating to supporting children with bladder and bowel problems in schools and standards for school toilets. Parents have shared with us their experiences of getting schools to provide better care and toilets. Read Nicola's story now. Continence Management Training for Schools We run training courses to help school staff implement best practice when managing pupils' bowel and bladder problems. Visit our training pages for details about the course including the topics covered, the expert speakers and upcoming dates and locations.