School nursing advice for problems using the toilet

Children are all different when it comes to learning to use the toilet and controlling their bladders and bowels.

These milestones rely on them gaining physical awareness, which involves hormones out of their control, and various physical and communication skills to use the toilet or get the help they need with using the toilet. Moving and replacing or fastening clothing, wiping, flushing and washing hands take a lot of practice.

Parents and carers need to help children to practice these skills every day. While some children will master these skills easily, many children’s learning journeys will be more challenging.

The school nursing team can provide some first line advice and guidance around how to best support your child with toileting.

Is it constipation or a UTI?

Whether your child is having wetting or soiling accidents in the day or the night, it is recommended to check for constipation first, before anything else.

You can learn all about constipation and check your child’s poo and symptoms against The Bristol Stool Chart on The Children’s Bowel and Bladder Charity (ERIC) website.

We always recommend taking your child to see the GP to check for constipation. The doctor can feel your child’s tummy and ask some questions to work this out. They can also test for a urinary tract infection (UTI) by taking a pee sample.

Medication

It is important to take any medication properly for constipation or a UTI as advised by the GP. This will often resolve some toilet issues. If you think the medication has not worked as planned, discuss your concerns with the GP.

A school nurse may be able to help if you are unsure how and when to give your child their prescribed medication.

Bedwetting

The type and amount of fluid a child drinks in the daytime, as well as how often they go to the toilet, can contribute to whether they are dry or wet overnight. Visit the ERIC website for more information on bedwetting and how to stop it.

Did you know that blackcurrant and caffeine irritate the bladder? Drinking blackcurrant squash or caffeinated drinks such as coffee, tea, hot chocolate, colas and energy drinks can contribute to bedwetting. Some people find that cutting out these drinks from their child’s diet helps them to stay dry at night. Also try to keep chocolate to a minimum as it also contains caffeine.

Some children have sensory difficulties that impact on their ability to manage their bladder and bowels. There are some useful resources for children with additional needs that we recommend.

What if we need more help?

The Sheffield Children’s hospital community continence team can help further if problems persist. They have specific referral criteria.

The Sheffield Children’s resource library also has lots more resources that you may find useful.