At this time of year, the National Continence Helpline receives many frantic calls from parents with this very question. While incontinence can be extremely distressing – for both child and parent – a proper assessment by a health professional can sometimes point to simple causes and a resolution in sight. In the meantime, we’ve outlined helpful steps so your child can settle into school life.
We expect children to be fully bladder and bowel toilet trained by four years of age and by six to seven for bedwetting. If your child is still experiencing issues after this time, it is important to speak to a health professional.
Sometimes people will tell you that your child will just ‘grow out of it’. In reality, we do not know which children will improve with age. Be reassured that with the right help, your child’s incontinence can be better treated, managed or cured. Your GP, maternal child health nurse and the National Continence Helpline can advise further.
Your child will require an assessment and this usually includes recording the drinks they take in and the urine and poo going out. It sounds like a bit of a hassle, but it really gives the health professional vital information.
A fix won’t happen overnight, so there are positive steps you can take now to help your child settle into school while seeking medical attention:
Try to avoid constipation
Try to avoid constipation by setting good habits around toileting and regular drinking. It may surprise you, but almost all cases of children soiling their underwear with poo are caused by constipation and the large bowel not emptying properly.
Maintain a good sitting routine
It’s important to maintain a good sitting routine on the toilet in the morning, which may mean getting up a little bit earlier. Encourage your child to sit on the toilet for three to five minutes, about 20 to 30 minutes after breakfast, as this is a time when the urge to open the bowels is strong. Make sure your child is well supported on the toilet with a footstool under their feet. It's great to settle into a routine like this because if a child is pooing before school then they are less likely to need to go when at school.
Take a book! Image: iStock.
Monitor fluid intake
Keep an eye on your child’s fluid intake to make sure it doesn’t decrease during school hours. This can be done by marking your child’s drink bottle so they know how much water they have to drink in the morning, lunch and afternoon or sending them to school with two to three smaller bottles.
Use positive and language
Do not punish your child when they have an accident. A common misconception is that incontinence is due to naughtiness, laziness or attention-seeking but this is certainly not true. Often, the child is deeply upset inside. If you need to prompt your child to go to the toilet, then give them a directive rather than asking if they need to go. Examples are: “It’s time to go to the toilet” or “Toilet time now, please.”
Even if your child’s accidents are happening irregularly, it’s important to plan ahead so they are supported at school. A school continence care plan needs to be made with input from a health professional, the school, parent/guardian and child. The care plan may include:
- supplying a change of clothes – preferably exactly the same as what your child was wearing so no one will notice if your child has changed
- wipes and plastic resealable bags for dirty items, as these help to stop any odour escaping from their school bag or bin
- your child being allowed to go to the toilet when they ask and potentially arranging a special signal to the teacher which means they are going to the toilet
- needing to use the closest toilet to the classroom or being discreetly reminded that it is time to go to the toilet.
It helps to plan ahead when it comes to using the toilet. Image: iStock.
It’s vital that your child’s teacher is aware your child has a continence issue and knows about the plan. Tell them about the Continence Foundation of Australia’s Toilet Tactics program, designed to equip teachers and schools with the confidence to promote good bladder and bowel health.
The online Toilet Tactics program also encourages improvement or maintenance of school toilets, as toilet standards can often be a culprit behind kids having accidents at school. We know that some children do not like using their school toilets for reasons like doors not locking, the smell, no toilet paper etc. Make sure that your child knows where the toilets are and ask them simply: “Are you using the toilets at school?”
Janine is a Nurse for the National Continence Helpline and maternal-child health. For further support and information, you can always free call the National Continence Helpline on 1800 33 00 66 to speak with the team of experienced continence nurse advisors.