Toileting Accidents at School

There is no doubt that the parents of children who have wetting or soiling problems know the public perception of these problems and much of their fear is of being tarred with the 'bad parent' brush by other parents and teachers.

It's that time of year again - when children and their parents flock to the school gates. Dressed in new 'room to grow' school uniforms, children eagerly form new friendship groups and anticipate the exciting new school year ahead. Parents smile and heave a sigh of relief that six weeks of grey and rainy school holidays are over and they no longer have to rack their brains for cheap ways to keep their offspring entertained.

This idyllic picture is not one that all parents envisage, some dread the new school term and fear whether their child will cope or will end up being picked on or bullied. What is the cause of these worries? Wetting and soiling problems at school.

Looking from the outside there is often an element of blame placed on parents - "Why didn't she toilet train her child properly?" or "She must be lazy, I toilet trained my child at 18 months and have had no problems!" or "Why do they let their child do that, I wouldn't put up with it!".

There is no doubt that the parents of children who have wetting or soiling problems know the public perception of these problems and much of their fear is of being tarred with the 'bad parent' brush by other parents and teachers.

Wetting and soiling problems are things that happen to children, and are not something they 'do' or can avoid without intervention and support from a health professional such as a school nurse or GP.

Let's look at daytime wetting first. It can happen for a variety of reasons, the most common are a UTI (urinary tract infection), an effect of constipation or an overactive bladder (when the bladder contracts without warning). All of these can be resolved with a visit to the GP or school nurse for medication or management techniques. An overactive bladder can take a lengthy time to overcome and a child will need quite a bit of support from parents and in school before they are fully dry.

Soiling creates the biggest problem as socially it is smelly and unacceptable. But imagine the confusion of the child who finds they keep getting bits of poo in their pants and they don't know it has happened or how to stop it happening. Soiling is caused by constipation and occurs when the bowel is full of hard poo. The newer poo leaks past the big lump or pieces break off the end as the hard poo pushes down and it simply pops out. When there is a lot of poo constantly in the bowel the sensation of needing to go gets weaker and the child often really doesn't know they have pooed.

A side effect of constipation is the pain of passing a large or hard poo which can cause a child to instinctively try to stop the painful poo coming out - this then causes even more problems. The way around this poo cycle is to visit the GP to have some paediatric laxatives prescribed - for many children they will need to take it for quite some time. Adjusting a diet can be useful but on its own it usually isn't enough as most constipated children have what is known as idiopathic constipation - it happens for no known medical reason, they are simply prone to it.

Ten top tips to help overcome children's wetting and soiling problems

1.Visit the GP or school nurse for an assessment, prescribed medication and management techniques. If you are worried, or something has recently changed with your child's toileting habits, don't put off making that appointment, things can be resolved much quicker if dealt with sooner, rather than later

2.Encourage children to drink well at school - water is best

3.A daily toilet routine can help with constipation and daytime wetting. Boys should be encouraged put a time in their day, every day, to sit down for a poo

4.Weeing should be in one relaxed stream. Pooing needs a bit of activity to push it out

5.Ask the school to allow your child to have access to go to the toilet straight away when they need it

6.A good varied diet is recommended and regular meals help the bowel to move

7.Exercise helps stimulate the bowel reflex and gets things moving

8.Put a clean-up bag in the school bag with spare pants, wet wipes and a sealed bag (to put wet or soiled pants in) and agree with your child when they should change and practice how to do it

9.Buy products that can reduce your stress and help you manage the problems - ERIC's website has a one stop shop for useful and attractive childhood continence items, such as a vibrating reminder watch (to remind a child to go to the toilet), discreet (panty liner type) pads for wetting or soiling accidents, discreet absorbent pants, swimwear, happypee! (for avoiding accidents when travelling) and much more. Visit www.eric.org.uk

10.Find out more about children's wetting and soiling problems and what can help by contacting ERIC - we have a Helpline you can call or email, a website with lots of useful free information to download including leaflets and message boards to interact with other parents and much more. Call the ERIC Helpline on 0845 370 8008.

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