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| Is your kindy-bound kid toilet ready? |
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'Big' school is just around the corner for thousands of children across Australia. Yet, many of these kids will be heading to school with the additional worry of not being fully toilet trained – whether that is daytime accidents, or wetting the bed, or both.
One in five primary-aged children will wet themselves during the day (Sureshkumar et. al 2000) and 10 per cent of five year olds still wet the bed at night.
So, what can you do as parents to address the problem before the first day of school arrives?
Daytime accidents
If your child is having daytime toileting accidents, talk to your early childhood education and care provider to assess why these accidents are occurring. Is your child too preoccupied in play? Are they still unaware of feeling the need 'to go'? Or is there something else happening? Put a toilet training strategy in place with your provider, working towards the start of the school year.
If accidents are a regular occurrence that you are concerned will continue into the new school year, raise it with the teacher at the new school during any orientation sessions you have, so they are aware of the problem. This way they know to watch for the signs, as well as remind your child to go at break time, or to always let them go during class time if they need to. Kindergarten teachers are very used to the problem, so can discreetly manage any accidents that might occur.
The significant change of heading to school can also lead to fully toilet trained kids regressing as they adjust to their new surroundings – with some children starting to 'hold on' during the day. This might be that they are too engrossed in the new experiences, the toilets are scary or smelly, or they don’t feel able to go during class time.
Holding on during the day can lead to bladder and bowel control problems, such as incontinence, so it's something that should be addressed early. Also, a Swedish study (Lundblad and Hellstrom, 2005) found that children who had negative associations with toilets at school in their early years could develop unhealthy toilet habits into their adult life.
To help schools and parents teach children how to adopt healthy toilet habits, Continence Foundation of Australia has released a Toilet Tactics pack for schools. The pack guides teachers and parents in encouraging and reinforcing good practices early, and to help them to recognise the signs a child might be experiencing bowel or bladder problems.
Night training
Health professionals recommend treating bedwetting (also known as nocturnal enuresis) earlier rather than later. So, if a child is still wetting the bed by age five, it is worth starting to take steps to address the problem.
The three common reasons for a child wetting the bed are:
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An overactive bladder – wetting the bed several times a night and also experiencing an urgency to go during the day.
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A deep sleeper – they simply sleep through the sensation of needing to go.
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Lacking certain hormones – some children don't produce enough antidiuretic hormone, so produce more urine at night.
The first steps to addressing nocturnal enuresis include:
- Treating constipation. Constipation squashes the bladder, which can lead to bedwetting.
- Ensure your child's diet includes plenty of fluids during the day, fresh fruit and vegetables.
- Reducing fluids at night. Ensure they have plenty to drink during the day, but avoid big drinks before bedtime, and always have them go to the toilet before they go to sleep.
If bedwetting is still a problem at age 6 or 7, it can be helpful to see a continence specialist for next-step treatment options. A common treatment option is a bed alarm, where the child wears a moisture sensing alarm that wakes them as soon as moisture is detected. There is a high success rate with bedwetting alarms but it can be exhausting for the whole family while the treatment is in progress. Another treatment option is a prescription drug that can reduce the amount of urine produced during the night, which a continence specialist or your GP can advise on.
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