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Up to 50% of children starting reception are still in nappies or pull-ups.
Some parents are being called into school up to five times a day to address their child’s toileting accidents. They have had to either give up work or remove their child altogether.
The usual critical voices say the problem is lazy parenting. In my professional experience of working with hundreds of families, however, that is not the case.
Most parents are highly motivated to help their child. They have sought out potty and toilet training advice from other parents, or social media influencers on platforms such as TikTok, but it only works to a point. Six to nine months down the line, their child is having accidents again.
A better way forward is for families and Early Years providers to work together to address the three key areas of toileting progress: Physical, Emotional and Environmental (PEE) factors.
When they do, all children – with or without additional needs, and regardless of age or ability – can get their ‘PEE & Poo in the Loo’ before school.
The job of the gut is to digest food. It also sends signals to the brain which, in both adults and children, can impact mood, food cravings, sleep, toileting and even behaviour.
The evidence shows that physical activity has many positive effects on gut health – from releasing endorphins to regulating stress and anxiety. From a toileting perspective, it also helps to improve how food moves from the mouth, through the digestive system and out of the body.
So, to help maintain a healthy gut, encourage children in your Early Years setting to move more – either through free play or structured exercise.
Young children can demonstrate behaviours that seem to change for no reason, almost like the weather. What is less understood is that these meltdowns are a sign of the powerful gut-brain connection, which sends signals to the brain and can trigger behaviours such as:
If you recognise any of these issues in a child under your care, use my free gut health tracker to monitor their habits, routines and responses. This will give you the insights you need to work with their parent(s) or primary caregiver to make meaningful progress.
In a busy Early Years environment, it can feel frustrating to be handed a child who will only poo in a nappy – adding to the demands of personal care.
When we let go of the negative belief that the child is being ‘difficult’ or ‘lazy’, however, we create room for curiosity around what is really going on and gain determination to help them.
In my experience, a child who is still pooing in the nappy does so for one or more of these reasons:
Most importantly, continuing to poo in a nappy is a sign that the child is struggling with either their internal or external needs – something that, as compassionate caregivers, we should want to help address.
Your task, therefore, is to work with the child’s family to identify what the internal or external need not being met is.
My free What to do About Poo guide – is an excellent starting point for identifying areas of concern and forming a plan of action.
Similar to the debates around older children still being in nappies, opinions can be divided on whether it is acceptable to force a child to eat. Some believe that children should not be allowed to leave the table until their plate is empty, or follow the mindset: “If they’re hungry, they will eat.”
Having to tell a parent that their child did not eat today at nursery can be stressful for practitioners and upsetting for them. You may worry you should have tried harder or fixate on understanding why they refused food.
In my experience, it is more constructive to switch your focus to when and how they do eat, and what is happening with their toileting to influence them eating in a certain way.
This simple shift can help you to start identifying and removing barriers – using my free download ‘Where to start getting PEE & Poo in the Loo’.
By now, you may have spotted some consistent patterns in my guidance, such as:
You may hear an internal voice that whispers: ‘I want to help, but I don’t have time for all this. What about the other children in our care?’ – something I empathise with greatly.
But let’s look at the consequences of not dealing with the toileting issues at hand:
Let me be the first to say to Early Years providers: it is important to recognise that while you play a vital role, you are not primarily responsible for ensuring children make progress with toileting. Parents and primary caregivers must be actively involved and continue supporting their child beyond the childcare hours you provide.
The best strategy is always for parents, educators and professionals to work together – taking a holistic approach to monitoring and recording toileting issues; experimenting with evidence-based solutions; and making a conscious effort to get children out of nappies and into reception, where they can grow and thrive with their peers.
This all begins with believing that every child has the capacity to have a healthy relationship with toileting – supported by good gut health.
Charmaine Champ
Continence, Sleep and Understanding Behaviour Consultant
Clear Steps Consultancy:
Website: www.clearstepsconsultancy.co.uk
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