Louie Says …

Building up the potty sits…

Increase the potty sits. After nap times and 20 to 30 minutes after eating are good times to aim for. This might mean that they sit on the potty around five or six times a day. Don’t keep them on the potty for too long – five minutes is enough. Having the potty in the bathroom sets a good routine. Your child will need to use the bathroom soon, so you can start as you mean to go on and keep the potty there.
When sitting your child on the potty, ensure their knees are above their hips and are well supported, with their feet on a flat surface. This is the best position for emptying their bladder and bowels. Praise your toddler if they poo or wee on the potty. Some children love
seeing their progress on a potty training chart. A chart can be used
to record every poo or wee, or just simply for sitting on the potty and
having a go. It is good to have some nappy off time after a poo or wee so your child learns how this feels.

What sort of potty should we get?

If a child doesn’t ‘get it’, it doesn’t mean you have to buy a different
potty. Buy a simple one and stick with it. Basic potties are good enough – it doesn’t have to play music, or flush, or look like a toilet. Boys should always sit down when they are learning to wee on the potty. This is because they empty their bladders best in that position. Louie does not recommended urinals for boys

What if my child can’t talk yet?

Your child does not need to be able to talk to be able to learn how to use a potty. Think of all the skills they have already learned before they can speak! You can help them understand by showing a teddy sitting on the potty. Talk to them about having a poo or wee on the potty. Let them see family members at home using the toilet.

Hand washing

Teach your child how to wash their hands after using the potty using soap and water.

What about childcare providers?

Potty and toilet learning starts at home. Ask other members of your child’s family to support them and follow the steps together. Speak to your childcare provider so that you can work together. Let all
those who support your child understand what you are doing so they can all be on board. Potty and toilet learning is a life skill and helps your child build their independence and self-esteem. Parents can help their child develop these essential skills for life by helping them learn.

You’ve got this!

Louie knows it’s not always easy! Potty training is a process and takes time. It is unusual for young children to suddenly ‘get it’. Don’t be disheartened and don’t give up if it feels like progress isn’t happening… keep the potty-sits going and help your child to build up the skills bit by bit.

Top tips:

• Show that you aren’t embarrassed to talk about poo and wee!
• Don’t expect instant success – potty learning is best tackled in a slow and steady way.
• Talk to your childcare provider about your home approach to potty training. Many places will be
  able to support what you are doing in their settings.
• Many parents believe summer is the best time to potty train. This can mean that there is a risk that
  potty learning may be delayed for another year. Children can learn how to use the potty at any
  time. Louie Says: ‘Don’t wait for summer.’

Introducing underwear:

Children can find pull-ups confusing. It is best to stick with nappies until you make the switch to underwear.

Plan to stop using nappies at a time when things might be a bit more stable for your child. For instance, if they are moving rooms at their childcare setting, or a sibling is on the way, it might be better to wait
for a short time until the upheaval has passed.

Set the routine:

Every day, keep up the potty sits. Around 30 minutes after finishing meals can be good timing for bladders and bowels. Don’t keep your child on there too long – up to five minutes is fine.

You might start to spot signs when your child needs to use the potty.

• Are they doing a ‘wee dance’?
• Are you starting to spot a pattern for when they tend to need a poo?

If you see the signals, gently direct them to their potty.

Use a potty before naptime. You can begin to phase out nappies when your child starts to be dry when they wake up.

Never punish or shout at your child. Potties and toilets need to feel like safe places. Praise and encouragement will help your child to learn the skills. Reward charts can also be great for motivation. Try not to encourage your child to go to the potty too often. The bladder is a muscle and needs to learn to stretch and hold liquid. Younger children might need to wee every 45 minutes but build up to 90 minutes as they get older.

Why stop nappies now?

Nappies and pull ups are very effective nowadays, which means that your child may not realise that they are wet. This makes it harder for them to make the connection between feeling wet and understanding that they can avoid that feeling by using the potty or toilet. The sooner you can help them to learn this, the better. Evidence has shown that it is easier to potty train a younger child than an older one. Pull ups can feel confusing to young children and can delay progress. (‘Am I allowed to wee in this? It can be pulled up and down like pants?’) It is better to make the switch to underwear sooner. Nappies are expensive and many families who potty train sooner like that they no longer have this expense.

Using the toilet

Introduce a toilet training seat when your child has become used to using the potty. These sit within your existing toilet seat to give a little more security. Make sure that your child is safe and stable and has steps to rest their feet on. Ideally their knees should be above their hips. This is the best position for emptying their bladder and bowels. Some children can feel worried they are going to fall into the toilet. Help them to feel calm, settled and relaxed. Do not hold your child down. Make sure they can safely get on and off the toilet. Teach your child how to flush the toilet. Encourage your child to learn how to wipe themselves clean. Always front to back for girls. Keep up the handwashing with soap and water every time they’ve used the toilet. Continue to praise your child when they have used the toilet. You could give a high five, or tell them how happy you feel that they have done a poo or wee on the toilet. You could use a chart to show when they have used the toilet. Phase out the potty chart and move on to a toilet chart.

Many people take a potty out and about with them. Regular stops and a car seat cover can be handy on longer journeys. When you’re out and about, remember to pack a change of clothes and a waterproof bag for any accidents. It’s important for your child to get used to seeing and using the toilet in other places. This helps them build confidence and understand that different toilets flush in different ways, and that some bathrooms and toilets can feel different to yours at home. It’s also good for your child to get used to some bathroom equipment that might not be at home, for example, hand dryers or paper towel
dispensers. This helps them be prepared for using the toilet when they start school.

Top Tips:

• Choose clothes that aren’t too fiddly for children and are easy to pull down and up again. Learning how to pull clothes up and down is part of developing the skills they need for using the toilet alone at school.

• Children love seeing their progress on a chart. As time goes on you can increase what you reward on a chart, such as pulling their own pants up and down and washing hands

• If you are able to let your child choose some underwear, this can help them feel excited about saying goodbye to nappies.

What about ‘signs of readiness’?

Some people talk about ‘signs of readiness’. However, we know that some children never show signs of readiness. This means that some families have delayed potty learning because they have been waiting for signs from their children. Some children might show an interest in using the potty or the toilet, however, not all do. This is why the bladder and bowel experts now advise potty learning needs to be led by the parents and not by the child.

Can I teach my child to go straight to the toilet and skip the potty?

If you don’t want to use a potty, you can still follow the Louie Says steps 2 and 3. You will need to use a toilet with a toddler seat. In step 1, Louie Says to start early with baby as soon as they can sit safely. It is not recommended that you sit a baby on the toilet however, so this advice changes if you decide you don’t want to use a potty. If you want to go straight to the toilet, pick up from step 2 and start to sit your child on a child’s toilet seat and follow the rest of the advice in step 2 (sit on the toilet shortly after meals for up to 5 minutes, build up to 5-6 times a day.)

It is good practice to get your child used to the bathroom environment before starting them on the toilet. For example, changing their nappies in the bathroom.

Make sure that your child is safe and secure on the toilet and that they have steps to rest their feet on so that their knees are above their hips. Knees above hips is a good position for emptying bladder and bowels.

Some children can feel worried they are going to fall into the toilet. Help them to feel calm, settled and relaxed. Do not hold your child down. Make sure they can safely get on and off the toilet.

Night time:

Staying dry at night takes longer. Your child might be comfortable with the daytime routine but still need a nappy at night. This is normal. Do not disturb your child’s sleep to go to the toilet. If your child is not dry at night by the age of five, ask for advice from your Health Visitor.

When things don’t go to plan:

Even if it seems that potty learning is not working, stick with the steps and keep up the routine. It’s all about helping your child learn to say goodbye to nappies and hello to pants. Be patient, persistent and
positive. It is normal for accidents to happen, and sometimes it can feel like your child is taking a step backwards. A potty chart can be great for your child to see the progress they have made and highlight the times when it has worked well. When accidents happen, involve your child in cleaning up (they can
pass you the paper that you are using to clean) and gently say that next time poo and wee needs to go into the potty or toilet. It’s important for your child to feel that they are not being punished or to feel ashamed about any accidents.

Help is at hand:

There is lots of help in Blackburn with Darwen to support you with potty and toilet learning. One to one support is available, as well as potty learning workshops. Family Hubs, Health Visitors, HomeStart and other services can all help you. See the back pages of this booklet for more information.

Being ready for school:

Most children are able to use the toilet independently when they start school. As your child approaches starting school, it is really important to give them plenty of time to learn the steps before the term starts. Aim to have at least a year of using the toilet before they start school if possible, but start as soon as you can.

Use other toilets when you’re out and about so that your child gets used to doing a poo and wee outside the home. They will also get used to other bathrooms and equipment such as hand dryers and
paper towel dispensers. Teach your child what they need to do when they start using the toilet by themselves. They will need to know how to flush the toilet, what to do if they get any poo or wee on the toilet seat, how to wash their hands and to put paper towels in the bin. Potty and toilet learning isn’t easy, but you’re helping your child develop their skills for being ready for school. You’ve got this, stick with it and celebrate the little wins!

Do I need to choose some time to really focus on potty learning?

Some parents think they will need to book time off work or have a few days where they don’t leave home to start potty learning. This isn’t needed; by following the three steps and making the potty part of the normal routine they can build this into every day life. A special chunk of time for potty training won’t be needed.

If your child has additional needs, it is important to follow the same steps 1,2,3 as early as possible. Some children with sensory needs might find aspects of potty training more challenging if they start later on. It’s even more important to build potty learning into their routine from an early age so it feels like a normal part of their day. Some children with additional needs can struggle with sensory elements of toilet training, such as sitting on a hard flat surface, the smells and the bodily sensations and the sounds of the flush or echoes in a tiled bathroom. Some older children can also struggle with changes to their routine. For these reasons, it’s even more important for families to introduce potty sits as early as possible so that it becomes a natural part of their daily routine. Remember that help is available in the Family Hubs especially for potty learning when children have additional needs.

Getting the environment right:

Consider your child’s sensory needs. Most people have the ability to filter out a lot of the sensory information they receive from the world around them. Some children can struggle with this and become
overwhelmed easily. Our senses of sight, hearing, smell and touch are bombarded as we enter the bathroom – bright lights, strange sounds, strong smells and cold, hard surfaces can make it feel like a difficult place. Your child might struggle to relax – but they will need to relax to let the wee and poo out.
If this is the case for your child, there are some things you can do to help the bathroom feel like a safer place.

• Putting a rug down on the floor can help the room sound less ‘echoey’ and feel softer underfoot
• Putting stickers on the tiles can help the child feel that they are in a friendly space
• Bright lights and reflective surfaces can feel overwhelming for some children. Can you minimise reflections with towels, or dim lights?
• Would it help your child to play with sensory toys whilst they sit on the potty or the loo? Some parents have ‘toilet toys’ that can be easily cleaned. These toys should only be kept in the bathroom and be easy to clean
• Blowing bubbles can help children to poo. This is because it’s harder to hold on to poo if you’re blowing
• Some children don’t like to be seen on the toilet. Some parents find that holding up towels as ‘screens’, building a towel fort or making a toilet cubicle from large box can help.

There are other factors around sensory that can feel different for children with SEND. Proprioception is how we sense our own body’s position and movements. Our vestibular system is to do with our balance. These both contribute to feeling safe on the toilet. Your child might feel like they need something behind their back to understand where their body is, or they might need to start with the seat down to feel safe during practice sits. Creating the right environment can make all the difference to your child. Visit the Eric website www.eric.org.uk or scan the QR code below for more information or contact the Family Hubs.

Physical needs:

We understand that it’s not always as straight-forward as following the 3 steps. Some children can experience physical issues that can make doing a wee or poo feel more difficult. It’s important to still get
started with potty sits early and not delay. Some children with additional needs and disabilities can be more likely to experience constipation. Constipation is when it can be difficult to poo. Constipation can cause problems with wee too, because the bowel expands and starts to take up space that the bladder uses. If children aren’t doing a poo every day, or at least every other day, they could be constipated. It is really important that children have around 6-8 drinks each day to make sure that their bladders and bowels have the best chance of staying healthy. The Eric website has some excellent information about constipation, including causes, symptoms and treatment. If you are worried about constipation, speak to your Health Visitor as soon as possible.

What if my child struggles to communicate?

Your child does not need to be able to talk to be able to learn to use a potty. Think of all the skills they have already learned before they can speak! Some parents help their children understand by showing a teddy sitting on the potty. Let them see family members at home using the toilet. Visual Supports: Some families use picture cards, songs, social stories, or step-by-step charts to help the process. Eric have produced some useful documents. See their Toilet visual schedule and Toileting social script on the Eric
website by visitng www.eric.org.uk or scan the QR code below.

Who should teach a child with additional needs to use a potty or toilet?

Potty learning starts at home. Speak to your child’s childcare providers about tackling potty and toilet learning so that you can work together. Let all those who support your child understand what you are doing so they can all be on board. Think about communication. Make sure that whatever your family uses (signs, symbols, songs) it is consistent across whoever is supporting your child.

Will I need a referral to a clinical service?

Our local clinical bladder and bowel service tell us that some children are referred to them just because additional needs are present, and families have felt that potty learning should be tackled by a specialist
service.

The nurses find that in most cases, potty training using the three Louie Says steps works well for children with additional needs. They advise that children with additional needs should start potty learning early in line with Step 1, but start as soon as you can if your child is older.

The clinical services will expect that potty learning has been tackled at home and that help from community supports has been used before a clinical referral is made.

Remember that help for potty learning for children with additional needs is available from Family Hubs, and this should be your first port of call before any clinical referrals are explored.

East Lancashire Bladder and Bowel Service supports children with constipation, soiling and over 5’s who are night time wetting. Speak to your health visitor or school nurse if you want more information on clinical referrals.

Top Tips:

• Dress for Success: Easy-to-remove clothing can be helpful and encourages independence.
• Short sits: it is recommended that you sit your child on a potty or the loo for up to 5 minutes. Any longer than that can put pressure on their bladders and bowels.
• Choose the Right Equipment: Do you feel your child needs a special potty with more support or a toilet chair? They need to be able sit with their feet flat and supported and knees above their hips. You can request an OT (Occupational Therapist) assessment if you think they cannot sit safely and comfortably in the right position on the family toilet. Your GP or Health Visitor can refer you for this.
• Celebrate the little wins: We know that potty and toilet training can be a long journey, but your patience and support make all the difference. Celebrate every step… it’s important to recognise effort, not just success.
• Check out Eric.org.uk: There are many hints, tips, podcasts and webinars for parents on the Eric website with useful information about toileting children with additional needs.
• Watch: Tom’s Toilet Triumph on YouTube. Lots of videos about potty training show children sitting down on the potty. Visual learners might need to see the actual poo and wee to make the connection. This video shows what actually happens when children poo and wee.

A note about drinks:

Children should drink 6-8 glasses of liquid each day. The best drink is water as it hydrates and is kind to
teeth. If children are hot or are very active, they will need to drink more. Drinking plenty of fluid is important because it helps to keep children’s bladders healthy and protects against constipation.

A note about constipation:

Constipation is common in children. Constipation is when it can be difficult to poo. Constipation can cause problems with wee too, because the bowel expands and starts to take up space that the bladder uses. Diarrhoea can be a sign of constipation, even though this might seem surprising. If children aren’t doing a firm poo every day, or at least every other day, they could be constipated.

The Eric website has some excellent information about constipation, including signs and symptoms and treatment. See Eric.org.uk

If you are worried about constipation, speak to your Health Visitor.

There are lots of places to go for help with potty and toilet learning in Blackburn with Darwen. Family Hubs, Health Visitors, Homestart and other services can help. There is 1-1 support, workshops, online information and phone options. Advice is available for potty learning for children with additional needs.

Useful Contacts

1-1 advice and support:

• Family Hub Early Years Development Team: 01254 585000 (Option 1) www.familyhubsbwd.org
• Your Health Visitor: 01254 585000 (Option 2)
• The Health Visiting Team have a daily duty service to take your calls and offer advice.
• Homestart BwD: 01254 692613

Online information (including FAQs and workshops about potty and toilet learning)

• Family Hubs: www.familyhubsbwd.org
• Eric (National charity dedicated to improving children’s bowel and bladder health): www.eric.org.uk
• Toms toilet triumph – https://www.youtube.com/watch?v=be2Zc1dmxIM
• Duggee’s potty song – https://www.bbc.co.uk/cbeebies/watch/hey-duggee-potty-song

As soon as your baby can safely sit up without needing to be supported, start sitting them on a potty. This is usually when they are around 6-8 months. We know this might feel really early. Your child is very unlikely to ‘get potty trained’ at this stage, it’s more about helping them become used to how it feels to sit on a potty and getting into the habit of potty sits.   

We recommend the following: 

 Starting with potty sits around 6-8 months (when baby can sit safely) 

Around 18 months start to increase the potty sits 

At 18-30 months aim to stop using nappies. 

Don’t worry if your child is already past these recommended ages. Just start as soon as you can and work through the steps.  Older children might be able to move through the steps more quickly. 

Some people used to talk about ‘signs of readiness’.  However, some children never show signs of readiness, which means that some parents leave potty learning really late.   

For this reason, we say that potty learning is best being parent-led and not child-led.  By incorporating potty sits from a very young age, babies accept that it is a natural part of their day, and it doesn’t suddenly become a big ‘thing’ to introduce all in one go later on.  

In the 1970’s and 80’s, 84% of children were potty trained by 18 months.  Nationally, the age of introducing potty learning has started to drift later and later, which has meant that some children are starting school still wearing nappies.  It also meant that parents have to find the money to buy nappies for much longer than they need to. 

This campaign aims to help parents and their children achieve potty learning early.  This way parents can save money on nappies and children are well prepared by the time they start school.   

All the information has been produced with Lancashire Bladder and Bowel Service and uses the guidance from Bladder and Bowel UK and Eric, the national children’s bladder and bowel charity.  

Potty learning starts with families.  Speak to your child’s childcare providers about tackling potty and toilet learning so that you can work together.  Let all those who support your child understand what you are doing so they can all be on board.  Parents need to lead the way and be supported by their childcare setting. 

First of all, it’s really important not to sit children on a potty or toilet for more than 5 minutes, as it puts pressure on their bladders and bowels.  Children are more likely to be on board with the potty sits if they’re only a couple of minutes at a time. 

It can be really tempting to sit them on the potty in front of a screen for a while, but this is not recommended.  Here are some things you can try. 

• Make this a positive experience for your child. What does your child like? You can sing, read, make lots of eye contact and help them learn that the potty can be a happy place. 

• Potty sits work well around 20-30 minutes after eating, as the bladder and bowels are more likely to empty then.  

• If they do manage to wee or poo, give plenty of praise. 

• Show a teddy sitting on the potty. 

• Keep a reward chart for sitting on the potty.  A small reward such as a sticker at the end of the day for getting ticks can be a good incentive.  Once they start to poo or wee on the potty, phase out the ticks for potty sits and introduce ticks for actually doing a poo or wee. 

• Keep a few potty/toilet toys that they can play with whilst they do their potty sits. 

• Introduce songs about going to the potty Learn how to use the potty with Hey Duggee’s Potty Song – CBeebies 

Give praise for sitting on the potty, whether or not they do a poo or wee.  Say how pleased you are that they sat on the potty.   

If you don’t want to use a potty, you can still follow the Louie Says steps 2 and 3.  You will need to use a toilet with a toddler seat.   

In step 1, Louie Says to start early with baby as soon as they can sit safely. It is not recommended that you sit a baby on the toilet however, so this advice changes if you decide you don’t want to use a potty.   

If you want to go straight to the toilet, pick up from step 2 and start to sit your child on a child’s toilet seat and follow the rest of the advice in step 2 (sit on the toilet shortly after meals for up to 5 minutes, build up to 5-6 times a day.)  

It is good practice to get your child used to the bathroom environment before starting them on the toilet. For example, changing their nappies in the bathroom. 

Make sure that your child is safe and secure on the toilet and that they have steps to rest their feet on so that their knees are above their hips.  Knees above hips is a good position for emptying bladder and bowels.  

Some children can feel worried they are going to fall into the toilet.  Help them to feel calm, settled and relaxed.  Do not hold your child down.  Make sure they can safely get on and off the toilet. 

Some children with additional needs can struggle with sensory elements of toilet training, such as sitting on a hard flat surface, the smells and the bodily sensations and the sounds of the flush or echoes in a tiled bathroom.  Some older children can also struggle with changes to their routine.  

 For these reasons, it’s even more important for families to introduce potty sits as early as possible so that it becomes a natural part of their daily routine.   

Ask your Health Visitor or Family Hub staff for a copy of the Louie Says guide.  Follow the advice and consider the extra tips in this leaflet.  

Remember that help is available with potty learning in the Family Hubs, including how to potty learning when children have additional needs.   

If it feels like you’re not making progress, it can be tempting to give up and try again later.  This 3- step approach encourages parents to take it slow and steady and stick with it.   

There are lots of skills that children need to learn for using the toilet, so introducing these in one go can feel like a lot for children and families.  That’s why this approach aims to make potty sits part of the routine from an early age and encourages families to help their children build up the skills slowly.   

If you have tried the programme and you feel as though you’re stuck, help is available for families in Blackburn with Darwen from Health Visitors, Family Hubs and other services (see our Help and Support section.)  If you’re reading this and you live outside Blackburn with Darwen, there is some excellent information on the Eric Website (plus Eric also have a National helpline) Home – ERIC 

Choose clothes that aren’t too fiddly for children and are easy to pull down and up again. Learning how to pull clothes up and down is part of developing the skills they need for using the toilet alone at school 

• If you are able to let your child choose some underwear, this can help them feel excited about saying goodbye to nappies 

Children love seeing their progress on a chart. You can start rewarding your child just for sitting on a potty, then build up to rewarding if they do a poo or wee on a potty. As time goes on you can increase what you reward, such as pulling their own pants up and down and washing hands. 

There is lots of help in Blackburn with Darwen to support you with potty and toilet learning.  

One to one support is available, as well as potty learning workshops. Family Hubs, Health Visitors, Homestart and other services can all help you.