It’s time for a new approach to teaching toilet training and toileting independence in schools and Early Years settings, says Elisabeth Whitebread…
Within the last two generations in the UK, there has been a revolution in potty training. Whereas our grandparents were nappy-free by 18 months, today many children are three or older before achieving toileting independence.
This delay has far-reaching consequences for children’s health, development and wellbeing. Yet, beyond a few health and early years professionals, it is little known or talked about.
Since 2020, Kindred2 have undertaken school readiness surveys. These are to assess the extent to which children are entering Reception with the skills they need to thrive.
They found that a staggering 24% of children start school still having frequent accidents. An overwhelming 90% of teachers report having at least one child in their class who is not fully toilet-trained.
Director Felicity Gillespie told me, “It never occurred to us that this was happening basically in every school in the country. And that it was happening to such a degree that it was skewing the entire provision of early years education for every child.”
These accidents often require two adults to assist the child. Based on Kindred2 data, I’ve calculated this leads to an average of an hour per day of lost teaching time per class.
Children’s health is also suffering. Research has linked prolonged use of nappies to an increased risk of urinary tract infections and constipation. Many children suffer anxiety and diminished self-confidence as a result.
Alongside the financial cost to parents and early years settings, the collection and disposal of nappies costs local authorities in England £160 million per year.
Moreover, each additional year a child remains in nappies consigns approximately 1,000 extra single-use plastic nappies to the rubbish dump.
Kate Spencer-Allen, head of Foundation Stage at St Matthews Primary School in Cambridge, told me: “The benefits of ensuring that a child is toilet trained are clear.
“We can see how it helps foster independence, boosts self-esteem and promotes a smoother transition into both the social and academic demands of the school environment.
“But it is also clear to see that more and more parents need support with how to achieve this.”
But why are parents teaching their children this crucial life skill later than they used to?
The answer to this question is a combination of societal changes, cuts to support services, and the single-use nappy industry.
With the rise of dual-income households, children are starting nursery earlier. In the past, early years settings tended to serve children aged three and up. Being toilet-trained was often a requirement of admission.
Nowadays, children usually start at a nursery or childminders aged 12 months or younger. Settings have adapted by including nappy changes as part of their provision.
Be it health visitors, much-missed Sure Start services, nurseries or family workers, early years education and support services have been chronically underfunded in recent decades.
Kindred2 found that 22% of parents had never even seen a health visitor. Only 30% of nursery staff receive training to support toileting independence.
This lack of support and reliable information leaves parents with little knowledge about potty training (as well as a whole host of other things). Meanwhile, early years professionals themselves do not receive adequate training due to lack of funding and high staff turnover.
The single-use nappy industry has played a crucial role in shaping current potty training practices, and has a vested interest in keeping children in nappies longer.
Famously, Pampers was Procter & Gamble’s first $10 billion brand. In the 1980s, the company funded paediatrician Barry Brazelton to advocate that parents should wait until their child is “ready”, a term often left vaguely defined but implying that the child will indicate when they are prepared.
This concept, combined with the marketing of products like pull-ups by Huggies in the 1990s, which often featured older children, has normalised later toilet training.
These factors, combined, have led to the emergence of three pervasive myths that perpetuate late and ineffective potty training. These are:
1. Starting between ages 2 and 3: Historically and globally, children start much earlier and are mostly trained by 1–2 years.
2. “Signs of readiness”: While some children show clear signals like the “wee wee dance”, many do not, leading parents to mistakenly think their child isn’t ready.
3. The “three-day method” can work for all: Promoted as a quick fix, this method is not universally effective and can be extremely stressful for parents and children, and if it doesn’t work can entrench further problems.
The evidence suggests that teaching the necessary skills gradually as children become developmentally ready, rather than through intensive “training”, is more in line with how they develop other skills and is likely to lead to starting potty training earlier.
Plus, it’s less pressurising for all involved than the one-size-fits-all “threeday method”, which expects children to go from never having encountered a potty before to being ready for accident-free outings within the space of a long weekend.
Rebecca Mottram, children’s nurse and pottying expert, says, “We wouldn’t strap children to a high chair for 18 months and then expect them to walk.
“We understand that learning to walk is a gradual process that starts with head control, and that there will be many steps and little tumbles along the way.
“We should think of teaching children to use the toilet in the same way.”
Mottram, alongside ERIC, the Children’s Bowel and Bladder Charity, advocates for an approach where children are introduced to the potty as soon as they can sit up on their own.
This method involves sitting children on the potty at times when they are likely to need it (e.g. upon waking, after meals) and praising them if they do a wee or a poo, helping them to form positive associations with potty use.
Some nurseries are already taking steps towards adopting this method. ERIC is working with Bristol City Council to provide training to their 10 maintained nursery settings.
Cheryl Hadland, founder of Tops Day Nurseries, tells me: “We plan to start potty training much earlier, imminently, so children become used to seeing other children and having their pees and poos caught in a pot as soon as they can sit securely.
“I think different managers and their teams will address this in different ways, and we will feed back on their success as we experiment.”
Currently, most nursery settings operate under a parent-led approach, meaning they wait for parents to signal that they are beginning potty training at home before providing support.
But what if nursery staff felt confident and empowered to proactively teach children and their parents the skills they need to become nappy-free sooner? In my experience, parents are crying out for this support.
I’d love to start a conversation with any early years professionals who would like to collaborate on developing an evidence-based, child-centred approach in their setting.
Elisabeth Whitebread is the founder of social enterprise Sprout, which is on a mission to transform infant toileting for the better.
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