This post has been written by Davina Richardson, Children’s Continence Nurse at Bladder & Bowel UK.

The Daily Mail recently featured an article (‘The nine year olds who still need nappies’ June 29 2017) about the number of children with toileting problems who are wearing nappies when they start school and “…children as old as nine who still cannot use the toilet properly.” It states that fifty years ago the average age for toilet training was 15 months.  However, it does not seem to ask or answer the questions about why children are toilet training later than in previous generations, and why some still have problems in the later stages of primary school.

50 years ago most mothers were at home full time and did not have access to good quality disposable nappies, that kept children feeling dry and comfortable and unaware of when they had passed urine or opened their bowels. Also back then, children wore Terry nappies. The child knew when it was wet or soiled and the mother had to wash the nappies, often by hand.  It was easier for parents to sit their child on the potty after every meal or drink to ‘catch’ wees and poos, than it was to clean a nappy.

Cotton Nappies

Today, parents are often taught to wait to potty train until the child says they want to wear pants or tells their carer that they need a wee or poo, in the belief that this will make training quicker and easier.

Sadly, too often this is not the case. The child may not want to, or even realise they need to change a behaviour that has been reinforced since the day they were born. Many professionals receive no proper education about what is realistic for children in terms of potty training and parents or carers may receive conflicting or no advice, leaving them confused and uncertain on how to proceed.

Toileting problems such as daytime wetting, bedwetting, constipation and soiling have always been present.

Nine year olds, or indeed any school aged child who “…cannot use the toilet properly” should be offered assessment and treatment for their health problem, in the same way they would if they had a mobility or speech issue.

Parents and carers should be encouraged to seek advice and support from their GP, health visitor or school nurse in the first instance. They may need a referral to a specialist children’s continence clinic or to a healthcare professional with a special interest in childhood continence.

There is information about all aspects of children’s continence on the Bladder & Bowel UK website and there is a free confidential helpline on 0161 214 4591.


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