down syndrome baby smiling

This post has been written by Davina Richardson, Children’s Specialist Nurse at Bladder & Bowel UK. It is often assumed that because children with Down Syndrome have delayed development, they will inevitably be delayed toilet training. Healthcare professionals often advise parents and carers to wait until the child seems ready.  However, there is no evidence or even agreement among experts about what is meant by being ready. In addition, toilet training is not a single event, but is about children learning a set of skills.

Things that help with toilet training are:

  • Trying to encourage your child to drink plenty of water-based drinks (about a litre a day for children aged 2-3 years old) and try to make sure they have a healthy diet, including fruit and vegetables
  • Changing children in the bathroom encourages them to associate wees and poos with toileting, particularly if any poos are tipped into the toilet.
  • When children can stand up on their own, it is a good idea to change them in a standing position. This way they can be more involved in pulling their clothes up and down and with checking their nappy to see if it is wet or dry, soiled or clean.
  • Making sure that everyone uses the same words for wee and poo, helps prevent confusion
  • When children are able to sit independently, then they can start to sit on the potty or toilet. They should sit for a very short time to start with (maybe just a few seconds), but should be praised for doing so and can be involved in checking to see if there is any wee or poo there. To start with the children are learning to sit and any success is a bonus!  As they learn to sit, they can be encouraged to sit for a bit longer and then the number of episodes of sitting in a day can be gradually increased.

It is important to remember that any child can have a problem with their bladder and or bowels.

The most common problems are delayed toilet training, constipation, day time wetting and night time wetting.  If any of these occur in a child who has Down Syndrome they should be assessed and appropriate advice or treatment offered. If you have any concerns about these problems in a child with Down Syndrome, then talk to their GP or health visitor.

There is information and resources about children’s continence, including toilet training on the Bladder & Bowel UK website.

Bladder & Bowel UK also have a confidential helpline for parents, carers and professionals. You can send an email to: or contact us by telephone on: 0161 214 4591.


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