Parents encouraged to seek help from health visitors on potty training

Parents are being encouraged to seek support from health visitors, school nurses and early years professionals in new potty training guidance aimed at tackling growing numbers of children starting school in nappies.

The guidance, developed by a coalition of early years experts and partner organisations including the Institute of Health Visiting (iHV), is endorsed by the Department for Education (DfE) and the Department of Health and Social Care (DHSC).

It aims to give families clear, consistent advice on toilet training at a time when growing numbers of children are starting school still wearing nappies.

According to the guidance, one in four children are not toilet trained when they start their reception school year. In comparison, in the 1870s and 1980s, as many as 83% of children were out of nappies by 18 months, it noted.

The new advice highlights the importance of toilet and potty training as a key developmental milestone that supports children’s independence, confidence and readiness for school.

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It recommends stopping the use of nappies between 18 and 30 months to support healthy bladder and bowel development.

Where can parents access support?

Parents are reminded that they do not need to manage potty training alone and encouraged to reach out to their health visitor or a childminder, nursery, pre-school team or a children’s centre or family hub for support.

Parents are also encouraged to raise questions about toilet training during routine contacts with health professionals.

It states that parents can expect their health visitor to talk about potty training at their child’s nine- to 12-month review, adding: ‘You can ask about potty training during any conversations you have with your health visiting team.’

‘A health milestone’ 

Commenting on the guidance the health and social care secretary, Wes Streeting, said: ‘Potty training is an important health milestone, helping children to be ready to start school and thrive.

‘This guidance is vital to achieving our mission of giving every child the best start in life, providing parents with expert-backed advice to support their child’s health and development.’

Helping children to stay dry at night 

The guidance also includes advice on helping children become dry at night. Parents are encouraged to ensure their child uses the potty or toilet at bedtime, even if they are wearing a nappy to sleep, to stop drinks an hour before bedtime, and to follow a consistent bedtime routine.

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Parents are advised not to wake children to take them to the toilet during the night, as this can encourage weeing during sleep.

Families are reassured that night-time dryness develops at different rates, but the guidance advises seeking advice from a health visitor, school nurse or healthcare professional if a child is not dry at night by the age of five.

Education secretary Bridget Phillipson said the guidance will be a ‘brilliant help’ for families to get their children potty trained and ready for school.

‘By giving families trusted support early on, we’re helping kids arrive at the school gates confident, ready to learn, and ready to shape their own future,’ she added.

A report published last October by speech therapist Professor Judy Clegg and produced by the Centre for Young Lives and Child of the North think tanks found that some new school starters were still wearing nappies, using pushchairs and unable to socialise with other children. The report found almost a third of four-year-olds could be classed as ‘not ready’ for full-time classroom learning.

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This month, the iHV partnered with children’s mental health charity Anna Freud on a new workforce development programme which recognises the key role of health visitors in promoting healthy and nurturing relationships between babies, and their parents and carers.

In November, the iHV published new guidance on toilet training to help tackle ‘unnecessary delays’ in transitioning children from using nappies to a toilet.

Speaking at the Covid Inquiry in October, the iHV’s chief executive Alison Morton told the latest phase of the UK Covid-19 Inquiry that the concerns of health visitors about families and children were not ‘taken seriously enough’ and that the significance of their role was not appreciated by government at the time.