shinecharity.org.uk email@example.com 42 Park Road Peterborough PE1 2UQ 01733 555988Toilet Training and Spina BifidaPotty training for the non-disabled child usually begins ataround the age of 18 months to two years, and the child isusually ‘trained’ by day at around two-and-a-half years.Every child is different and it is appropriate management shouldadvisable to watch for signs in the be in place.child’s development which maysuggest he/she is ready to begin Toilet training for a child with spinapotty training, such as : awareness bifida is likely to be quite differentthat they are passing urine or from that of other children. Veryhaving a bowel action, waking often, damage to nerve pathwaysfrom naps with a dry nappy, asking which coordinate the bladderto have their nappy changed. and bowel function and promote the sensations, mean that controlFor children with spina bifida, cannot be learnt in the usual way.bladder and bowel continenceshould be addressed at the same Toilet training should begin attime and the way the bladder works around two years of age. Theshould be assessed in infancy in toilet should be comfortable andorder to protect the kidneys from not damage pressure areas (thedamage. This should be done skin on the buttocks and thebefore starting toilet training, and backs of the legs).
Toilet Training and Spina BifidaA young child with spina bifida may have difficulty balancing Bowel trainingwhen sitting. The potty or toiletshould provide a stable and secure Bowel training depends onposition, with a comfortable, developing a habit of opening thesupportive seat. If necessary, bowels at roughly the same timethere should be rails or something each day and clearing a largefor the child to hold on to, to give amount from the bowels eachstability to the upper body. The time. Do not allow constipation tochild should be able to place his/ develop. Ideally, the faeces shouldher feet flat on the floor or a box/ be firm and formed.plinth. An occupational therapistshould be able to help with Watch for times in the day whenequipment if the child has poor the child opens his/her bowelssitting balance. to see if a pattern emerges. The bowel is more active after meals,A child who is using clean especially breakfast. Sit the childintermittent catheterisation can on the toilet at these times andalso be encouraged to sit on the encourage her/him to push downtoilet and pass urine, although it is gently.not always necessary. It is essentialto continue with the catheterising To encourage this, try tickling toregime as well. get the child to laugh or the child could blow a party toy (not balloons and always under supervision) and the effects of gravity will also help. Even if there is no result, continue to sit the child on the toilet after meals. However, the child should
not sit on the toilet for longer than5 minutes.All programmes will involve sittingon the toilet even when there isno sensation (feeling) of a needfor bowel action. If it becomes anormal part of the daily routinefrom early childhood, it is lesslikely to become a major issuelater on. If this is unsuccessful, itmay be necessary to seek advicefrom your continence adviser.Encourage the child to clean her/himself with tissues and attend toclothing, as far as possible.For further advice; contact yourcontinence adviser, school nurseor Shine medical adviser.
Help usShine relies on people’s generosity and support so we can help our clientswho depend on us for help and advice - people with hydrocephalus,spina bifida, their families and carers. To donate to Shine please visitwww.shinecharity.org.uk or call 01733 421329.This information has been produced by Shine’s medical advisers andapproved by Shine’s Medical Advisory Committee of senior medicalprofessionals.Shine - Registered charity no.249338To see our full range of information sheets and to find out how to donateto Shine please visit www.shinecharity.org.uk