Policy briefing

Support for children with bowel and bladder problems

Practical guidance covers how to promote good bladder and bowel health in schools, including managing incontinence, safeguarding and examples of continence policies and care plans.

Practical guidance covers how to promote good bladder and bowel health in schools, including managing incontinence, safeguarding and examples of continence policies and care plans

Picture shows boys taking turns drinking from a water fountain at a park. Practical information aimed at schools, nurseries and colleges to support children with bladder and bowel issues and toileting has been published by Bowel and Bladder UK.
Picture: iStock

Essential facts

Continence conditions are among the most common health issues affecting children and young people, with more than 900,000 children in the UK affected by bowel and bladder difficulties, according to the children’s bowel and bladder charity Eric.

Growing numbers of children are also starting school still wearing nappies, which places a burden on teachers, according to the charity.

Bowel and bladder problems are associated with stigma, embarrassment and shame, affecting social interactions, well-being, educational attainment and progress.

What’s new

Practical information aimed at schools, nurseries and colleges to support children with bladder and bowel issues and toileting has been published by Bowel and Bladder UK and Eric.

It covers how to promote good bladder and bowel health in schools, including managing incontinence in schools, safeguarding and examples of continence policies and care plans.

The charities say schools can use the information to avoid discriminating against pupils with bowel and bladder conditions and make sure that these children are fully supported.

It recommends avoiding caffeinated and fizzy drinks, which can irritate the bladder, and encouraging open access to water and drinks where possible.

Learners should have open access to clean, safe, well-stocked toilets throughout their hours at school. This is particularly important for younger children, those who have difficulties with their bladder and/or bowel and for girls who are menstruating.

Disposable continence containment products should only be used to manage incontinence in school if recommended by a healthcare professional who is involved the learner’s care.

For specific concerns related to individual learners it is usually appropriate to discuss the child’s needs with their parents and healthcare professionals. The school nurse is in a unique position to be able to support and coordinate this.

Expert comment

Picture of Davina Richardson, a children’s specialist nurse at Bladder & Bowel UK. The charity has published practical information aimed at schools, nurseries and colleges to support children with bladder and bowel issues and toileting.Davina Richardson, children’s specialist nurse at Bladder & Bowel UK

‘Children spend large parts of their day in school. Adequate fluid intake across the day and open access to clean, well-stocked toilets are essential for bladder and bowel health for all. To understand the issues and their roles in conditions that are not widely known about or discussed, schools and nurseries may need support and education.

‘Children with bladder and bowel problems often lack self-esteem or self-confidence and may have reduced educational attainment. Failure to offer timely intervention may result in problems escalating and becoming chronic and children failing to meet their potential. Currently there are gaps in care nationally, as not all areas commission children’s continence services.

‘Problems have increased since school nursing and health visiting moved to a public health role and in many areas are no longer providing direct support for continence issues.’

 

Key points for nurses

  • Many families find it difficult to ask for help and many people believe bowel and bladder problems are caused by poor parenting. If met with an inappropriate response or lack of understanding from health services, nurseries, schools or colleges these problems are compounded.
  • Be aware that schools should support healthy bowels and bladders by encouraging children to remain hydrated. They should have half of their daily fluid requirement in core school hours.
  • Schools should also ensure that pupils have access to clean, well-stocked toilets at intervals appropriate to the needs of the individual child.
  • Children must not be refused admission to school due to continence difficulties.
  • Learners who are known to have continence difficulties should be offered a care plan to ensure their individual needs are met in school.
  • Parents should not be expected to come to school to change their children.

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