Childhood continence problems are common. One in 12 children are affected by a bowel or bladder problem: that’s around three children in every primary school class. In an average secondary school, around 30–40 of young people struggle with a wetting or soiling issue (Joinson et al, 2018).  

It may also come as a shock to know that one third of all children will experience constipation (Koppen et al, 2015). Many people are not aware of the scale of the problem or the impact it can have on young lives. The embarrassment and shame surrounding continence problems mean that many young people and their families are suffering in silence with no one to turn to.  

THE COVID EFFECT  

Since the first lockdown in spring of 2019, there has also been a worrying rise in the numbers of children experiencing toilet anxiety and regression. Reports by the UK Government (https://bit.ly/3N4mvAg) and UNICEF (https://uni.cf/3POJmS5) during 2020 highlighted the negative impact of the Covid pandemic upon children’s wee and poo habits, with previously toilet trained children regressing back to nappies. In the surveys conducted, teachers report that more children than ever before are arriving in their reception class unable to use the toilet independently alongside other basic skills.  
 

RISING CALLS FOR HELP  

At ERIC, we have recorded a sharp rise in the number of people calling our helpline for advice on potty training over the same period. In the year to August 2021, numbers reached 660, up 68% on the previous year. This accounts for 19% of all calls to the ERIC helpline, compared with being 13% of the total the previous year.  

TOILET ANXIETY AND POTTY TRAINING CONFUSION  

Toilet anxiety and withholding of wee and poo are common reasons for caregivers to get in touch. They express confusion, stress and fear around how best to support young children to achieve continence. They are seeking reassurance from our advisors to help them decide what they should do to support their child. Knowledge and confidence around potty training is missing for many families.  

Three in every four calls received are from families of children (usually toddlers) who are struggling with the same problem – letting go of poo and wee. Stool withholding and delaying emptying the bladder are both issues which can cause a huge amount of stress and confusion to families. Here, at ERIC, we knew that something needed to be done to help these children and their caregivers.  

ERIC’S NEW WITHHOLDING RESOURCES  

As the UK’s leading charity supporting all children and teenagers with a bladder or bowel problem, ERIC has written some new resources to help support parents and professionals, see our website, Wee and poo withholding (www.eric.org.uk/Pages/Category/withholding). 

We explain the reasons why children may try to stop wee or poo from coming out when it should. There is information on how this can affect a child’s body and behaviour and what can be done to help them to feel more positive about going to the loo. Withholding most commonly follows on from a period of constipation and the withholding of poo is very likely to result in constipation. Breaking the withholding cycle needs a ‘two pronged’ approach. First, to sort the physical, then working on the psychological and behavioural effects that the physical problem has created. Treating constipation early will give the best chance of a good outcome. See ‘Advice for Children with Constipation’ (www.eric.org.uk/advice-for-children-with-constipation) to get more information, and please share these free resources with your colleagues and service users.