Dry by Night - Toiletting Stage 2

Tonight we 'nervously optimistically' kissed Natty goodnight and praised her for being such a big girl for not needing 'sleepy pants' for the second night on the trot (pardon the pun!). 

(Nappies, diapers, pull-ups, dry nites, whatever you call them, be banished.)

It is precisely a year ago that we were in the thick of very concerted toiletting efforts, helping Natty become dry by day. She was due to begin school in September and she was ready. 

And here's is the most important thing to bear in mind with any child; it is not the chronological age that counts, but the developmental stage they are at when attempting this kind of life change. Starting too soon and becoming stressed could backfire. 

So relax, see the funny side, and enjoy your toiletting journey. It will involve accidents, it will involve poo. Buy cheap pants/knickers you can throw away when beyond redemtion, take a plastic bag and several changes of clothing. Pack your sense of humour.

Here is my post about Natty becoming dry during the day, with tips and techniques to help you all. Ode to Potty Training part 1. I also know many parents who have found making a picture timetable useful for providing a visual reminder of the small steps involved in using the toilet.

That stage went pretty well.  Natty started school wearing pants but continued to have the odd accident throughout the year, but then I figure most children do that don't they. We decided to trust her and not look back. Even on long journeys we prepared for accidents, but never once returned to using nappies during waking hours for fear of confusing her.

At bedtime, nappies became named 'sleepy pants', to distinguish them from what she had given up during the day. We bought the pull-up variety that seemed a little more grown up. I made a conscious decision to wait until I saw a sign from Natty that she was ready to relinquish these. I decided not to push or stress about when that moment came, not to compare her to other children, with or without Downs, but to wait for her lead.

2 weeks ago, the moment came. Natty woke with dry sleepy pants and showed me, proud of herself. We knew the bladder control existed. We knew she could do it. We said no more and waited. Several days passed with wet nappies in the morning then another one or two with dry ones. Natty and I had a chat about how grown up she was, and I asked her straight if she wanted to try no sleepy pants like Mia, Mummy and Daddy. She beamed and said yes....  there is nothing like intrinsic motivation.

Other, happy coincidental factors to my decision to start now are that it is summer, we can hang washed bedding out to dry easily, there is no school so the timetable is more relaxed and I am mentally in a place to deal with it. There is no point in trying to do this if you have a lot of other stresses on your plate.

So, we bit the bullet as it were. I've stocked up on bed-protectors to help save the matress's life. You can buy disposible ones or plastic-backed towelling varieties, but you will need them. The White Company sell them. We have a couple of cheap spare undersheets and lots of PJ trousers. Knowing that makes any accident just a quick change of a sheet and PJs and not a major disaster. Prepare for the worst and you will take it all in your stride.

We carried out our usual bedtime routine, but brought the little drink of warm soya milk forward to before story time and not during. We then introduced a 'big girl's second wee' just before lights out. We did this with Mia, and ensures and emptyish bladder as they fall asleep. Natty seemed proud to be invited to do the 'second wee', as if it were part of a big grown up ritual.

The final part of the plan, and one I am less certain about as we never once did this with Natty's elder sister, is lifting her from her slumber to sit her on the loo as we go to bed at around 11pm. I guess this satisfies parent insecurities about the rest of the night to come being dry. I guess one is supposed to phase the lifting out in time. But for now I am going to do it, encouraging Natty to walk back to her bed and snuggle back down. 

Oh, and I nearly forgot the reward of a chocolate drop in the dry mornings!

Anyway, the main thing left to say is; 

Natty, Mummy and Daddy are immensely proud of you.  We'll crack this next step together, however long it takes x

Ode to Potty Training

Not an ode exactly, more of a nod towards potty training/toilet training/toiletting.

One of the most stressful uphill challenges in any parent of a young child's life.

Add in the fact that your child has a learning disability (deep sigh).

Already that hill of a task has become Mount Everest, hasn't it.

Well, yes, teaching your little one to use the toilet will be tricky, but take a deep breath, accept that fact, and look around for tips that might help your journey become easier and more humorous.

First of all, accept that ALL children are different, and the timetable for wanting to use the toilet will differ for each one.  Any time from 3 years to 8 years and upwards is 'normal' for  a child with Down's Syndrome.

Wait for the cue to come from your child.  Do they pull at their clothes or tell you when they are wet or soiled?  Do they try to imitate older siblings or friends by trying to use a potty or toilet?  Are nappies (diapers) dry for longer periods of time?  Then they are ready for your help to move them forward in the toiletting game :)

This is just our experience, yours will be different.  Let yourself be led by your child. (And burn any potty training manuals written by ladies who don't have children of their own..!)

To begin with we sat Natty on a potty just before bath time each night.  It was fun, and there was no pressure, she relaxed while the bath ran, and occasionally produced a wee!  We did this for about a year without moving forward.

A year and a bit before she started school, we discussed potty training with her pre-school.  They were keen to help out and we made plans together so that we did the same at home and at pre-school.  We spoke to a lovely Continence Nurse (I think I inadvertently pushed past several short lists, simply found her work number and rang her...)  She was a wealth of knowledge! She made sure there wasn't a physical barrier to starting toilet training...could Natty go several hours with a dry nappy for example?  Once we were sure this was the case, she suggested using a ladies' incontinence pad (brands other than TENA Lady are available I'm sure!)  inside a pretty pairs of girls pants (I guess that is panties for our American friends, not trousers!).  This way she could choose her own pretty 'big girls' ' pants, and feel grown up, with all the security of a nappy.  We had tried 'real nappy trainer pants' before as they let the child feel when they are wet, but the bulkiness and similarity to a baby's nappy were now holding us back.

We started using the pads.  Each day we asked her 20 times at least if she wanted a wee.  We took her each time we went, and each time her sister went to the loo.  After a few weeks, we began to get a few 'hits' on the potty.  The progress was painstakingly slow, and I guarantee you nappies would have been the easier option.  Particularly tempting as they are free from the government for children with disabilities.  I focussed on the end goal and refused them.

We began to buy smaller pads in the hope that by feeling wet she would ask for the toilet.  This didn't happen, but we calmly took spare clothes wherever we went and simply changed her several times a day, when damp.  We focussed on the successes and praised Natty highly.  We never once got cross with Natty for her failures (although I have privately screamed in a cupboard when she has wet on a freshly made bed, new carpet or sofa.)

Finally we reached a point (it happened to be summer) where we felt Natty was being a bit lazy and was capable of more (perhaps 6 more months after starting to use the incontinence pads).

We bit the bullet and stopped using any kind of protection during the day.  No turning back.

Day one - 6 accidents.

Day two - 5 accidents.  (that's a lot of washing...but hey, it was summer.)

We stepped up our reminders.  We realised Natty preferred sitting on the toilet to the potty, so we put all the potties in the loft (1 for each room of course) and bought sturdy, large steps and comfy, padded child's toilet seats.  These are even available with arms to help independence.  Do not be afraid to ask your Physio or OT if you have one, for a sturdy large step that your child feels safe to climb and turn around on.

We bought 'Piddle Pads' to protect car seats and chairs. (See Useful gadgets page)

The accidents continued, but with perhaps the same number of successes each day.  We questioned Natty's readiness, but I think I could be quoted as saying I knew that she was ready and that she would start school in pants if it killed me!  Then after day 10 we noticed only 3 accidents.  This was the point of no return.

We bought hilarious fluffy toys in the shape of a wee and a poo (pictured above).  We encouraged Natty to hold whichever one she needed at the time (and if that failed, they at least made us giggle during the many hours spent in the lavatory!)

We made up ridiculous songs "If you do a weeeee weeeee on the tooooilet, you can have a chocolate drop, yum, yum, yummmm" (Did I mention the bribery?  The less said about that the better ;) )

We read books and looked at flash cards while Natty sat on her throne to pass the time.

Star charts meant nothing to Natty, but give them a try.  We also bought a large pink potty that sang when she produced a wee...but she got wise to how it worked and simply pushed the buttons inside to get the reward.

That was 6 months ago.  Natty began school in September, aged 4 years, wearing ordinary pants, and now only has 1 accident every fortnight or so (aged just 5)... just like her 'typically developing' peers.  She still rarely remembers to go to the loo when she needs to, seldom actually asks, but we now only have to remind her every couple of hours or so.

I think we can count that as a resounding success, don't you.

To read about part 2 of our toiletting journey, Dry at Night, click here.

For more practical info and continence products, visit ERIC: Education and Resources for Childhood Continence

Rock and Pop advice for constipation