New thoughts on potty training

More and more children every year start school wearing nappies.  The advice of when and how to potty train is being debated.  Parents are getting conflicting advice: you must start potty training before two; children do it themselves when they are ready. Growing evidence, currently anecdotal but significant is suggesting two things:

1 Children need to be prepared for potty training; suddenly introducing a potty and pants at 2-3 years doesn't seem to be working

2 There is no evidence that potty training early does damage.

Children in real nappies tend to potty train earlier but it's not automatic. Some intervention as described below is necessary, especially for first-borns.

There is no set age for your child to potty/toilet train. Every child is different. The most important thing is to prepare your child. Then they can develop an interest and you can read the signs to see when they are ready for you to take away daytime nappies.

We don't delay cleaning our child's teeth until they can do it themselves. We start to clean their teeth as soon as the teeth come through, right? It's the same for toilet training. Teaching your child about pee and poo from an early age is important preparation. (This tends to be most important for the first-born who don't have older siblings as role models.) It means that when the time for potty training arrives (ie removing nappies during the day and using cotton pants - all day, every day) the process will be quicker and easier.

It's also important to note that control of bowels, control of bladder and staying dry at night are 3 different things. They tend to happen at different times. Children can be clean by one, dry by 18 months and dry at night around three. But it depends on the child - and possibly more importantly, you giving your child the stimulation and awareness to show you s/he is ready.

How do we prepare for toilet/potty training?

Always talk about poo and pee in a positive way - "Lovely poo, well done"

Talk about poo and pee. If your child wears cotton nappies talk about when the nappy is wet and when it is dry.

Get a potty. Your child can sit on a potty from an early age. Encourage your child to sit on the potty ONCE a day (if possible when you expect a poo) for a short time (a couple of minutes as a guide). It should be a relaxing time. Nothing needs to happen but if a poo or pee comes give praise to show this is what the potty is for. Warning: don't go overboard with the praise or it will be overwhelming for the child - although the prospect of you child coming out of nappies may be incredibly thrilling to you!

Open door policy: let your child see you on the toilet.

Visit the library and borrow different books about using the potty.

Create a game with your child about helping a teddy or doll to use the potty, praising teddy or dolly when they do a pee or poo on the pot and keep their pants dry. Get your child to role play being the teddy or doll and repeat the steps to you.

Visit a home where there are children of a similar age who use the loo and encourage your child to take an interest.

When to potty train ie when to help your child stop wearing nappies during the day?

If you do this preparation your child is highly likely to show an interest - letting you know a nappy is wet or poo is coming.

The act of toilet training has been found to help the bladder develop so current thinking is that we do not wait until the child can stay dry for 2 hours

Your child may already be using the potty/toilet for poos


How to start Potty/Toilet Training?

Choose a time when your child is showing an interest in the potty and you can spend some time together. Set aside a few days to spend mostly at home and devote the time to helping your child develop this skill. Prepare your child for what is going to happen - that s/he is going to stop wearing nappies during the day.

Tell your child that s/he is only going to wear pants from now on during the day and will only wear a nappy at night.

Make it exciting. Go on a special shopping trip with your child to buy some cotton pants. If your child is going to use the toilet straight away get a step and a special seat too.

For the first few days encourage her/him to sit on the potty/toilet every few hours - about half an hour after a drink. But make sure s/he knows that s/he can also tell you if s/he needs to go, and that you'll accompany her/him whenever s/he wants you to.

Some toddlers won't sit on the potty long enough to relax and let anything come out. Calmly encourage her/him to sit there for at least a minute or so. Stay with her/him and talk calmly, or read a story. It's best to start boys off with sitting too. Peeing standing up can be learned later.

When your toddler uses the potty successfully, give her/him lots of praise, though don't go too overboard, as s/he may find too much fuss overwhelming. Even if s/he continues to have accidents, s/he'll then start to grasp that getting something in the potty is an accomplishment.

When you think your child is ready stop reminding her/him to use the potty/toilet. There may be a few accidents but your child does need to get the feeling of when s/he needs to go to the toilet him/herself. 

What do we do when we go out?
Once this process has started be consistent. Stick with it and don't go back to nappies. When you go out you may need a portable toilet so s/he can use it. Choose to spend time at a park with toddler toilets (such as Coram's Fields) or a drop-in with small toilets so that your child will see 'big' boys and 'big' girls going to the loo.


What if there is no progress?
If you feel that your child is not ready after all go back to nappies and try again when your child shows an interest. This process takes co-operation. Your child should be an active participant. Be consistent in whatever seems right for your child.

What about night training?
Most children become dry at night within 6 months or so of becoming dry in the day but up to 20% will still wet at age 5 years. If so parents need to speak with their school nurse or GP re appropriate treatment to help their child become dry.

What about children with special needs?
Having special needs does not mean that your child cannot become toilet trained. Get expert advice
PromoCon
Disabled Living
Tel: 0161 607 8219
Email: promocon@disabledliving.co.uk
Website: www.promocon.co.uk
PromoCon, working as part of Disabled Living Manchester,
provides impartial advice and information regarding a whole
range of products, such as musical potties and other toilet
training equipment and swimwear and washable trainer pants
for children who have delayed toilet training.
Information is also available regarding which services and
resources are available for both children and adults with bowel
and/or bladder problems



If you're interested in your child developing bowel and bladder control from an early age have a look at this post on Elimination Communication. In particular see comments from parents who have experience of this method.


Help needed
This advice is based on listening to parents, health visitors and paediatric continence professionals over the last 15 years.  Comments on this draft welcome!







http://www.realnappiesforlondon.blogspot.co.uk/2012/10/are-potty-training-methods-in-west.html

Use it or Lose it

The future of Real Nappies for London and its voucher scheme is not guaranteed. We need to prove that there's a demand for the vouchers and it is growing. Please tell your friends about the voucher, your NCT group or midwife. Let us know of good places or people who are happy to put up posters or give out leaflets.

One of the other benefits of the scheme is that it encourages the development of real nappy networks, for example the Hackney Real Nappy Network (HRNN). This group of parents hold lots of events including the very successful Real Nappy Flashmob, to draw attention to real nappies; how great they look these days, how easy they are to use and of course the fact that they reduce waste (approx 7kg per week per baby)!

The RNfL voucher scheme also supports shops that sell real nappies, nappy laundry services and the companies that run nappy information sessions so you can see, touch and feel and ask questions about real nappies before you buy them. Please do buy from these suppliers with your voucher. They will only continue to exist if they can keep operating in this difficult economic phase. Some of you use these events for information but then look for the cheapest deal on-line. Please remember, these companies have costs to cover; rent, staff, room hire, travel to and from events with stock. We need to support them so they can continue to offer this valuable service.

Another blog that may interest you: Remember the Waste Hierarchy

Should we expect new borns to sleep through the night?

For many years now parents have been telling us they put their baby in a disposable so they can get a good night's sleep. Usually the idea came from their NCT teacher. Was this useful advice?

This articles in the BMJ says parents shouldn't expect their babies to sleep through the night.

This advice also has implications for continuing breastfeeding. If you want to see the full article it's accessible via this NZ web site you can read it here. Download the pdf.


If you want more information this web site looks useful: Infant sleep information


This has reminded me of the way P&G (Pampers) got mums in China to use disposable nappies. They ran ads to say a disposable nappy would give the baby a good night's sleep and make the child more intelligent.

Here's a study that says this may be true - after one year! So that's when babies in cotton nappies would be sleeping through the night anyway.


For more on Pampers in China see this post by Futerra.

It's just annoying to see the misinformation given to new parents by businesses that put profit before caring for the interests of their customers - and the planet. But eventually the truth does come out.


Another related post that may be of interest: on bed wetting

Best Real Nappy Week Ever!

This Real Nappy Week, in the lead up to Defra’s call for evidence: Waste Prevention Programme for England (deadline for submissions 29 April) has demonstrated a massive success by businesses, local authorities and real nappy activists to engage a particular group of consumers – expectant and new parents – in reducing disposable nappy waste. I also want to pay tribute to the Women’s Environmental Network (WEN) for campaigning to reduce disposable nappy waste since 1989.

What we can see at Real Nappies for London is that
despite the Environment Agency’s Nappy Life Cycle Analysis, published in 2005 that said washables were no better for the environment than disposables (the update published in 2008 said reusable nappies can have up to 40% lower carbon impacts than disposables;
despite the availability of ‘bio-degradable’ disposables that simply go to landfill and incineration;
despite the increasing number of Bounty Packs (junk mail, right?) given to expectant and new mums by the midwife containing samples of disposable nappies;
despite Pampers’ sponsorship of the leading parenting charity the National Childbirth Trust (NCT;
despite the vouchers and offers on disposable nappies with high visibility on the shelves of supermarkets;
despite the ‘free’ disposal of nappies as part of household waste,
interest in real nappies is growing all the time.

But nappy waste disposal is not free of course. Our councils pay for it ie we do. It was WEN that identified this hidden subsidy and championed the Waste Minimisation Act. Before this act local authorities could pay for waste disposal but it was illegal for them to spend tax payers money on reducing or preventing waste. It was this act that allowed councils to give incentives and rewards to residents for reducing disposable nappy waste and to promote real nappies during Real Nappy Week.

And disposable nappies are not just a waste issue. They also have negative physical and mental health impacts. This modern convenience product possibly does more harm than good. And it’s not just our children. Our elderly in hospitals and care homes are being left in disposable continence products and changed as part of a routine, rather than helped to the toilet according to need. It's not the staff who are at fault, it's bad routines and procedures. In the wake of the Francis Report it’s time to say we want to learn from the mistakes that report reveals, which many of us have witnessed and reported.

When convenience products mean the needs of the most vulnerable in our society are neglected; the young, the disabled and the elderly, we need to work together to change things for the better. Small actions undertaken by individuals will mean together we can make real change happen for all our futures but also to improve the lives of those we love, ASAP and forever.

WEN has more great work to do, more big issues to tackle. It has been the pioneer of many campaigns that are now part of the mainstream. Learn more, visit www.wen.org.uk

Why don't parents use real nappies?

That's the question that was fired at me (Hilary Vick) on Radio 4's You and Yours last Thursday. My response was that it's because disposable nappies are promoted in the hospitals via free samples and vouchers in the Bounty pack, via the National Childbirth Trust (the sponsorship money from P&G helps the NCT's work but surely association with the respected NCT charity brings P&G more sales of Pampers) and they are so visible and easily available in the supermarkets. This makes disposable nappies 'normal nappies' and most of us like to follow the norm, especially when we're feeling insecure because we've just had a life-transforming experience; like having a baby!

Under these circumstances the surprising thing is that so many parents use real nappies, right? And I've asked lots of you why you do it. And usually it's because it makes you feel good. You love the fact that you're not sending all that nappy waste to landfill. And you also tell me you do so much washing when you have a baby that washing nappies doesn't feel like a big deal.

And that's an important point. As two of the Swansea mums on You and Yours said, even the offer of a £100 incentive doesn't get them over the thing that really puts them off; washing dirty nappies. Indeed, research by Go Real (the national real nappy campaign), funded by the Waste and Resources Action Programe (WRAP) said fear of the 'mess' of washing nappies is the main barrier to people opting for real nappies.

But is washing nappies messy? It's true babies poo a lot in the first few weeks (if you can call that mustard coloured curdled milk poo. It doesn't even smell unpleasant, it just has a sort of sweet yeasty smell.) But within a few weeks many babies only poo once a day or less. That means most nappies are only damp. But how can we could get that message across?

As many of you know, 10 years ago I set up a nappy laundry service in London. Most people sign up because they are afraid of the washing or don't have the space to dry nappies. What happens is that about 50% of the people who sign up to use the laundry service find out - from their own experience - that after baby is weaned (about 6 months) there are only about 5 nappies a day and most of them are only damp. So they stop using the laundry service and wash them at home.

So let's get these messages out this Real Nappy Week:
1 most nappies are merely damp
2 using real nappies makes you feel good
3 you're not a disposable nappy parent; you just wanted everything to settle down before you got started on real nappies, right?

And by the way, wet nappies do not cause nappy rash, as said by one mum who contacted You and Yours. If your baby gets nappy rash when using cotton nappies you need to find out the real cause.

Thank You for Using Real Nappies

The last quarter of the financial year 2012/13 has just finished and we want to thank the growing number of parents, childminders and nurseries in London using washable nappies.

Based on our database we issued 1,387 vouchers last year (1 April '12 to 31 March '13). You have spent 942 of them already. Our database calulates that 3,110 babies were wearing washable nappies (bought with RNfL vouchers) during that period resulting in at least 620 tonnes of disposable nappy waste NOT going to landfill or incineration.

So you prevented over 3.3 million single-use nappies going to landfill and incineration during the period 1 April 2012 to 31 March 2013. This is great and we want to thank you.

If everyone who used RNfL vouchers used real nappies 100% of the time you changed around 931,000 real nappies in the last quarter of the year. That’s 71,610 real nappy changes every week, over 10,000 every day. And this doesn't account for all of you who haven't claimed vouchers but use real nappies you were given by friends and family, bought or acquired second-hand or just bought them without a voucher.

To give you a sense of what you have achieved by using real nappies you can look at the figures put out by the nappy recycling business Go Green . But it's better than that because not only did you prevent disposable nappies going to landfill, incineration or recycling. You prevented those single-use nappies being manufactured, packaged, sent to the supermarket, transported to your home and then transported to the recycling plant.


Viva la revolution!

Real Nappy Flashmob

Really excited about the first ever London Real Nappy Flashmob. It's TOMORROW, Friday 8 March. On the Southbank.

This is hosted by the Hackney Real Nappy Network as a Climate Week Event to draw attention to the fact that the carbon impacts of real nappies can be up to 40% lower than those of disposable nappies. With the additional bonus of being Zero Waste.

Sorry to those of you who can't be there because you are working. But there's another opportunity coming up to show off your baby in a real nappy. Camden-based Nappy Ever After will be celebrating its 10th birthday at Coram's Fields on Sunday 24 March. As part of the event there will be a real nappy fashion show.

And if you're not able to come to that, there is the Great Cloth Nappy Change at the Bethnal Green Museum of Childhood on Saturday 20 April with another real nappy fashion show. So save the date! And if you live in West London there is a Great Cloth Nappy Change happening in Hillingdon.

Because we love real nappies!

An uncomfortable truth

Perhaps Pampers are green. Research carried out by Kiel University in Germany suggests throwaway nappies may reduce male fertility. This could mean that over the long term, disposables may curb population growth across the world. Then the SAP filled disposable nappy will turn out to be the greenest nappy afterall. And that cotton nappies may ensure the survival of the human race.

Great short video introduction to real nappies on You Tube

Is recycling disposable nappies the answer?

Recycling disposable nappy waste is being sold to the public as ‘green’. But is it? Because of the massive industrial scale of the nappy recycling plants there would only ever be 6 in the UK. That means the nappy waste has to be transported to the site over long distances. Not only this, the environmental impacts of recycling disposable nappy waste are high (as are the running costs) because it takes a lot of water and carbon to run the process.

We are told that recycling is the ‘realistic’ option because people enjoy the convenience of disposable nappies. It's true people use disposables because they are sold in supermarkets, advertised on TV and in the Bounty pack, free to throw away and ‘normal’. But our research at RNfL shows that if expectant parents know 3 or more people who use real nappies they are not just likely to try real nappies but also very likely to continue to use them. Therefore the task is to make real nappies normal again – as they were just 30 years ago.

But what about the impacts of washing real nappies? According to a government report in 2008 washing nappies at home can have up to 40% lower carbon impacts than using disposable nappies. At RNfL we believe local nappy laundry services in metropolitan areas could have even lower impacts (if they use ozone to sterilise the nappies rather than heat and plug-in electric vehicles for deliveries and collections) and really help families living in small flats with nowhere to dry nappies.

And the other benefits? Zero waste nappies save parents money. They also save local authorities money because with real nappies there is no nappy waste to collect and send to landfill, incineration or the recycling plant.

The cost of recycling disposables is just going to go up and up. Savvy boroughs know this and offer incentives to their residents to try real nappies. They are developing a culture of real nappy use amongst their residents that will grow and grow and bring down costs over the long-term and more importantly, protect the planet for future generations.

If not vouchers for all then ...

We understand that real nappy vouchers for all with prescription exemption cards may take time to set up. It's really important that people get information about alternatives to disposable nappies urgently. So why can't the NHS just put some information about Go Real - the impartial national real information web site - with the prescription exemption card? That way at least it balances out all the advertising for disposables given out by Bounty and the NCT.

Let us know your views. Anyone up for starting an on-line petition?