Potty training for the non-disabled child usually begins at around the age of 18 months to two years, and the child is usually ‘trained’ by day at around two-and-a-half years.

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Toilet Training and Spina Bifida
Potty training for the non-disabled child usually begins at
around the age of 18 months to two years, and the child is
usually ‘trained’ by day at around two-and-a-half years.
Every child is different and it is appropriate management should
advisable to watch for signs in the be in place.
child’s development which may
suggest he/she is ready to begin Toilet training for a child with spina
potty training, such as : awareness bifida is likely to be quite different
that they are passing urine or from that of other children. Very
having a bowel action, waking often, damage to nerve pathways
from naps with a dry nappy, asking which coordinate the bladder
to have their nappy changed. and bowel function and promote
the sensations, mean that control
For children with spina bifida, cannot be learnt in the usual way.
bladder and bowel continence
should be addressed at the same Toilet training should begin at
time and the way the bladder works around two years of age. The
should be assessed in infancy in toilet should be comfortable and
order to protect the kidneys from not damage pressure areas (the
damage. This should be done skin on the buttocks and the
before starting toilet training, and backs of the legs).

2. Toilet Training and Spina Bifida
A young child with spina bifida
may have difficulty balancing Bowel training
when sitting. The potty or toilet
should provide a stable and secure Bowel training depends on
position, with a comfortable, developing a habit of opening the
supportive seat. If necessary, bowels at roughly the same time
there should be rails or something each day and clearing a large
for the child to hold on to, to give amount from the bowels each
stability to the upper body. The time. Do not allow constipation to
child should be able to place his/ develop. Ideally, the faeces should
her feet flat on the floor or a box/ be firm and formed.
plinth. An occupational therapist
should be able to help with Watch for times in the day when
equipment if the child has poor the child opens his/her bowels
sitting balance. to see if a pattern emerges. The
bowel is more active after meals,
A child who is using clean especially breakfast. Sit the child
intermittent catheterisation can on the toilet at these times and
also be encouraged to sit on the encourage her/him to push down
toilet and pass urine, although it is gently.
not always necessary. It is essential
to continue with the catheterising To encourage this, try tickling to
regime 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

3. not sit on the toilet for longer than
5 minutes.
All programmes will involve sitting
on the toilet even when there is
no sensation (feeling) of a need
for bowel action. If it becomes a
normal part of the daily routine
from early childhood, it is less
likely to become a major issue
later on. If this is unsuccessful, it
may be necessary to seek advice
from your continence adviser.
Encourage the child to clean her/
himself with tissues and attend to
clothing, as far as possible.
For further advice; contact your
continence adviser, school nurse
or Shine medical adviser.

4. Help us
Shine relies on people’s generosity and support so we can help our clients
who depend on us for help and advice - people with hydrocephalus,
spina bifida, their families and carers. To donate to Shine please visit
www.shinecharity.org.uk or call 01733 421329.
This information has been produced by Shine’s medical advisers and
approved by Shine’s Medical Advisory Committee of senior medical
professionals.
Shine - Registered charity no.249338
To see our full range of information sheets and to find out how to donate
to Shine please visit www.shinecharity.org.uk