Toileting Issues and
Toilet Training for parents
Whether you're just getting started with the potty, wondering why progress has stalled, or looking for support with constipation or bedwetting - you're in the right place. Our free Pants4School programme has helped over a thousand families get their child with Down syndrome out of nappies and into pants. We're here to help you do the same.
You don't have to wait!
Many parents are told to “wait until your child is ready.” But there’s no evidence base for waiting and for children with Down syndrome, early action makes a real difference.
Children with Down syndrome often need the skills for toilet training to be broken down and taught step by step. Those skills don’t always come naturally, but they absolutely can be learned. And the sooner you start building them, the easier the journey will be.
You can begin from as early as six to nine months old at the same time as weaning. If your child is older, don’t worry. It is never too late to start.
“We’ve supported and enabled children as young as 19 months and as old as 12 years to be able to stop wearing daytime nappies and go into pants – the programme works at every age.”
June Rogers MBE, Independent Practitioner (Retired Children’s Specialist Continence Nurse)
The Pants4School Programme
Our free Pants4School programme breaks toilet training into four manageable steps, so you can make progress at your child’s pace – whatever their age or stage.
Step 1
Getting started
(around 3–9 months)
The nappy doesn’t come off yet. This step is about getting the right equipment in place, building healthy eating and drinking habits to help prevent constipation, and introducing your child to short sits on the potty.
Step 2
Regular potty or toilet times
Gradually build up the time your child sits on the potty or toilet, working towards around one minute per year of their age, up to a maximum of five minutes. Offer sits at natural times in the day – when they wake up, after meals and drinks, before bath time and before bed.
Step 3
Timed toileting
Once your child is sitting happily and occasionally using the potty, it’s time to match toilet visits to their natural bladder pattern. Use a baseline bladder and bowel chart (see resources below) to find out how long they can stay dry between wees. Take them to the potty or toilet at that interval – but no more than once an hour.
Step 4
Going into pants
When around half of your child’s wees and poos are happening on the potty or toilet, it’s time to remove the daytime nappy. Some accidents are to be expected – this is a normal part of learning. Have plenty of pants, spare clothes and waterproof covers ready.
Constipation issues
Constipation is very common in children with Down syndrome and is one of the most frequent reasons toilet training feels difficult or stuck. It’s important to know about it early, because in many cases it can be prevented – and where it does develop, it responds well to the right treatment.
Our constipation page covers everything you need to know, including what constipation looks like, how to prevent it, and how to get effective treatment from your GP.
Hirschsprung's disease and ano-rectal malformations
Around one in 10 babies with Down syndrome is born with Hirschsprung’s disease or an ano-rectal malformation (ARM). Both conditions affect the bowel and usually need surgical treatment. If your child has Down syndrome alongside Hirschsprung’s disease or an ARM, we have dedicated information and a closed support group for families.
Toileting issues at school or nursery
Schools and nurseries have a legal obligation to support children with toileting needs. If your child needs help with toileting at school, their setting must make reasonable adjustments – it is not acceptable for a school to ask parents to come in to change their child, or to suggest returning to nappies.
Our resources for schools and nurseries explain what schools should be doing and provide a template intimate care plan to share with your child’s setting.
Free resources
Frequently asked questions
Start very small – even five or 10 seconds counts as a win. Use a timer so your child knows exactly when they can get off. Try putting an open nappy over the potty if they’re resistant – the familiar feeling can help them feel safer. Songs, books and bubbles all make sitting feel less of a chore.
No. Children with delays in speech or mobility are successfully toilet trained every day. You may need to adjust your approach – for example using Makaton signs, picture cards or physical support to sit – but the goal is absolutely achievable.
Yes. It’s very common to feel stuck, and it usually means the timing or approach wasn’t quite right for your child at that stage. Going back to the step that matches where your child is now, and making sure everyone involved is following the same approach, can make a big difference. Our Toilet Training Bootcamp is specifically for families in this situation.
Yes. When the nappy comes off, children feel wetness properly for the first time. This often leads to a start-stop pattern of frequent small wees while the child gets used to the different sensations.. Most children improve noticeably within a few days. We’d encourage you to stick with it rather than returning to nappies.
No. We never say never and our programme is adaptable for all children regardless of their age. There may be different challenges when toilet training older children, but we can offer lots of advice and support. Giving children every opportunity to reach their full potential is important.
Want expert support?
Toilet training bootcamp
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Connect with other families at the same stage as you.