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Schools and nurseries
Information for education settings and teachers on how to promote good bowel and bladder health among children.
Children spend a significant proportion of their day at school, so we need to ensure we continue promoting good bowel and bladder health at school as well as home.
Bowel and bladder issues such as daytime bladder problems, bedwetting, constipation, soiling and delayed toilet training can have a devastating impact on a child’s learning, development and well-being.
Children with continence issues are at high risk of bullying and withdrawing from social situations. Most suffer embarrassment and stigma. Furthermore, continence difficulties may also be associated with behavioural or psychological problems, poor self-image and peer victimisation.
Research has also found that teenagers with incontinence are at greater risk of underachieving academically and need more support to remove barriers so they can reach their academic potential.
A lack of awareness amongst health and education professionals, along with the stigma that still surrounds wee and poo, can affect many children and teenagers' school experience.
This page outlines the key principles of supporting good bowel and bladder health within schools and nurseries.
For further information on the bowel and bladder issues themselves please refer to our main advice sheets (includes downloadable PDFs):
Promoting bowel and bladder health in schools and nurseries
Education staff should have information about continence problems in children and young people in order that they can provide appropriate support if required.
The principles of good bowel and bladder health should be supported and promoted in all schools.
1. Access to drinks
Children should be drinking 6 – 8 water-based drinks each day.
As well as preventing dehydration, which can impact on learning and wellbeing, good drinking habits promote good bladder health, help to prevent urinary tract infections (UTI) and constipation.
The total volume that a child needs varies according to their age, size, activity levels and environment, with more required for children who are overweight, when the environment is hot, or when children are exercising (this includes breaktimes).
Therefore, the size of the cup should be relative to the child’s age and size: about 200ml for a 7-year-old and 250ml for an 11-year-old, with extra encouraged at the times outlined above.
Good practice involves:
- Ensuring children have a good fluid intake. We cannot rely on children being ‘thirsty’ as they may not yet be fully aware of this feeling or may have reduced awareness of it. The majority need encouragement to drink, so should be prompted to do so regularly throughout the school day.
- Children should be having half their daily water-based fluid intake (i.e. 3-4 drinks) in school hours.
- Children should be encouraged to drink water. However, for those who will not drink water, they should be allowed to have diluted fruit squashes, preferably sugar-free. These should be provided by parents and brought to school ready to drink in a sports-style water bottle that is opaque, so other children do not realise they are having something different.
- Children should avoid fluids that contain caffeine (tea, coffee, hot chocolate, cola and many energy drinks) as these irritate the bladder.
- Fizzy drinks should be an occasional treat only, as they may irritate the bladder.
- When children increase their fluid intake, they may require more frequent access to the toilet. However, as their bodies adjust, so long as they are drinking within normal limits, their bladder capacity should improve and the need for extra toilet visits should reduce.
Schools should consider how they could facilitate good drinking habits among all their learners. This may include:
- Open access to drinks unless this is clearly inappropriate, for example, in science or computer laboratories
- Provision of easily accessible water fountains or taps to top-up water bottles
- Encouraging learners to bring their own water bottles in from home, or providing water bottles in school.
2. Toilet access
No child should wait to go to the toilet if they ask.
Schools should be aware that some learners avoid eating and/or drinking in school so that they can avoid using the toilet. This is more likely if they feel that toilet access is restricted, or they feel the need for additional privacy, or school toilets are poorly maintained and stocked.
Some learners will need prompting to use the toilet; it may be appropriate to do this after breaks, meals and snacks.
As children mature their ability to use the toilet opportunistically increases. For most this means they will go at break/lunch time. But it is important to remember that every child’s bladder and bowels are individual - they function to their own timetable, and this is not necessarily in line with the school’s.
For children with bowel and bladder issues, younger children and those who are menstruating, open access to clean, safe, well-stocked toilets is even more important.
A system should be provided to allow them to have open access as soon as they need it.
For primary school children this may be a non-verbal sign that they are going to the toilet, as many are too embarrassed to put their hand up and ask.
For those at secondary school or college it might be more appropriate to issue them with a ‘medical’ or ‘time out’ pass, which grants them liberty to leave the classroom as they require. Learners may be reluctant to use a pass that states it is for toileting.
For further information please see our page School toilets.
If access to toilets and drinks is not granted universally, the affected young people are likely to have increased anxiety about their condition, associated with the embarrassment and stigma of such personal health problems.
Last Reviewed: January 2025
Next Review: January 2028
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