<strong>A Puffins Guide to Toilet Training</strong>

1. First steps

Children’s drinking habits

Before you can consider whether your child is ready to start to toilet train, they need to have good drinking habits.  Every time your child sits down for a meal or snack, encourage them to drink water from a cup (not beaker or bottle) they should be drinking around 200ml of water, about 1 small cup. Always make sure they have access to water throughout the day too.  If offering children milk, limit this to no more than 1 pint per day as this can cause constipation.

Drinking this amount encourages children’s bladders to expand, which in turn sends signals to children that they need a wee. Without this drinking habit, their bladders may not send them the signal that they need to use the toilet, and this is when accidents occur.

 Getting ready for toilet training

 Children may show signs that they are ready from around 18 months but often it’s around 2-3 years old.

The signs they show are not limited to this list but your child should have some before starting toilet training:

· Has the ability to sit on a toilet unaided,

· Drinks around 6-8 cups of water daily,

· Good ability to follow simple instructions

· Awareness of wet or dry nappies (talk to them during nappy changes to introduce the idea).

 · Indicate when they need a wee,

· No sign of constipation or infection,

· Gap between wet nappies is around 1-1.5 hours,

· Poo soft stools at least 4 times a week.

To support your child to feel more comfortable about toilet training, during nappy changes, even if the child hasn’t started toilet training, offer the child a chance to sit on the toilet before a fresh nappy is applied – but don’t force it if they say no.

 Nappy test

If you are unsure if your child is ready, then you can try the “nappy test”. Pop some kitchen roll in your child’s nappy and see how long they can last before it’s wet.

Monitor every hour and make a log, writing down if they are wet or dry. After 2 days of this if you look back over the log and find that your child has stayed dry for most of the time then your child is ready for pants.

2. Making a toilet plan

The next step is to make a toilet plan. This needs to be consistent between both the home and the nursery setting, so your child knows what to expect. Things to consider:

· It is recommended that children start straight on the toilet with a step and a seat (unless you have child sizes toilets). However, you will need to consider if you wish to use a potty.

· If you choose to use a potty then the potty should remain in the same space, such as in the bathroom. This is to encourage continuity for the child – but it should also be a private space for them

· When sat on the toilet, a step should be provided so that the child’s knees are slightly higher than their hips.

· Children should wear loose clothing that they can easily pull down and up.

Ensure that when you are out and about or when the child is at nursery that they have    plenty of clothing to change into. Remember toilet training takes time and consistency is     part of the process.

It is recommended that children to go straight into pants rather than pullups. Pullups are designed to hold the liquid and so children do not feel that they have wet themselves.

3. Time for the toilet

As much as possible, children should be encouraged to have long sits on the toilet, i.e. 1 minute per year of age, then 5-10 minutes for 4 year olds +.

Encourage a child to sit on the toilet and engage them with a book or let them blow some bubbles. The blowing bubbles motion helps the child to relax their body and to release their bladders and can make the whole experience positive.

Although we don’t recommend setting a timer, for the first few days it’s worth taking your child to sit on the toilet every 90 minutes, as this is how long they might be holding their bladder. 

Even if the child has had a wet accident, encourage them to sit on the toilet to empty anything left in their bladders. This helps to prevent an accident shortly after.

Consider incentives or rewards for children who use the toilet to sit on, not just for when they use the toilet for its purpose.

For children learning to use the toilets for poos, this may take a little longer. If the child knows they need a poo but doesn’t want to go on the toilet, keep the child in a nappy but loosen the tabs. If the child is happy with this option, the next step can be to line the toilet bowl with a nappy, before eventually taking the nappy away altogether.

 Things to remember

· Every child is different, toilet training is a routine and routines take longer to learn.

· Children start out only holding their bladders for 1 hour to 90 mins. As they develop, so does their bladder.

· Use the same language for toileting and keep consistent with any rewards

· Remain positive and calm, we want this to be a positive experience, there will  always be a few accidents,

· If children are unwell, constipated or have infection then toilet training won’t go to plan!

· Children who are toilet trained are not likely to stay dry during the night until they are older.

· Toilet training for a poo takes a longer time for a child to adjust.

· Keep communicating progress between the home and nursery setting.

Children who are 5 years and older who are struggling to grasp toilet training should be discussed with a GP.

Children with additional needs can still undergo the “Nappy test” and follow the methods used, however this will be more relaxed and an occupational therapist may be able to support this further with ideas and steps to take.

Heat Health Advice

Children and some vulnerable adults cannot control their body temperature as efficiently during hot weather and so can be at risk of ill-health from heat. Heat- related illness can range from mild heat stress to potentially life-threatening heatstroke. The main risk from heat is dehydration (not having enough water in the body). If sensible precautions are taken children and adults are unlikely to be adversely affected by hot conditions.

See below for our best tips for protecting children during these hotter months.

Protecting children outdoors:

During periods of high temperature, the following steps should be taken:

  • Children should not take part in vigorous physical activity on very hot days, such as when temperatures are in excess of 30°C.
  • Encourage children playing outdoors to stay in the shade as much as possible.
  • Children should wear loose, light-coloured clothing to help keep cool and sunhats with wide brims to avoid sunburn.
  • Use sunscreen (at least factor 15 with UVA protection) to protect skin if children are playing or taking lessons outdoors for more than 20 minutes.
  • Provide children with plenty of water (such as water from a cold tap) and encourage them to drink more than usual when conditions are hot.

Protecting children indoors:

During periods of high temperature, the following steps should be taken:

  • Open windows as early as possible in the morning before children arrive, or preferably overnight to allow stored heat to escape from the building – it is important to check insurance conditions and the need for security if windows are to be left open overnight.
  • Almost close windows when the outdoor air becomes warmer than the air indoors – this should help keep the heat out while allowing adequate ventilation.
  • Use outdoor sun awnings if available, or close indoor blinds or curtains, but do not let them block window ventilation.
  • Keep the use of electric lighting to a minimum.
  • Switch off all electrical equipment, including computers, monitors and printers when not in use – equipment should not be left in ‘standby mode’ as this generates heat.
  • Oscillating mechanical fans can be used to increase air movement if temperatures are below 35°C – at temperatures above 35°C fans may not prevent heat-related illness and may worsen dehydration.
  • Encourage children to eat normally and drink plenty of cool water.

Safer Sleeping For Children!

The safer sleep advice gives simple steps for how you can sleep your baby to reduce the risk of sudden infant death syndrome (SIDS) which is commonly known as cot death. It can give you the peace of mind to enjoy this special time.

The article below includes information about:

  • Safer sleep in winter
  • The safest room temperature for babies
  • The best sleeping position for your baby
  • Sharing a room with your baby/Co sharing a bed
  • Smoking during pregnancy and around your baby

There is lots more articles with different information, please see link below.

How to reduce the risk of SIDS for your baby – The Lullaby Trust

Scarlet fever and Group A Streptococcal infections.

Due to the recent increase in notifications of scarlet fever to the UK Health Security Agency, above seasonal expected Levels.

We would like to take this opportunity to remind you of the signs, symptoms and the actions to be
taken if you think that you or your child might have scarlet fever.

Signs and symptoms of scarlet fever
Scarlet fever is a common childhood infection caused by Streptococcus pyogenes, or group A
Streptococcus (GAS). It is not usually serious, but should be treated with antibiotics to reduce further risk. The early symptoms of scarlet fever include sore throat, headache, fever, nausea and vomiting. After 12 to 48 hours, the characteristic red, pinhead rash develops, typically first appearing on the chest and stomach, then rapidly spreading to other parts of the body, and giving the skin a sandpaper-like texture. The scarlet rash may be harder to spot on darker skin, although the ‘sandpaper’ feel should be present. Patients typically have flushed cheeks and be pale around the mouth. This may be accompanied by a bright red ‘strawberry’ tongue.
If you think you, or your child, might have scarlet fever:
• contact your GP or NHS 111 as soon as possible
• make sure that you or your child take(s) the full course of any antibiotics prescribed. Although
you or your child will feel better soon after starting the course of antibiotics, you must
complete the course to ensure that you do not carry the bacteria in your throat after you have
recovered
• stay at home, away from nursery, school or work for at least 24 hours after starting the
antibiotic treatment, to avoid spreading the infection

Invasive Group A Strep (iGAS)
The same bacteria which causes scarlet fever can also cause a range of other types of infection such
as skin infections (impetigo) and sore throat. In very rare cases, the bacteria can get into the
bloodstream and cause an illness called invasive group A strep (iGAS). Whilst still very uncommon,
there has been an increase in iGAS cases this year, particularly in children under 10 years old. It is
very rare for children with scarlet fever to develop iGAS infection.
As a parent, you should trust your own judgement.
Contact NHS 111 or your GP if:
• your child is getting worse
• your child is feeding or eating much less than normal
• your child has had a dry nappy for 12 hours or more or shows other signs of dehydration
• your baby is under 3 months and has a temperature of 38C, or is older than 3 months and
has a temperature of 39C or higher
• your baby feels hotter than usual when you touch their back or chest, or feels sweaty
• your child is very tired or irritable
Call 999 or go to A&E if:
• your child is having difficulty breathing – you may notice grunting noises or their tummy
sucking under their ribs
• there are pauses when your child breathes
• your child’s skin, tongue or lips are blue
• your child is floppy and will not wake up or stay awake

Stop the spread
Children and adults with suspected scarlet fever should stay off nursery / school / work until 24 hours after the start of appropriate antibiotic treatment. Good hygiene practice such as hand washing remains the most important step in preventing and controlling spread of infection. You can also help stop the spread of infection through frequent hand washing and by not sharing eating utensils, clothes, bedding and towels. All contaminated tissues should be disposed of immediately.

5 ways to protect your under 5s this winter!!

As this is the first winter without pandemic restrictions in two years, you and your children may be more susceptible to the usual winter bugs and viruses this year. Click the link to find out how to protect you and your child.

5 ways to protect your under 5s this winter – UK Health Security Agency (blog.gov.uk)https://ukhsa.blog.gov.uk/2022/10/25/5-ways-to-protect-your-under-5s-this-winter/

Health for Under 5s

Did you know that Devon CC have launched a trio of websites dedicated to providing help and advice for young people and parents, from pre-natal right through to teenage years?

You can access information, guidance and advice, compiled and written by Public Health Nursing professionals, about a range of issues that affect you and your child. The “Health for Under 5s” website covers pregnancy to reception class.

Click the link below.

https://healthforunder5s.co.uk/devon/

Save money on your childcare bills with Tax-Free Childcare!

If you’re a working parent or carer, you can get up to £500 every three months (up to £2,000 a year per child) to help with the costs of childcare. If your child has a disability, you can get up to £1,000 every three months (up to £4,000 a year per child). You can use it to pay for childcare including:

• childminders, nurseries and nannies

• playschemes, before and after school clubs, and holiday clubs

Puffins is signed up for the scheme.

How it works

You set up an online childcare account for your child. For every £8 you pay into this account, the government will pay in £2, up to a maximum of £2,000 a year (or £4,000 if your child has a disability). You can then use the money to pay your childcare provider. You need to reconfirm your eligibility for Tax-Free Childcare every three months. You’ll get a text reminder and it’s easy to do through your online childcare account.

Am I eligible?

To get Tax-Free Childcare, you need to be working at least 16 hours a week, earning at least the National Minimum Wage or National Living Wage. This includes being:

• self-employed

• on maternity or parental leave

• on sick leave or annual leave.

Your child is eligible until the September after their 11th birthday, or until their 17th birthday if they have a disability.

Each parent or carer can earn up to £100,000 per year and still be eligible for Tax-Free Childcare. Your eligibility doesn’t depend on how much tax you pay, so it won’t affect your income tax liability or any other tax, like VAT. You can’t claim Tax-Free Childcare at the same time as Working Tax Credit, Child Tax Credit or Universal Credit.

Find out more

To find out how much you could get towards your childcare costs and check whether you’re eligible, click here.

Tiny Happy People!

Tiny Happy People helps to develop your child’s communication skills. Explore their simple activities and play ideas and find out about their amazing early development. There is activity inspiration for all ages, that are proven to help your child’s development, from newborn to 5 years.

Follow this link to access all of their great activities!

Do you know about Tax Free Childcare?

You can get up to £2,000 a year per child to help with the costs of childcare at nursery.

If you are eligible for the Tax-Free Childcare, the government will pay £2 for every £8 you pay your childcare provider. This is paid via an online childcare account that you set up for your child.

You use the Tax-Free Childcare account much like you would a bank account, transferring money in and out of it to pay the costs of the childcare. You can get Tax-Free Childcare in addition to receiving the 30 hours grant a week if you are eligible for both.

Puffins of Exeter is a registered childcare provider with the Tax-Free Childcare. Find out if you are eligible through the following link.

Please contact Abby (abbywardle@puffinsofexeter.com) at the Head Office for any support in applying for the tax free childcare or if you have any further questions.

Help children aged 2 to 4 at home during coronavirus

In line with government guidance, all our settings are open from 1st June. If your child is not yet returning to nursery

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