Nappies And 4 Year Olds & The Key Person Role...

[Lyanne]

We've set up a nappy changing record to demonstrate the children's nappies are being regulary on the advice of our development worker who is helping us make sure we're ready for Ofsted as we're in a new building so know they'll being coming to scrutinse us at some point... We're open 8.45 to 11.45 with some staying for lunch, then 12.30 till 3.30. Some children do am sessions, some pm sessions, some full days... Previously, we changed dirty nappies as soon as we could, but didn't change wet nappies unless the child asked, looked uncomfortable with very full nappy, leaked... So now we've decided to check all children in nappies at least once a session & record if nappy was wet, dirty or dry (it gets changed if wet or dirty...), and since the children are now in for at least 3 hours that's probably a good idea anyway.

 

We aim for the child to be changed by their key person, if available. Of course, if they're not in or are working with another child eg on a 1-1 basis, this doesn't work. So, in practice, I (or another member of staff, it's not just me) start with my key children, then go onto the children of key persons not in, then those of a key person working 1-1 with another child, then realise another key person is doing snack so change her key children, and the other key person is engaged in some really good play with the children so as long as their key child is happy with me changing them I do their nappy too.

 

Yesterday afternoon I changed 11 nappies. 2 of the children whose nappies I changed are now 4, I am neither of their key persons. Now, I know we have children in the preschool whose additional needs mean they're still in nappies, but I'm not aware that applies to either of these children. I had to leave work early to get to my son's parents' evening so didn't get a chance to talk to their key persons, today I should be at uni but am off sick. So I'm sitting here thinking about nappies.

 

I had a child in the summer term who was nearly 4 and coming in wearing pull-ups but using the toilet, so as his key person I spoke to the parents & together with my encouragement, they left the pull-ups off - he's not wet himself. My key children this term, I've got a 2 year old in nappies, a 2 year old in pull-ups that stays dry if reminded & helped to go to the toilet, and a 3 year old in nappies who is always wet when I change him, he was 3 in August.

 

I talk to the parents of my key children at parents' evening and suggest they do something about toilet training if they haven't thought about it, ie 'So, thinking about Johnnie's personal, social and emotional development, he's 3 and a half now, have you thought about toilet training? I've noticed when I change his nappy, it's dry about half the time.' I'll speak to them sooner if the child's taking nappies off when wet or to go to the toilet!

 

What do others do? Do you speak to parents or wait till the parents/child are ready? Do you think I'm over-reaching my role when I do speak to them about it, or not giving enough advice? Any suggestions?

Edited November 10, 2010 by Lyanne

[Rea]

Does anyone else hate pull ups??

I think I might have a quiet word with the parents of the 4 year olds, they might just need some advice on how to start or a prompt.

It wont hurt to mention it but I wouldnt make it an issue. Some parents might object if they feel you're making decisions for them.

[Fredbear]

I think at age 4 and if there were no underlying medical needs in preventing toilet training, i would certainly be gently supporting parents and child to enable them to achieve this.

I am somewhat surprised that this has not already happened and that the parents/carers in question have not thought it was about time they were clean/dry and using the toilet.

I would suggest a shall we work together for............ to try to use the toilet, giving lots of praise to child for any success.

 

We work closely with all families to encourage this. Sometimes a parent/carer just needs a gentle i think it maybe time to try comment.

 

It is up to each key-person to check nappy, pull-up during a session and change when necessary. Will be interested to see what others think too.

[lynned55]

Yes Rea, I do I think (although I am prepared to be shouted down here they are a waste of time. When you have a child that has spent all their short life being allowed to do what they do in nappies, why put a pull up on them that feels exactly the same and not expect them to wet it, the amount of parents I have seen express surprise that they are wet. They are far more difficult to get off as well.

[Guest]

I do agree that it might be worthwhile trying to support the parents of these children to help their child develop their self help skills. Maybe they think it is less bother for the staff if the child is in pull ups than if they need changing after an accident. I am a little confused by the advice to change the children according to a routine though. We have a policy of changing if required as the OP said they used to. I feel changing the children because it is x time is not in the spirit of the unique child and could interrupt their play when they need to be left. Not a criticism of the OP but I just wondered if you could elaborate on the advice you were given please?

[Gezabel]

Yes Rea, I do I think (although I am prepared to be shouted down here they are a waste of time. When you have a child that has spent all their short life being allowed to do what they do in nappies, why put a pull up on them that feels exactly the same and not expect them to wet it, the amount of parents I have seen express surprise that they are wet. They are far more difficult to get off as well.

 

You certainly won't be shouted down by me! I totally agree with you. In terms of 'feel' and absorbency there is no difference between nappy and pull up and I don't 'get' the purpose of pull ups for regularly use. I understand for a child who isn't quite reliably toilet trained they can be useful on the odd occasion rather than putting them 'back in nappies' but to be worn permanently instead of a nappy - what's the point??

[Guest]

Our advisor says for children to wear pull-ups so they can go to the toilet like everyone else, but to have knickers or pants inside so they get the discomfort should an accident happen while we are toilet training in Year R. I've had this advice from several different sources over the last couple of years (not before). It does seem to work for girls - haven't tried it for boys.

I don't mind pull-ups, but not in conjuction with tights!!

as to frequency of changing - we change whenever necessary, though if a nappy hasn't been changed in the morning we do so after lunch as a matter of routine, though I am talking about just a few children, not 11.

[louby loo]

I'd have the 'sensitive chat'.

 

We seem to have had a least two parents lately that, when asked have actually said they only put the pull-ups on to save us the mess/trouble if their child has an accident with us- and that they never use them at home!

[Hello Kitty]

I hate pull ups as well. In my experience if you put them into pants/knickers they are dry sooner as they don't like to be wet so don't have too many accidents whereas in pull ups it makes no difference!

We run the same as maryw... we change as and when needed but when we come together at the end of the session for a story, one person checks that all those in nappies have been changed at some point during the session and if not, they change them (unless bone dry of course!) We ask all of them if they want to sit on the toilet (low level ones) when we take the nappy off and find that as they see their friends doing the same they quite often will do so with us more readily than at home

We don't stick to our own key children, we just change them if we notice they need it though.

We do log our changes too - is that something most settings do?

Each child has their own 'intimate care' log sheet and we fill it in to say they were changed and whether it was wet/soiled then the person that changed it signs and the parent/carer signs. It's a real pain and the parents always moan when they're held up from collecting children because they have to sign stuff!

 

I have to say though that they do seem to be getting later and later in toilet training - I blame pull ups

I'm not sure if it's just busy parents who find nappies easier or what...

[Lyanne]

We didn't use to record it when nappies were changed, unless the parent had specifically requested it - one child with additional needs has a diary that we reocrd nappy changes, snack etc.

 

I wasn't the one actually speaking to the development worker, so as far as I know, she said to keep a log of when nappies are changed - so we now have a list of all the children in nappies/pull-ups that we put the days's date at the top & record the times changed/checked & tick to say whether wet/dirty or dry.

 

I then spoke to our manager & said 'Look, up till now, we've changed as soon as possible when we realise they've a dirty nappy, or if so soggy they hang down, but not routinely - what do you want us to do now?', to which she said 'check them all during the session so we can record that & show it.'

 

We have one child who hates having his nappy changed, so we only change him if dirty. What I like to do is look for the time that's good for the individual child - so if one of my key children have finished snack and are wandering over for a hug, I'll say 'Shall we check your nappy?' I'm not saying that's what all the other staff do, but with the directive to check all nappies, it can be tight getting them all in...

 

Thinking about the toilet - in our old building, we changed in the toilet - we only had one toilet - so it was easy to say 'Are you going to use the toilet while we're here?'. In our new building, we change in the accessible toilet which has an adult size toilet, not in the children's toilets which have 2 small toilets & 1 tiny toilet. So it's not so encouraging for the children to try to scramble up onto this hefty great toilet.

 

I hate pull-ups, and am not to happy with disposable nappies either. My elder son was dry at 14 months because he wanted to be - but having only worn terry nappies, he knew when he was wet & what it felt like. Younger son wanted to stop wearing nappies at 14 months too, but being with hubby & childminder who both wanted to use disposables it just seemed to take forever & he's still not dry at night now in year 3. Didn't help either with childminder asking to put him in pull-ups when at toddler group as she had 3 not reliably dry at the time... I understand why she wanted to do it - she has to go by what's best for all the children in her care & he was wetting himself but it wasn't best for my child!

[Guest]

Thanks for that extra info Lyanne. I can see how it might work doing it your personal way and that seems quite sensible, although I know some of our children wouldn't get changed during the time of our session if they were at home so I'm not sure how parents would react to being asked to bring at least one nappy per session for us to use. My concern would be that, as you hint at, not all staff would do it in your way and it would start to become a conveyor belt approach. I'd be interested to hear if your setting continues with the new routine.

[Lyanne]

I know some of the children need changing mid-morning as they've been changed when they get up in the morning, then done the school run with elder siblings before coming to us - and we also seem to have more needing changing since we've been offering cartons of milk at snack time & the children gulp down 1/3 pint of milk...

 

I also have to admit some of our parents really don't seem to change nappies often - we've had to change children 15 minutes after coming in for theafternoon session because the nappy is hanging down to their knees.

[lynned55]

Why do you record whether wet/soiled? I can understand the reasons why you record the actual changing but I dont see what difference it makes to tell parent whether it was wet or soiled after all we dont tell parents what the child does in the toilet do we? Or maybe some do!! Just curious that's all.

We dont record nappy or clothes changes parents would be told or given the soiled clothes/nappies.(cant leave nappies in the bin so they get them back)

[Lyanne]

It was suggested that we do by the development worker, but actaully since we'd started doing it anyway, have had 2 parents ask for the info, so we went straight to the list & said 'Johnnie had 1 dirty nappy on Monday, but none on Tuesday' - cue impressed parent! In terms of what they do in the toilet - most we wouldn't know as they go on their own, so I hope no-one from LEA/Ofsted suggests we record that!

[Mouseketeer]

I totally agree with the 'how does the child know it isn't still wearing a nappy' theory regarding pull ups, we have an almost 4 yr old wearing them that actually uses the toilet when reminded but will soil them when not, have had chats with parent who's take is that she is the parent and will decide not us

 

we also have a lot more children wearing them since not being able to say they need to be toilet trained and then the school are telling us they're not coming in as aware of their personal needs as they should be/used to be

[Beauvink]

As a childminder the reason why pull-ups may be requested is that unlike a nursery or pre-school the children are out and about, so a bathroom to clean up a soiled child is not always available. But I too hate pull-ups as progress is slightly slower. I did put pull-ups on when out and about, again useful for when you have 3 children potty training but not entirely ready. But as soon as we were home changed the children into grown up pants etc., This complimented what parents did at home and did not compromise the childrens safety when out and about. Safety in relation to keeping an eye on the other children whilst standing the soiled child in a sink to wash down excrement!

 

Also as a childminder training only started with a child when they showed an intererst in potty training. It was never enforced because a child reached a certain age. From experience if a child is not physically or mentally ready, meaning they have no understanding of bowel control then this can lead to problems down the line with holding and refusing to go.

[Guest]

I have never understood the logic behind changing a non soiled nappy, could someone explain why you might do this? What benefit is it to the child?

[Guest jenpercy]

because full wet ones eventually leak!!!!!!

[Lyanne]

I have never understood the logic behind changing a non soiled nappy, could someone explain why you might do this? What benefit is it to the child?

 

I guess you mean, why change a wet nappy instead of leaving it till the child has done a poo?

 

After a while - depending on the absorbency of the nappy & how much the child wees, the nappy reaches saturation point and any more wee comes out. If it's one of the better quality nappies, by this time the nappy is very full & the child looks uncomfortable - you certainly wouldn't want them sitting on your lap or on your best sofa like it...

 

Depending on the strength of the child's wee & what they've had to eat/drink, you can have a very strong urine smell around.

If the child gets nappy rash, leaving them in a wet nappy can make their bottom sore/more sore - even with disposables. Actually, I found with my boys that I could leave them longer in wet terry nappies that I'd washed myself than in disposables that have chemicals in them to absorb the liquids, as the chemical irritated their eczemateous skin.

 

If no-one is checking the child's nappy till it's dirty to see if it's wet, no-one's going to be suggesting to the child 'Hey Johnnie, your nappy's still dry & you 've had it one for a couple of hours - do you want to do a wee on the potty/toilet?' Hence the lateness of some children in toilet training because no-one at home's suggesting they use the toilet...

 

I honestly think it's just gross - I changed my sons when possible as soon as they'd wet just as I would if they wet their clothes and do think that's why elder son was ready to stop using nappies so young. I'm fully aware this is coloured by being the eldest sibling & seeing my mum changing my younger siblings nappies frequently & both my sons having eczema & getting horrid nappy rash if I left them in wet nappies too long or in wet disposables...

 

If you meant why change a dry nappy, I wouldn't usually change a dry nappy but sometimes with cheap nappies if they've been on a while they get really ruckled up & uncomfortable looking, or tear while you're checking if it's wet or dry. It was good yesterday - we've 3 siblings & I'd changed them all & could say to mum 'Noticed Johnnie's nappy was almost dry when I changed it - I know you said he's under the weather & I also know he usually has a very full nappy. I'll just check how much he had to drink today.' If I'd not changed it, mum wouldn't have known I hadn't changed it so would have thought the nappy was dry because I had changed it - if that makes sense?

[Guest]

Goodness! I suppose I did say 'soiled nappy' in my post which looking back I suppose most people take to mean poo, but I would obviously never question why a wet nappy needed to be changed! That surely should be obvious to anyone and certainly is to me.

 

I was questioning why I dry nappy needed to be changed so thank you for the explanation. I guess I've only ever come across children wearing good quality ones because I've never seen the tearing/rucking issue.

[Lyanne]

Goodness! I suppose I did say 'soiled nappy' in my post which looking back I suppose most people take to mean poo, but I would obviously never question why a wet nappy needed to be changed! That surely should be obvious to anyone and certainly is to me.

 

I was questioning why I dry nappy needed to be changed so thank you for the explanation. I guess I've only ever come across children wearing good quality ones because I've never seen the tearing/rucking issue.

 

Sorry Kariana, I didn't get a notification that you'd replied so only now checking back...

 

Some of our famillies have what I call 'false economy' stuff - cheap wipes that are so astringent they give the child nappy rash, cheap nappies that tear and leak. I'm not saying all cheap stuff is bad value - my younger boy had all Primark T-shirts & jogging trousers for preschool - but sometimes more expensive is better value.

[Cait]

I've seen cheap ones 'in action' too, the sticky doesn't stay stuck and in one case one of my staff put masking tape on just to hold it shut! With this child we eventually put a pair of knickers on over the top to hold it all together. Thankfully that was a few years ago, and they do seem to be better nowadays.

 

My own children had terry nappies and if I did it all over again that's what I'd use now. I really dislike disposables. The terry really made children aware of the sensation of being wet, which I think is lacking from disposables, so the uncomfortable feeling isn't there.

 

Back in the olden days when my two were babies, they were put on the potty routinely at each nappy change anyway so they were aware of what it was for. Initially just 'performing' for the praise but quickly understanding the sensation of whether there was something or nothing to come.

 

I agree that since 'the rules' were dropped about a child being toilet trained before they started, it's become the exception that children arrive already out of nappies. I also think that if children don't feel wet, can wee or poo wherever and whenever they want, there's no 'drive' to be out of nappies.

 

And don't get me started on dummies! :(

[Lyanne]

Now-a-days, most disposables have velcro-y fasteners, but some of the cheap ones still have sticky fasteners. I just love getting my diposables gloves caught in the tapes!