Wednesday, 16 November 2016
Sunday, 13 November 2016
When a child turns two suddenly the word on every parents lips is potty training… if you think the pressure for your child to walk or talk first was intense… you have experienced nothing until you enter the unchartered, unsupervised waters of potty training. At least there was no bodily fluids involved when learning to walk and talk and there was a health visitor checking their every skill level intently with surveys and check-ups, giving you tips and ideas.
No when it comes to potty training you really are alone and weirdly surrounded by parents and children who are apparently natural masters of the potty… you will hear ‘my child just decided one day he didn’t want to wear nappies anymore and potty trained himself’ ‘have you tried the three day technique, it’s amazing, I just don’t understand what all the fuss is about?’ ‘my little one was dry within a week of getting rid of nappies’ ‘I can’t wait to get rid of these expensive nappies’ ‘isn’t it awful the number of children still in nappies when they start school? Lazy parenting’.
That September school deadline looms over you, you know they NEED to be dry by then or you are going to be that lazy parent who expects the school to toilet train your child. The media are pushing it, nappy companies are trying to squeeze every last penny out of you with pull ups and training pants and health visitors are weirdly no where to be found at this point and you feel like EVERYONE is judging you.
The reason 10% of children aren't dry by five...
The last two years have been the hardest two years of parenting for us. I have felt like a failure as a parent, like the only one who couldn’t teach their child the simple skill of using the toilet rather than their clothes to wee and poo in… there have been tears and temper tantrums from all parties involved… but then I found out something… 10% of children are not fully toilet trained at 5 years old… even more are not toilet trained at 4… so where are all these parents and why do we have so much pressure placed on us to achieve a goal which for 1 in 10 children is unachievable?
I am going to speak out for those 10% now, I hope that someone reads this and doesn’t feel like the failures that we did.
There are lots of reasons why children might not want to use the potty or toilet, for example, anxiety, fear or just plain stubbornness but what I am going to talk about is a medical reason which I now know affects 1 in 10 children aged 5 and which I feel every parent should be given information about.
Even more importantly is that having started talking to women whose children have been exposed to anti-epileptic drugs in uterus, this seems even more common in this population of children. Obviously there is no research, no reliable data to support this claim as with most of the impact of AEDs on unborn babies, it isn’t a priority for anyone to research at the moment.
If I had been told this could be a side effect of my medication would I have not had children? Definitely not, however if I had been told to watch for signs of an overactive bladder would I have approached potty training completely differently… absolutely and the last two years would have been very different. Hindsight is a glorious thing and I will definitely be looking at potty training Benji very differently.
So what is an overactive bladder?
We now describe Riley’s bladder as a naughty bladder. You may also hear this condition being called a ‘twitchy’ bladder. When the bladder fills with urine these ‘naughty’ bladders send messages that the child needs the toilet before the bladder is fully full. This means that the child will have a small bladder capacity and so will need to go to the toilet more frequently. When the bladder squeezes this can be so strong that urine leaks out then and there, causing damp pants something we have been struggling with for years and meaning Riley has to change her clothes multiple times a day.
So the symptoms are:
- Frequent weeing (8 or more times a day)
- An urgent need to get to the toilet quickly
- Smaller bladder capacity
- Urinary tract infections
- Children will often try to stop the need to wee by squatting, sitting on an ankle or standing on tiptoes.
But with Riley these symptoms have only become clear in the last year or so as she has grown older and more able to communicate complex ideas. Before that it was much more vague, she just didn’t seem to get potty training and yet she was meeting all her other milestones even ahead in things like imagination and emotional maturity. She just had a lot of accidents and never told us when she needed a wee so we just thought she was being lazy or we were doing it wrong.
We tried every reward we could think of, marbles in a jar, sticker charts, Velcro charts, a shop that she got coins towards every time she did a wee or poo. We tried rewarding wees and poos, we tried rewarding staying dry instead. We bought a wobble watch to remind her to use the toilet every 30 minutes. We got her to change her clothes herself after an accident to try to show her it is much easier to use the toilet. Every time we introduced something new she improved but within two weeks she would slip back again it felt like taking three steps forward then two steps back and it was exhausting.
Finally I couldn’t take anymore I went to the drop in health visitor clinic and when I was told they were too busy to see me and the clinic was really only for babies I broke down in tears in the waiting room and finally got to see a health visitor. She came and did a home visit and it quite quickly became clear we hadn’t done anything wrong and they weren’t able to really offer much more advice. Finally we got a referral to a paediatric urologist…
The moment everything changed
So I wrote everything down and went along to the appointment, the doctor was lovely talking to Riley as well as me. She sat and listened to everything, my two years of a nightmare. Then she smiled, a kind but knowing smile… she said to me I wish I could tell you that your child is unique however almost every parent who walks through that door tells me the same story. She then explained to Riley and me that Riley had a naughty bladder and she said to me that Riley was particularly receptive for a 4 year old and so we could introduce an easy exercise to try to help. But the main thing is that most children grow out of this problem… so we just have to wait.
Why did no one mention this before… why did no one say 1 in 10 children won’t be dry by school at it’s not the child or parent being lazy… it’s a medical thing that no one can change. Suddenly I looked on the whole situation differently. We had just spent two years trying to get Riley dry in pants… I had even bought some ‘Dry like me’ pads but didn’t want to use them in case it made her lazy.
I left that appointment and went straight to the shops, I bought Riley a little bag, some nappy sacks and a packet of wipes and the next day I showed her the ‘Dry like me’ pads. I explained to her that the pads would mean that when her bladder was naughty and squeezed some wee wee out that it would go in the pad, it wouldn’t smell, it wouldn’t make her clothes wet and all she had to do was change the pad herself when she went to the toilet. This has been a game changer. Suddenly our life isn’t ruled by toilet training. Riley can manage her own pads and when to use the toilet 95% of the time, we still get the odd accident but it is so much more manageable.
My top tips for managing an overactive bladder:
Make sure your child is getting enough fluids, they should have over 1000mls of water at the age of four, that is quite a lot and it does take persistence to achieve. This helps the bladder to fill and stretch and also stops the urine getting too concentrated which can make the ‘twitching’ worse.
Only allow your child to drink water. Other drinks can again increase the twitching, caffeine is the worst, so tea, coffee, cola are definitely off limits. Artificial colourings and flavourings can make bladders more ‘twitchy’ too so we always avoid these and even natural blackcurrant juice can have an impact. With Riley we give her watered down apple juice as a treat as this tends to have the least impact.
Take your child to the toilet at regular intervals to try to do a wee especially when they are busy, a vibrating watch can make your child more independent with this. It can be hard for them to differentiate between their bladder being naughty and squeezing and when they really do need to go to the toilet so when they are busy it is easy for them to forget.
Measure how much urine your child is producing when they wee. The problem suddenly became clear to us when Riley had a kidney scan and the radiographer said she only had 60mls of urine in her bladder and so couldn’t possibly need a wee even though Riley said she did. I went home and started measuring each wee and suddenly realised she wasn’t ever producing more than 80mls of urine. Her scan was sent back as normal so I had to go back to the GP to make it clear this wasn’t normal.
When they go to the toilet make sure they empty their whole bladder. It can be good to encourage them to count while on the toilet and blow out.
If your child is struggling with poos, or doing poos in their pants, even if they go everyday they could be constipated. We give Riley a small cup of prune juice each morning which seems to really help her. Being a little bit constipated can put pressure on the bladder and make it even harder for a child to work out when they need a wee.
Don’t be afraid to use ‘Dry like me’ pads. These are like sanitary pads and go in their pants. If your child’s pants are constantly damp the pad will stop them having to change their clothes so often, will stop them being smelly and getting sore. Forget trying to get them dry, just aim for them to be able to manage the problem independently. It turns out schools aren’t so bothered about dryness, they just want the child to take responsibility for their toileting.
Try to encourage your child to try to hold their wee, the doctor said to Riley to try to count to 30 elephants when she feels she needs a wee and see if the urge to wee has gone. That way you can train the bladder to fill and stretch a bit more, increasing its capacity.
Get the school onside, explain your child’s problem, make it clear they can’t wait for toilet breaks and if they are using pads show them that they have a little bag that contains everything they might need. Our experience has been that the school has been amazing and really supportive.
Don’t worry about night time dryness, it may seem like everyone else’s children are out of nappies at night but if your child’s bladder can only hold 100mls of fluid in order to keep them dry at night your child will have to be getting up quite a lot to manage a dry night. Also the twitching doesn’t stop at night so they may well leak without waking up. Surely a goodnights sleep is more important for everyone. Night time dryness is also reliant on the child producing enough of a hormone called vasopressin which your body needs to stop you making so much wee at night.
I really hope this blog helps another family struggling with toilet training feel less alone and empowers you to look at things differently. I will be looking at the whole process very differently when I potty train Benji, I have learnt so much from the past two years about the amount of pressure we put on ourselves and our children to achieve developmental milestones.
ERIC is a brilliant charity who have some brilliant resources for parents, children’s and school and who have been fantastic with giving us advice through their helpline so I would definitely encourage parents to contact them if you are struggling.
Tuesday, 8 November 2016
Thursday, 3 November 2016
I can’t thank the empatica team enough for this amazing product, it is helping me to feel more confident when looking after my kids on my own or while out running and training for the marathon. I really do feel this is going to be life changing for so many people living with epilepsy.
Sunday, 16 October 2016
Date: Saturday 29th October 2016
Time: 2pm - 4pm
Venue: Horizon, Assembly Walk, Carshalton, Surrey, SM5 1JH
Items in the auction open for pre-bids (send bid by email to email@example.com)
2 hours in a professional recording studio with an award winning producer and leaving with a professional quality recording on CD or online
CV and interview advice by a professional recruitment consultant
Horse transport (up to 100miles) and groom for a day (excluding plating tails)
Linked in profile copywrite
5 hours of babysitting in the Redhill/Reigate area
Improvers ski lesson by professional ski instructor (at Brentwood ski slope, transport can be included)
3 hours of base guitar lessons
Cooking tutorial from a professional chef culminating in a restaurant quality 3 course meal in your own home
An amazing made to order cake from Little Blossoms Cakery (truly works of art)
Vintage China for an event for 30 people perfect for a baby shower or hen party
Fudge factory experience
Pony experience - spend half a day learning to care for and then ride a pony (children under 8 years)
Auction items available on the day only:
Transport to and from the airport
Beginners knitting lesson
Family meal including desert delivered hot to your door
1 to 1 make up lesson by professional make up artist
2 hours of ironing
Kids rainy day craft box
frozen slow cooker throw bags
2 hours of gardening
Meal for four people cooked in your own home
5 beginner piano lessons
We are also going to have a raffle on the day and raffle prizes so far include:
Family ticket to Godstone Farm
Afternoon tea for 2 at Edibles in Banstead
2 person ticket to Bockett's Farm
Garson's Farm gift voucher
Woodcote Green garden centre gift voucher
Free bowling at Tolworth Bowl
Mini canvas by the talented artist Jenny Greenland
£10 dry cleaning voucher for Banstead
1/2 case of wine
30 minute go karting session in Crawley
And much much more...
Also on the day there will a cake sale with tea and coffee, crafts for the children, face painting and Riley will be singing a song to make everyone smile!
If you aren't able to come along to the event but would still like to support my marathon attempt anything you can donate would be greatly appreciated. My just giving page is:
Friday, 16 September 2016
In the years since there have been moments where my anxiety has seemed to get worse, during my pregnancy with Benji when I was worrying about labour was one of those times but it was then that I learnt about mindfulness and really used it to take some control back over my thoughts and worries.
So when I was planning going back to work I thought it would be ok Benji starting nursery, me starting work, Riley starting school and running my first half marathon all in the same month... not sure exactly what I was thinking but all I can say is this last month has been a tough one.
Monday, 15 August 2016
When you are pregnant you want to do everything you can to protect your unborn baby. You watch what you eat and drink, giving up things you loved before just in case it impacts on the life you are growing inside you. But for those of us who have no choice but to take medication during pregnancy it is a huge weight on our mind throughout those 9 months and beyond.
Pregnancy and the early days
That first scan is so scary, but then so is every scan after that, what if they find something, what if the drugs have affected the baby, I think it’s the only time in life where you want your child to be completely average and I felt blessed that both mine were.
Then they are born and the relief that both my babies we’re ok was huge. The first few days with Benji were a worry, he didn’t poo straight away and the doctor was questioning whether his digestive tract had developed correctly. We heard her making irate phone calls to the consultant and the whole time I was sat there thinking maybe this is because I took Keppra in pregnancy. It turns out he is fine but the worry at the time was very real.
So once they are home I though the guilt would pass, we have two healthy children we could get on with life.
Small problems start to show
But then we noticed Riley’s eyes would sometimes roll outwards, to begin with I thought I was imagining it but by the time she was two others started to notice it too. It turns out she has a divergent squint, she controls it really well and I am so proud of how grown up she is when she goes to the hospital and has her eyes tested. But in the back of my mind I question why does she have this problem, could it be the lamotrigine I took in pregnancy? She may need surgery in the future, it’s not a problem that is likely to go away and I worry that other children will notice her eyes and bully her for it.
Then there are her little toes, they are slightly deformed, they are slightly high on her foot and the nails are small and impossible to cut. I have mentioned it to the doctor and we were told they may well bother her when she gets older and require a small surgery to correct them. But a few weeks ago Riley asked me why her toes are funny, it was because Benji’s are normal so when I cut their nails together I can do his really quickly but with hers I have to get clippers out and try to pull the nail back to cut them and it hurts her. She asked why her nails were so hard to cut when Benji’s toes were so much smaller and yet his nails were easy to cut…
Finally there is potty training, this has been a complete nightmare, the hardest part of parenting so far for us… we have tried everything. We have used so many different reward charts, we have got her to clean up the mess, we have used a wobble watch to remind her to use the toilet, we have given her big drinks to try to stretch her bladder and still we have regular accidents.
Don’t get me wrong things are improving, we definitely have less accidents now than 18 months ago but we struggle to go more than 2-3 days without an accident and some days we will have loads. The health visitors are all out of ideas, nursery are all out of ideas and for a child so bright and articulate it seems strange she can’t grasp a simple concept of using the toilet.
At first it was really hard seeing all her friends just getting it. But it has gone on for so long now I have learnt to accept it but it is still hard when there are children so much younger than Riley who are successfully potty trained.
There is also so little support out there when you are struggling. I had to break down in floods of tears to the health visitor to even see them. We had a scan done and it showed her kidneys are normal but it would appear her bladder is small. We don’t know why yet but we have finally got a referral to the paediatric urologist, it has taken a long time and a lot of heart ache to get there. And now I wonder could it be the medication I took in pregnancy which is behind this problem.
Could it be the medication?
The truth is we will probably never know whether these problems are caused by the lamotrigine because while data is collected on major birth defects at birth, small problems like this are not recorded anywhere and without the large data sets you can never tell whether it’s just unlucky that she has these problems or whether it’s due to the drugs.
Of course these little problems wouldn’t have stopped me having a baby because I was taking epilepsy drugs, I wouldn’t change Riley for the world. I suppose it’s more the guilt that is linked with them, I blame myself for Riley’s problems. Because no one can tell me either way whether it’s the drugs I blame myself for the decisions I made, like to up my lamotrigine dose during pregnancy because my levels dropped.
It’s also a funny situation because I feel like because Riley and Benji were exposed to different drugs during my pregnancy and Benji doesn’t seem to have these problems that if I had taken the plunge and tried Keppra sooner Riley might not have these problems. I chose not to try Keppra sooner because I was worried about it effecting my mood because of all the things I had read about it so I feel guilty for that.
What needs to change?
I suppose what I am trying to say is that more needs to be done to record the long term effects of medication on children exposed to it in uterus. Drug companies need to take more responsibility for their medications so women can have all the facts available to them. I wouldn’t have chosen not to have children because of these small problems but now I feel guilty for every problem my children have, it would be good to know which are linked to the medications and which aren’t and just to receive better support and understanding from health professionals.
There is so much information on the risks of smoking and alcohol in pregnancy and at the end of the day there is no need for women to smoke and drink in pregnancy (and the risks seem pretty obvious) yet there is so much data on the risks. But for medications that many women have no choice but to risk in pregnancy the data just isn’t being collected and that seems wrong somehow.