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Children’s Bladder and Bowel Service

The Community Children’s Bladder and Bowel Service (CBABS) is a team of Registered Nurses, with support from health care support workers and the wider multi professional team, who work with children from age 0 – 18 years with bladder and bowel problems. 

The service can help with: ​ 

  • constipation from 0-18 years​ 
  • day time wetting from 3.5 years if toilet training has been achieved​ 
  • nocturnal enuresis aged 5 years
  • children with neuropathic bladder and/or bowel from birth
  • core training packages for schools of up to 4 Teaching Assistants as required for procedures such as Intermittent Self Catheterisation. ​ 

The service actively seeks to promote healthy bladder and bowels by undertaking a thorough assessment by Children’s Bladder and Bowel Nurse Specialists. Each holistic assessment takes into consideration the physical, mental, psychological, social and emotional wellbeing of the child. 

Treatments are tailored towards the promotion of bladder and bowel health and improved management of them based upon evidence based guidelines. The team liaise with multi-disciplinary health care professionals and other children’s services to deliver individualised care for all children within the service. 

Appointments are undertaken in countywide face-to-face clinics, by phone, or virtually using Microsoft Teams.

Referrals can be made via health professionals, GP's and consultants. The preferred method of referral is by completion of a referral form. Please send all referrals to: icntteamreferrals@mbht.nhs.uk

Referral letters detailing the individual’s continence issues and desired outcome will also be accepted, with appropriate initial interventions e.g fluid balance and abdominal assessment.​ 

Referrals will only be accepted following appropriate level one assessment and interventions taking place.​ The service will redirect children to the appropriate services if toilet training has not been attempted prior to referral.

The service will not accept children with day time wetting who are under 3.5 years or children with nocturnal enuresis aged under 5 years. 

The service will not issue product provision without a child going through an initial assessment and toilet training program.

The service does not provide ‘pull up’ disposable products and does not provide continence products for nocturnal enuresis. If Containment Products are prescribed, a supplementary provision of three will be provided per 24-hour period as per policy.​ 

Please note we do not provide bedwetting alarms.

Frequently asked questions about my child in containment products

How many free containment product/s am I entitled to from the NHS?

The NHS is not legally required to provide any containment product. However you will be offered an assessment by a health professional. In most cases when it is not possible to get full continence up to 3 products can be offered. There is an expectation that if you want any more you would purchase this yourself. You will be assessed every 6 months via telephone and/or face to face to support and reassessment or your need.

You will be expected to confirm your delivery every 3 months with Abena via telephone 44 24 76854800 or ABENA UK | - Search products

I only get 3 containment products a day; can school staff leave the containment product on longer?

The wetness indicators on most products tell us when they are full. Only at this point should they be changed, unless the product is soiled. If the child is changed at 7am the pad can remain for most of the school day.

How do containment products; do they really lock wetness away from the skin?

Yes, the containment product have a super absorbent gel, which keeps the moisture locked away, preventing problems with the skin. Although this is great for the skin it can mean that the child has less awareness of being wet, so can be counterproductive to getting children ready for toilet training. Using normal under pants and putting the nappy over the top can help raise their awareness, when you are trying a toilet training regime. You can discuss this with your school nurse in the first instance.

If my child is swimming will I need to send in another nappy?

Yes as it has been exposed to the air for more than 30 minutes, it should be changed unless it is dry; therefore you are likely to be requested to send in another product for that day. Children must not swim in normal nappies as it can be dangerous.  There are a range of products on the market please refer to Bladder and Bowel Uk for a Full supplier list.​​​​​​​

What if my child is soiling several times a day? 

Your child may be constipated or have overflow soiling. Check out “poo nurses” video clip on YouTube. Speak to your school nurse or book an appointment with your GP to assess their abdomen for constipation.

Is there a normal volume of fluid which is healthy for us to achieve? How much should my child drink to keep him/her healthy?

For most of us, we do not drink enough. However, some children/people drink too much. The reason for this will need to be explored to exclude anything medical. Your school nurse will be able to offer a urine dip stick, a simple test to exclude a urine infection or other abnormalities. She can let you know the results.  Often this is a behaviour that has been learnt over the years. This should be addressed early to avoid problems later. Normalising fluids to their actual body weight is advised to prevent loss of essential salts which could cause increased fluid in the brain -hyponatraemia.

NICE guidance indicates good practice in fluid intake in children depending on boys/girls and age.

The containment products are not holding my child’s urine output. What can I do?

It may be time for a re-assessment; ideally you will receive this once a year. You can also check that you are fitting the containment product correctly via ABENA. Make sure you are not using oil based creams and talcum powder which will hinder absorbency. Ensure that they are drinking only within the normal values. It is important that volume of urine is measured by weighing pads or nappies; weight in grams is equivalent to volume in mls of urine. ​​​​​​​

My child is becoming sore?

This is usually a fitting or absorbency problem and your child may require re-assessment so speak to your nurse. If you suspect an adverse reaction, which is rare report this to Abena. Use creams sparingly, avoiding oil based creams such as sudocrem. Increasing absorbency of pad unnecessarily can increase risk of skin breakdown as natural moisture will be absorbed from the skin.​​​​​​​

I would like pull-ups to help my child toilet train; I think they would feel they were getting older and improve their readiness for toilet training?

Disposable pants should not be supplied for toilet training. They are more expensive than alternative products and more likely to leak. In addition, studies (Simon et al 2006, Tarbox et al 2004) and clinical experience have shown they do not support toilet training.  Instead we have moved to a 2 piece system, so a pad insert is used inside a pair of snug fitting underpants. This helps with the transition from “nappy” to “typical underwear” as they are already familiar with underwear. ​​​​​​​

I am concerned about the impact of using nappies on the environment but what can I do?

There is no easy answer, but all containment product companies do their best to use sustainable materials. You could consider re washable products and the NHS can provide some. It is advisable to look at purchasing some yourself to ensure you are happy with the product.​​​​​​​

Integrated Children's Nursing and Therapy Team 
Ryelands House
LA1 2LN 

01524 518966

The service is open Monday - Wednesday, 9am - 4.30pm. We also hold an advice and guidance hotline every Wednesday between 2pm - 4pm.