Stepping Stones

Stepping Stones is a service teaching a toilet training method inspired by the practices of indigenous peoples from around the world. It helps infants to develop continence before their first birthday. It is beneficial to child health, and the environment.

Planet
STUDENTS INVOLVED
Peter Williams
Deepu James
ABOUT
ERIC - The Children's Bowel & Bladder Charity
Context
The age at which we as a society are toilet training our children has been rising, and this is having a negative impact on how easy the task is to complete. It is also associated with higher risks of continence issues for school age children which can lead to psychosocial problems into adolescence. Further to this, later toilet training means higher volumes of waste and CO2 emissions. Reusables reduce physical waste but the extra washing generates just as much emissions. By supporting parents and carers to toilet train earlier, Stepping Stones offers families the potential to save money through reduced nappy usage. It could also save council and health services money via reduced waste management and health treatment costs.
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Theory of Change

In many cultures around the world a gentle caring approach is used to teach continence, it can commence in the first weeks or months of life. UK social norms mean that toilet training is rarely investigated by parents in time for these approaches to be an option. Additionally the instructions available are open to interpretation which makes them difficult to study and subsequently they are not supported by our institutions.The Stepping Stones method is ideal for study and if it is shown to be a suitable and viable toilet training method, it could be endorsed by health visitors who meet parents at the perfect time to share information about it. If Stepping Stones were to receive institutional backing, councils and health services could more than cover the cost of support and subsidies through savings in waste management fees and future health treatment costs.

Service Features

Sign-up is easy and gives parents access to the online resources, app and a tipper.The tipper is a simple device that infants learn to use as a signal to carers that they require toileting assistance.The resources include: instructions and videos to guide parents through preparation and the four-step method, along with blogs, community-building toolkits and a peer-support forum.Babies learn at different rates: the app delivers an easy way to record progress and lets you know when it’s time for the next step.Toilet training is often spread across different environments and involves multiple carers such as parents, grandparents, childminders or nursery nurses. Events can be recorded for the same child on more than one device. Alternatively, in a nursery one device can record events for multiple children.

Product Features

The specific method taught by Stepping Stones is based on a study from 1985. Instead of a tipper that study used a potty that children learned to reach or grab for as a signal that they required toileting assistance.As well as being a more sanitary object, the tipper provides a signal that anyone can recognise. This means that in a nursery setting carers do not need to tune into the specific body signals relied upon by other forms of assisted infant toilet training. The integrated bell addresses concerns that constant observation is required and the easily recognisable graphics help to provide continuity for a child that has started the method at home and continues at nursery.The objectives for each phase of the original study make for a well-structured method, however they are quite technical. The app simplifies data collection and the calculation of progress.

Money to the Wrong Places

34% of families with one child under five are living in poverty. Households where there is a child under the age of 3 are most at risk.UK child benefit payments for all children aged 0-2.5 come to £1,7B, the disposable nappy market value is £800M, 47% of those payments.

The Social Cost

Delaying the development of continence means more nappies, or more washes if using resusables. Every year in the UK disposable nappies account for 8% or 1,000,000 tonnes of non-recyclable collected domestic waste. They survive for hundreds of years in landfill. Are damp in nature and offer poor energy recovery when incinerated. The carbon footprint of their use equates to 400,000 tonnes of greenhouse gas emissions each year. Per child, laundering reusable can produce as much or more emissions.Incontinence and constipation issues are increasing, more children than ever are starting school in nappies and this can lead to social isolation and adverse consequences for a child’s psychosocial wellbeing into adolescence. Family & health services are not resourced to provide best practice care for those affected.At the same time councils are spending £140M each year collecting and disposing of single use nappies. It doesn't make sense.

special thanks

A huge thank you to Juliette, Alina, Brenda and Kate from ERIC - The Children’s Bowel & Bladder Charity and also Rebecca from Little Bunny Bear who have and continue to provide tremendous support to this project. Thank you to Dr Carol Joinson of Bristol Medical School for the co-supervision of my work. Last but not least thank you to John Makepeace who, as tutor expertly critiqued my work and helped me to stretch my abilities.

students involved on the project

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