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Staying Healthy: Toileting

Many germs and bacteria are spread in the restroom. This lesson focuses on ways of using and teaching hygiene practices for toileting. It includes a description of how to handle accidents and how to follow toileting procedures as required by your program.

  • Describe the importance of maintaining hygienic conditions in restrooms and changing areas.
  • Consistently implement general hygiene practices to cut down the spread of infectious diseases.
  • Promote children’s self-care skills and independence while assisting with toileting and clean-up.



While some children may still be in diapers in a preschool room, many children have just mastered the skill of using the toilet. Children are fascinated by their bodies and all the things their bodies can do. They may also be fascinated by--and sometimes fearful of--the restrooms they use every day. They approach the restroom the same way they learn about other things: through exploration. They might love to flush the toilets, turn faucets on and off, watch toilet paper unroll, and explore the sounds their voices make in the restroom. Unfortunately, all of this learning comes at a price. Restrooms are full of bacteria; and as a teacher, you must be prepared to promote learning and healthy hygiene.

It is critical to keep restrooms and changing areas clean in child care programs. Toileting is a major source of contamination. Unsanitary practices can put you and children at risk for illness and infection. This lesson will focus on general practices for maintaining hygienic toileting practices and procedures for helping a child who has had an accident.

In preschool programs, most of the children you work with will be toilet trained. However, this does not mean there will not be toileting accidents. The best way to prevent accidents is by maintaining regular toileting routines and watching for signs that a child needs to use the restroom.

Encourage preschool-age children to try using the restroom at least every two hours. Be sure to remind them to use the restroom before you go outside, go on a field trip, get in the car to go home, or begin any new activity that involves leaving the classroom. Also watch for signs that a child needs to use the restroom. Holding the genital area, squirming, or moving uncomfortably could all mean a child needs to use the restroom.


What do healthy hygiene practices look like for preschool restrooms? The answer to this question might vary across programs, but there are some major features that should be found in all programs. First, cleanliness should be a habit. In healthy restrooms, you won't see paper towels or toilet paper on the floor. You won't find clogged toilets or messy seats. Watch this video to see examples of ways programs keep restrooms clean.

Restroom Hygiene

Clean restrooms are critical for keeping children healthy.


Help Children with Self-Care and Hygiene

Preschool-age children occasionally need assistance with toileting and dressing-especially if the child has had a toileting accident. Accidents can be embarrassing for preschool children. It is important to help the child clean up, get dressed, and return to the learning environment quickly and safely. You must also work to prevent the spread of germs and contaminants during the clean up. Proper hygiene is important for you and the children in your classroom. Many illnesses can be spread through fecal matter.

Once you know an accident has happened, prepare yourself to help the child clean up and change clothes. A space for changing the child is important. You must be sure to keep the changing space, the child, and yourself clean. Follow these steps:

  1. Wash your hands.
  2. Bring supplies over. You will need: clean clothing, wipes, plastic bags, paper liner for the child to stand or lay on, wet cloth or paper towel, and disposable gloves.
  3. Follow the procedures described in Caring for Our Children (2019). These procedures are provided in the Changing Soiled Clothes resource in the Apply section below.

Consider the following scenario while thinking about the information shared above. What would you do to address this situation?

Several children in your class are finishing breakfast. One of your preschoolers refused to use the restroom when she came in this morning. She said she did not need to go, washed her hands, and sat down for breakfast. Now as you walk to the breakfast cart to start cleaning up, you notice a puddle on the floor behind her seat. You think she spilled her drink, but you notice that her cup is full. You ask her to stand up so you can clean the puddle. You see then that her pants are all wet, and you suspect she had an accident.

You should do the following:

Make sure all children are supervised and block off the soiled area. Wash your hands and gather supplies. Ask the child who had the accident to go into the restroom area while you gather supplies. Put on gloves and follow changing procedures (see Apply section of this lesson) to help the child remove soiled clothing and clean herself. Put soiled clothing in a sealed plastic bag to be sent home. Clean your hands and the child's hands with fresh disposable wipes. Help the child get dressed in clean clothing. Wash your hands and make sure the child washes her hands thoroughly. Then let her return to play in a supervised area. Clean and disinfect the changing area. Wash your hands. Clean and disinfect the soiled area of the classroom. Wash your hands again.

Watch this video to learn more about responding sensitively and hygienically to toileting accidents.

Helping Children after Accidents

Review steps to take to clean up after a toileting accident.

General Hygiene Procedures for Toileting

There are many ways to maintain a healthy environment throughout your classroom. The restroom is an important place to start. Follow these steps to create healthy habits for yourself and the children in your care:

  • Check the restroom regularly to make sure toilets are flushed.
  • Check to make sure floors, doors, and walls are clean.
  • Make sure paper towels and other trash are thrown away properly.
  • Make sure running water, soap, paper towels, plastic bags for soiled clothing, and toilet paper are available.
  • Make sure you put disposable gloves on before handling soiled clothing or diapers. Remove gloves before handling clean clothing and diapers.
  • If possible, use a separate sink for general use and handwashing after toileting. If you must use the same sink, disinfect it before use for general or food-related use.
  • Always wash your hands after helping children use the toilet, assisting with soiled clothing, or touching contaminated surfaces. Even if you wear disposable gloves, you must wash your hands.
  • Make sure all children and adults wash their hands properly.


It is important to think ahead about how you will respond when preschool children have accidents or problems in the restroom. Use the What Would You Do activity to read the scenarios and describe the steps you would take to keep children healthy. Consider healthy hygiene practices, handwashing, and modeling healthy habits. Share your responses with your trainer, coach, or administrator. Then compare your answers to the suggested responses.


Use these documents to help provide a healthy restroom environment. Review the Gloving Guidelines from Child Care Aware of North Dakota, and post in your program where appropriate.  Save the Changing Soiled Clothes guide to use as a reference.


Fecal matter:
Solid human waste or the product of a bowel movement


Mattias had an accident on the playground. His underwear, jeans, socks, and sneakers were soiled. His teacher took him inside, prepared the changing area, and helped him get cleaned up. She washed both of their hands. She helped him dress in clean clothes and put his sneakers back on his feet. Which of the following should Mattias’ teacher have done?
Which is not a way to prevent toileting-related accidents in your classroom?
Andrew is a preschool teacher. He notices that one of the children in his class, Peeta, has wet jeans after nap time. Which of the following is the best way for Andrew to respond?
References & Resources

American Academy of Pediatrics. (2019). Caring for Our Children, National Health and Safety Performance Standards. American Academy of Pediatrics. &

Cryer, D., Harms, T., & Riley, C. (2003). All about the ECERS-R. Kaplan Early Learning Company.

Extension Alliance for Better Child Care (2019).  How should child care providers handle toileting accidents in young children?

Pennsylvania Chapter of the American Academy of Pediatrics. (2010). Changing Soiled Underwear for Toddlers.