I get asked about constipation in children all the time. Constipation can be the culprit for urinary
incontinence during the day and can also be one of the main reasons for bedwetting at night.
Toileting positions are so key and I know it can be difficult to encourage children to sit properly on
the toilet especially when they want to get back to playing.
So here is a picture of my 7 year old, it did involve a few bribes!!! It has taken us a long time to get
to where we are but it is now part of his routine to sit properly on the toilet with no straining.
1. You want the
knees to be
the hips –
onto a block.
2. Straight back
3. Elbows resting
4. Relaxed belly
Posture is so important because it allows the pelvic floor muscle to relax when having a bowel motion and ensuring that your child is fully emptying their bowels. If they are in a poor position they can often be gripping through their belly and fixing through their shoulders to balance when sitting on the toilet and this is not going to enable them to empty their bowels.
Once you have encouraged good posture on the toilet the next thing you want to look at is ensuring that they are not gripping through their belly, holding their breathe and squeezing with all their might!!! This is not going to encourage a good emptying pattern. I use bubble blowing a lot when retraining toileting patterns because it encourages good gentle breathing and no bracing. The aim of the game is to blow as many bubbles as possible without popping them.
I know this probably sounds like hard work but honestly it does work. Take one position at a time and then gradually add the others in. You don’t have to be sitting on the toilet for long periods of time, even just a few minutes.
Thanks to Lisa, one of our women’s health and Children’s pelvic health physio’s for sharing.