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The Baby Child Website A Website For The Important Little People In Our Lives |
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A Parent's Guide To Medicine Safety Home Schooling Your Child Guide
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BOWEL CONTROL Bowel control is often achieved before bladder control. Parents can usually tell when a bowel movement, or BM, is about to happen. When they suspect a BM is imminent, they can bring their child to the potty to see if the child is able to relieve themselves there. However, potty training is a very individual process, and some children may achieve bladder control before bowel control. Ultimately, you'll find what works best for your child. At some point your child will no longer have bowel movements during the night. They become a daytime process for most children. The more regular your child is, the easier it will be to start bowel-control training. Children often stop playing when they are having a BM. Some even hide in a favorite spot. Others just grunt or get red in the face. Saying, "I see you're having a BM" helps a child identify what is occurring and associate those sensations with the process. Constipation, if part of your child's history, may actually delay toilet training for your child. This is not anything to be worried about, but just one more variable you can be sensitive to. Explain to your child that you will be taking him or her to the toilet or the potty chair and that you expect the bowel movement to go there rather than in diapers. "This is what Mommy and Daddy do, what grown-ups do and now what you should do because you're getting so big and grown up" is the kind of language to use. Give advance notice as to when this procedure will start. Children need to hear what you expect in pleasant tones and words. They can't read your mind. Your attitude, your anticipation, your relaxed tones will also convey much of the message. If your child has a regular time for a bowel movement, choose that time to go to the bathroom. If they have no regular time, try within 30 minutes after a meal. When the stomach is full, the colon is often stimulated to empty. As we’ve said before, be prepared to sit with your child to keep him or her company. Don't insist your child sit for more than a few minutes but only as long as he or she is comfortable. At the same time, know that some children need to be alone to have a bowel movement. Bright bathroom lights and too much conversation may inhibit them from relaxing their sphincter muscles. Praise your child for every bowel movement made in the potty or toilet. Also praise a child for even sitting and trying to go. If your child will still be wearing disposable diapers at this point, you will be involved in getting them on and off. Keep masking tape on hand to refasten clean ones. In general, we don’t advocate keeping diapers on children who are learning to use the toilet. This just sends a mixed message, but in the event that is the route you chose, there you go! It is not uncommon for boys to achieve bladder control before -- sometimes long before -- bowel control. Parents sometimes feel that a child with belated bowel control is unwilling, uncooperative, or just plain stubborn but that's rarely the case. Again, patience is called for. A reluctant-relaxer may require different approaches until you find one that works. Consider breaking the task into small, slow steps. Encourage a child to sit on and use the potty (or toilet) with clothes and a disposable diaper on to begin with. After a child is comfortable with this procedure, progress to going with only a disposable diaper sides ripped open. Then you can move from sitting with a disposable diaper across the seat to just using toilet paper across it. Other children may be able to relax and void (just remove feces quickly with little fuss) while in a warm bath before making the transition to the potty chair or toilet. Or insist, that even using a diaper, a child stay in the bathroom when having a BM and then empty diaper into the toilet and flush. Constipation is most often a factor in belated bowel control. A child who cries, screams, or kicks when urged to use the potty may be doing so because of the discomfort or pain experienced due to constipation. In this case, it is not stubbornness, but fear (real or imagined), that is keeping the child from doing what you ask and holding back. Some even believe there can be an inherited tendency towards constipation. Constipation is NOT diagnosed by infrequency of bowel movements, but by the hardness and character of the stool. Dry BMs that don't stick to the diaper can be a description of constipation. And what may be considered hard to pass by adult standards is not the same for children. Whatever makes passing stool difficult or painful for a child will inhibit a child from wishing to repeat the procedure thus compounding the problem. Avoid suppositories and enemas as they will be seen as an "assault" by the child. If your child cannot gain effective control of his or her bowels, there might be a medical reason. Consult your doctor if there seems to be a really huge problem with your child’s BM. Encopresis is the term used for lack of control of bowel movements for anyone over the age of 4. It is NOT uncommon. In fact it is reported that 1%-2% of children over age 4 are known as "fecally incontinent." For unknown reasons it is more common for boys than girls. It has incorrectly been assumed that this is the result of emotional disorders (which are more often the result-not the cause-of it) or by lax toilet training. A child can also be born with poor muscle tone in the bowel or anal sphincter. It seems, however, the majority of cases are the result of chronic constipation, though, of course, it can be complicated by other stresses in either toilet training or life situations. With chronic constipation, colon tissue can be stretched to the point that nerves fail to receive proper signals and the muscles no longer contract properly so that a child no longer feels the urge to go. A child may even have no awareness of when stool pushes out into the underwear. Watery stools can also seep past harder stool, soiling pants without a child being aware of it until after the fact. Regardless of the basis of the problem, both parents and children need to know they are not alone here and no one is to blame for this problem. Not all doctors are trained in successful therapy for this problem so look for one who is, as this problem needs to be approached medically as well as psychologically. If your county medical association can't help, seek out a children's hospital or university teaching hospital. Encopresis is treated by a gradual retraining of the bowel which includes dietary changes, supplements, and behavior modification. There is not an overnight cure for this condition. The first step toward treating constipation should be changing your child’s diet. What do you need to know?
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