Potty training for number twos!
Q: “Our daughter, aged three, is great at doing wee's -she even wakes up to go in the night and is dry. She will not wear nappies. But we are really struggling with poos. She is not scared to sit on the toilet and will do small poos if we catch her in time. Most of the time though she would rather jump around doing the 'poo dance' and when we say ‘do you want to go and do a poo?’ she just says ‘no’ and eventually fights off the urge until the next time. Please can you suggest anything. We are running out of soap powder!”
Q: “My son is four in August, and has been potty trained for wees for more than a year. He WILL NOT and has never once done a poo on the potty or toilet. He only will poo in his nappy. We have tried treats, reward charts, stickers, praise, presents in the bathroom - but NO! Nothing. We have withheld the nappies - then we get tantrums, tears and he holds himself for days or just goes in his pants. I am also at my wits end, HELP!!!!!”
One of the most common and frustrating toilet training roadblocks is when a child willingly pees on the potty but demands a nappy, or uses his pants, for bowel movements. Some children will actually hold their bowel movements and create severe constipation, which further complicates the issue. (Read one mum's story about how her son learned not to hold in his poo).
Children typically resist having a bowel movement on the toilet, or hold back from going, for these reasons:
• Bowel movements take too long to wait for and an active child dislikes having to sit on the potty for the extended length of time.
• After being used to the squashed sensation of stool coming out into a nappy, the feeling of letting it loose into the air is unsettling and strange.
• A child is used to standing or moving during BMs and sitting still on the potty is an uncomfortable change of routine.
• Your child thinks the stool is part of him and doesn’t understand why he should flush it away.
• A bad experience, such as being splashed on the bottom with urine or water during a movement, or having a messy accident, causes a child to avoid having it happen again.
• Pain from a previously difficult or hard stool makes a child afraid to poo on the potty.
• A current case of constipation is preventing usual elimination.
Don’t try to solve the problem without understanding why it exists.Once you identify your child’s impetus for avoiding bowel movements you can create the best plan for helping him to have regular and natural elimination.
As you put your plan together consider these basic Dos and Don’t Dos:
What not to do:
• Don’t get angry. Don’t scold your child or make her feel ashamed. Your little one isn’t doing this on purpose, he isn’t trying to make you mad, and he doesn’t understand how to solve this any more than you do.
• Don’t make your child sit on the toilet and “try” or push. BMs come out when the body is ready, and forcing them can create small tears in the anus (fissures) or hemorrhoids, which cause all-day pain in the rectum. This will cause the child to avoid pooing even more, which leads to constipation, which creates hard stool, which causes more hemorrhoids, and on and on and on to generate a dreadful cycle of pain and frustration.
• Don’t let your child strain when he sits to poo. Of course a little bit of pushing can be necessary for a normal bowel movement. But if he is grunting, straining and forcing, it’s a sign that either he’s not quite ready to go, or he’s somewhat constipated. Have him drink a big glass of water, eat a piece of fruit and then try again in ten or twenty minutes.
• Don’t ever make your child “hold it.” When she announces the need to go, or if you notice that her body signals are indicating a need to go, find a toilet immediately. Delaying and holding contributes to constipation and other bowel problems.
What to do:
• Make certain that your child is drinking plenty of fluids all day long. Stick to water and juice (apple, pear, cranberry, grape and prune juice, but not orange or other citrus juices.)
• Be sure your child eats plenty of fibre-rich foods every day: vegetables (especially raw ones), fruit, whole grains, brown rice, and oats are some examples. Avoid giving your child junk food, refined sugar, sugary fizzy drinks, sweets and chocolate.
• Limit foods that constipate such as bananas, rice, applesauce, cheese, citrus juice, and fizzy drinks.
• If your child has food allergies or lactose intolerance (milk products) these can cause constipation for him. If you suspect this may be true talk to your doctor.
• If your child has been constipated apply petroleum jelly or nappy ointment to her rectum before potty visits.
• Make sure your child has plenty of daily exercise, which stimulates digestion, prevents constipation, and is necessary for proper elimination.
• Be sure that your child is peeing every 1 ½ to 2 hours. Regular urination is a necessary component to regular bowel movements.
• Take your child to the potty first thing in the morning and ten to 30 minutes after a full meal when BMs are likely to happen.
• Teach your child to go when the urge hits. Explain that the poo is trying to come out and she should go right to the potty.
• Purchase a soft, padded child’s adapter seat for the toilet, or a potty chair with a soft seat. Some children find it difficult to sit on the hard surface for the length of time it takes to make a bowel movement.
• If you find your child has had a bowel movement in her pants, calmly take her to the bathroom. Flush her poo down the toilet with a comment to explain that’s where it goes. Have her sit on the potty while you wipe her bottom, and let her know that soon she’ll do her poo on the potty.
• If your child will only go in a nappy begin to have her do so in the bathroom. Progress to having her sit on the potty, in her nappy if she’d like. Once she is used to this suggest taking her nappy off and putting it into the potty bowl as a ‘pocket’ to catch her poopie.
• You might find success by cutting through the crotch of the nappy so that it still is wrapped around her, but the bottom is open to let the poo drop into the potty.
• Make sure that your child sits long enough to empty her bladder or bowel each time she uses the toilet. Make it a relaxing three to five minutes.
• Make sure that your child’s legs are comfortable and knees are slightly apart and that feet are firmly planted on the floor or a sturdy stool.
• Help your child relax on the potty by reading books, telling a story, singing a song or chatting.
• Have your child close her eyes, and take a few deep breaths while you talk or sing softly.
• Play soothing music during potty sits.
• If your child is giving signs of needing to poo, but on the toilet and not having success, try having your child lean forward and rest his upper body against you while you rub the lower back gently. You can also have him sit backwards on the toilet and lean against the tank.