Follow the ‘Rule of 1’
- Toilet training to be done by one person
- One routine (5 -10 minutes after each major meal)
- One place
- Decide One word (e.g. sheeshee /poop/potty etc.) you will use to describe toileting and try to be consistent. Keep in mind that your child will use these words with other adults and children.
Create a Toilet Routine
- Ensure your child has enough time in toilet with privacy inside.
- Make your child sit in the toilet, 2-3 times a day for 5-10 minutes after meals (within 30 minutes of meal intake) or whenever he/she shows its time.
Teach them Proper “pooping” Position
- Teach your child to sit in squatting position if an Indian toilet is used.
- If your child is using an English/ western toilet, use a foot rest. It should be high enough that the child's knees are slightly above the hips.
- This position helps to relax the muscles that support comfortable and easy passage of stools.
Support Regular Bowel Habits
- A bowel diary, reporting the frequency, consistency of stools and episodes of accidental soiling in his/her underwear, can be useful to know bowel habits.
- Do not punish your child for not passing stools during the toileting time or for soiling the underwear.
- Sometimes your child may hold his/her stool that could cause painful bowel emptying later. To reduce their fear for painful stools, reassure them to pay attention to the nature's call.
- Treat anal fissures, if present. That will make the defecation painless.
Offer Praise and Rewards
- Motivate them by praising and offering rewards for stooling and the behaviour of toilet sitting.
- Star/sticker charts can be used at appropriate ages.
References
- Tabbers MM, Boluyt N, Berger MY et al. Clinical practice: diagnosis and treatment of functional constipation. Eur J Pediatr. 2011 Aug;170(8):955-63.
- Yachha SK, Srivastava A, Mohan N et al. Management of Childhood Functional Constipation: Consensus Practice Guidelines ISPGHAN Chapter of Indian Academy of Pediatrics. Indian Pediatr. 2018 Oct 15;55(10):885-892.
- Bharti LK, Kumar B. Constipation in Indian Children, Clin Surg. 2017; 2: 1644
- Adapted from ‘’ https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics ‘’ accessed on 7th April 2020