Managing Constipation in Children: Tips on Toilet Training

Table of Content

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

  1. 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.
  2. 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.
  3. Bharti LK, Kumar B. Constipation in Indian Children, Clin Surg. 2017; 2: 1644
  4. Adapted from ‘’ https://www.uptodate.com/contents/constipation-in-infants-and-children-beyond-the-basics ‘’ accessed on 7th April 2020

 

 

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