Tag Archives: constipation

How To Teach Your Child To Wipe “Back There”

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Potty training is a process.  For most kids, the final frontier is managing bowel movements.  Compared to learning to pee into the toilet, little kids are often more stressed by bowel movements and have less opportunities to practice.  Most of us just don’t have more than one BM per day but we urinate many times per day.

Constipation or just the discomfort of normal elimination can make them wary, sometimes enough to convince some children that this is a process better done in a diaper.  In comparison, urination isn’t an uncomfortable experience for healthy children.  Bowel movements sometimes happen only a few times a week, instead of the multiple times a child needs to urinate per day.  Less practice and fewer opportunities for rewards (even if your reward is warm praise) make bowel training harder.

So when they finally make the leap and manage to do #2 in the toilet, a lot of parents decide to delay teaching their child how to wipe themselves.  After all, wiping can be messy and it has to be done well enough for good hygiene.  Here are my top suggestions to make “making” a complete success:

  1. Teaching should still be part of your narrative while you are the one doing the wiping.  In my book, The Practical Guide To Toilet Training Your Child With Low Tone, I teach parents how to transform daily diapering into pre-teaching.  While you are wiping, and even while you are waiting for them to finish on the toilet, your positive narrative about learning this skill doesn’t end.  You are telling your child how it’s done, in detail, as you are doing it. You convey with your words, your tone and your body language that this is a learn-able skill.
  2. Don’t forget the power of the “dry run”.  Practice with your child when he is in the bathroom, whether it is before bath time, before dressing, or during a special trip to the bathroom to practice.  Dry runs take away the mess but teach your child’s brain the motor planning needed to lean back, reach back and move that hand in the correct pattern.  The people that invented the Kandoo line of wipes have an amusing way to practice posted on their site:  spread peanut or sunflower butter on a smooth plate, and give your child some wipes or TP.  Tell him to clean the plate completely.  This is a visual and motor experience that teaches how much work it is to clean his tush well.  After this practice, your child will make a real effort, not just wave the paper around.  Brilliant!
  3. Will you have to reward him for this practice? Possibly.  It doesn’t have to be food or toys.  It could be the ability to choose tonight’s dessert for the family, or reading an extra two books at bedtime.  You decide on the reward based on your values and your child’s desires.
  4. Use good tools.  The adult-sized wet wipe is your friend.  The extra sensory information of a wet wipe versus a wad of dry paper is helpful when vision isn’t an option.  They are less likely to be dropped accidentally when clean, but having a good hold is especially important after it has been used. “Yucky”stuff  makes kids not want to hold on!  Wet wipes are more likely to wipe that little tush cleanly.  Don’t cut corners.  Allow your child to use more than one.
  5. Take turns.  Who wipes first and who bats “clean-up” (couldn’t resist that one!) is your decision.  Some children want you to make sure they are clean before they try, and some are insistent that they go first with anything.  This can change depending on mood and even time of day.  Be flexible, but don’t stand there like a foreman, ordering work but not willing to help out.  One of my favorite strategies is to always offer help, but be rather slow and inefficient.  This gives children the chance to rise to the occasion but still feel like you are always willing to support them.
  6. Teach them how to know when they are done wiping.  It’s kinda simple;  you wipe until the toilet paper is clean when you wipe.  This usually means little kids have to do at least two separate wipes, but they get the idea quicker.  Little hands are not that skilled, but dirty versus clean is something they can grasp.

 

Looking for more information on toilet training?  Take a look at my e-book, The Practical Guide To Toilet Training Your child With Low Muscle Tone to get a clear understanding of how to prepare for and execute your plan without tears on both sides.  Will it help you even if your child doesn’t have low muscle tone?  Of course!  Most of my techniques simply speed up the learning process for typically-developing children.  And who doesn’t want to make potty independence happen faster?

This e-book is available on my website tranquil babies, at Your Therapy Source (a great site for parents and therapists), and on Amazon.  Read more about my book with Amazon’s “look inside” section, or by reading The Practical Guide to Toilet Training Your Child With Low Muscle Tone: Potty Training Help Has Arrived!

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Low Tone and Constipation: Why This Issue Delays Toilet Training Progress

Kids with low tone and sensory processing disorders are not the only children who struggle with constipation, but it is more common for them.  The reasons are many:  low abdominal and oral tone, less use of available musculature because they use compensatory sitting and standing (the schlump, the lean, the swayback) patterns, and even food choices that have less fiber.  If you struggle to chew and swallow, you probably aren’t drinking enough and eating those fruits and veggies that have fiber.  Sucking applesauce packets may get you Vitamin C, but it has pulverized all that fiber.  Now add discomfort with the sensory experience: the smells, feelings, sounds of bathrooms and using the potty.  It can all be too much!

Without fluids, fiber and intra-abdominal pressure to support peristalsis (the automatic contraction of the intestines), children with low tone are at a huge risk for constipation.  And constipation makes pooping harder and even painful.  Sensory overload makes kids agitated, distracted, and sometimes even aggressive.  Not good for learning or letting it go into the toilet.  Hence, resistance and even fear of pooping, and therefore more stress and withholding of stool.  A really big problem, one that you may have to get your pediatrician’s assistance to solve.

It can change.  Here is your secret weapon: your child’s occupational therapist.  If you haven’t been involved in your child’s therapy before, this might be the time.  Research has shown that sensory-based issues can contribute to toileting problems, and OTs are capable of evaluating all the sensory and motor-based contributors.  While  your pediatrician gives you recommendations on diet, laxatives and more, your OT can help your child stay in the alert-but-calm zone where digestion is relaxed, get better core stability to help push that poop along, and adapt the toileting experience for minimal sensory aversion and maximal sensory perception.  Take a look at Low Tone and Toilet Training: How Your Child’s Therapists Can Help You and Low Tone and Toilet Training: The Importance of Dry Runs (Pun Totally Intended).

Update:  Many of my clients have been successful with a creative combo approach:  they use stool softeners, they limit refined carbs (sorry, Goldfish crackers are cheese plus refined carbs!), ensure lots of fluids and then add some tasty fiber.  Prunes covered with chocolate have been popular, but beware the results of too much of a good thing!  They use abdominal massage and make sure that their physical and occupational therapists are working those core stabilizers.

There are medications that improve gastric motility, but they aren’t always tolerated or even prescribed for small children.  Pediatricians are very hesitant to be aggressive with a small child that could dehydrate in a few hours of diarrhea.  Find a doctor that listens to you and is creative.  My suggestion?  Think outside the box and consider an osteopath.  They are “real” doctors, but they have more training in alternative and manual treatment approaches.

Think constipation is only going to affect pooping?  Wrong!  Read Is Your Constipated Toddler Also Having Bladder Accidents? Here Are Three Possible Reasons Why to understand more about how this problem can contribute to other toilet training struggles.

Good news!

My book, The Practical Guide to Toilet Training Your Child With Low Muscle Tone, is done and available at  Your Therapy Source ( a terrific site for parents and therapists!), on Amazon as well as on my website, tranquil babies !!  Just click on the “e-book” section, and start making progress with your child today!

I include detailed readiness checklists and a full explanation of how to train your child in all aspects of toilet training.  You will know how to get the right equipment, what clothes to use so that dressing doesn’t derail your child’s best efforts, and how to deal with defiance and distress.  And yes, constipation is addressed in more detail than in this blog post.  It may turn out to be only one of the issues that you have to confront.  Don’t worry, help has arrived!

If you want a hard copy, contact me through my site and request a mailing address for your payment.

            As I say in my book:  be prepared, be consistent, expect to practice, and be positive that you and your child can do this!