Toilet Training &
Toilet Posture
Your best Friend - The Potty
Optimising Toilet Training- it is a marathon and not a sprint!!
Toilet training age: Initiation of toilet training prior to 24 months can be associated with
dysfunctional voiding, Toilet training is a developmental process- the nervous system needs
to develop for the child to recognise the stretch of the bladder or the rectum and to voluntary and not reflexively react to the message.
From the age of 2 years the child may perceive that the blader is filling and can may indicate
discomfort when wet.
From the age of 2-3 years, they can stay dry for 2-4 hours and show interest in the toilet.
From the age 3-4 years voluntary bowel and bladder control in the day happen and they can distinguish between pee and poo.
From age of 4-6 years voluntary bowel and bladder control at night develop.
Dr Hodges’s rules for potty training the constipated child:
- Wait until your child is ready to potty train, not when you or your pre-school are ready!!
- Ideally the child needs to be:• Dressing and undressing without help
• Showing interest in using the toilet
• Noticing when they have a dirty diaper
• Telling you they need to poo or pee- 2 hrs between each pee - Explain to your child why it is important to poop daily and pee often and that everybody poops.
- Help the child recognise, and act on the urge to pee and poop.
- Send the message of:• “Use the toilet when your body tells you it’s time" rather than it is important
to stay dry
• I got the feeling in my body I needed to pee, so I went right away - Point out where the toilet is when you are in shops/friend’s house or playground.
- Prompt to pee every 2hours. Establish pee schedule that fits easily into the day. Prompt first thing (breakfast) and last thing (before bedtime) and then every 2 hours or when you see them doing the potty dance.
- Watch out for wee holding e.g. crotch grabbing, squirming, curtseying, squeezing legs together.
- Boys must learn to pee sitting on the loo. This helps them to avoid tilting their pelvis forward to pee, which activates the pelvic floor muscle and gluteus muscles.
- Girls must have legs apart. It relaxes the pelvic floor muscle and prevents urine pooling in the vagina and staying wet (which can cause urinary tract infection especially if constipated).
- Always provide a high stool to support their feet.
- Relax on the toilet and “let it all out”. No strain to wee, no red face or hard tummy
muscles. Breathing in and relaxing until fully empty. Entertain with books, puzzle, egg timer. - Never shame or blame for accidents. If still having accidents after a month, the child was either not ready or needs constipation investigations.
- Do not ever stop asking children how aften they poop!
Withholding Manoeuvres
Toilet Posture
Anorectal Angle
- Pooping in a squatting posture is easier. Human beings were designed to squat while pooping.
- Squatting straightens the rectum, letting poop fall out easily. By contrast, sitting upright is like trying to poop uphill. With the rectum bent, poop has a tougher exit.
What is more, toilets are too tall for children. With their feet dangling, kids often clench their
inner thighs and can’t relax
- If your child is on the smaller side, make sure he sits on a kid-sized toilet seat, either a flip
- down seat or one that you place on the rim.
- When kids sit on an adult-sized toilet, they clench their pelvic-floor muscles to keep from falling in.
- We cannot see them doing it, and they may not even know they are doing it, but I assure you, they are!
in a squatting posture
- Always wipe from the front to the back, new paper for every wipe
- Mouth and lips relaxed, no breath holding.
- Footstool
- Wipe From Front to Back
DRYNESS FROM BLADDER OR BOWEL LEAKING
If your child has multiple symptoms, do not expect them all to clear up at once:
1. Poop accidents (encopresis) diminish first- within a week to nearly a month all cases resolve.
2. Then daytime pee accidents diminish.
3. Then overnight accidents diminish.
4. The longer the child has been wetting the bed, the longer it takes for the wetting to stop.
If your child has multiple symptoms, do not expect them all to clear up at once:
1. Poop accidents (encopresis) diminish first- within a week to nearly a month all cases resolve.
2. Then daytime pee accidents diminish.
3. Then overnight accidents diminish.
4. The longer the child has been wetting the bed, the longer it takes for the wetting to stop.