Toileting – constipation, bedwetting & more

Toilet training

Here is a practical guide to  toilet training – how to know when your child is ready and how to embark on the process. Importantly, ensure to keep calm, be patient and provide encouragement. Incentives such as praise and rewards work well to help children learn this new skill. Occasionally children may do well with using the toilet to wee but adamantly refuse sitting to poo. Here is a handout of suggestions to tackle this particular challenge.

Some children seem to toilet train themselves, others may need more support, encouragement and time to achieve continence, particularly those with disabilities including developmental delay or autism. The continence foundation of australia has a comprehensive booklet and video (below) to assist parents of children with special needs.

 

Day time wetting

There are a number of reasons why your child may have ‘accidents’ during the day.

Optimising bladder function is important – embark on bladder retraining with these simple steps. Children need to drink water well throughout the day, regularly wee (‘void’) rather than ‘hold on’ and relax when they pass urine to ensure the bladder empties adequately.  You may be asked to complete a bladder diary which makes it easier to track what is happening with your child’s continence.

Constipation

Constipation is a common condition in childhood particularly around the time when solids are introduced into a baby’s diet or when toilet training begins. When bowel motions are hard, difficult to pass and/or painful, children may become fearful and will often ‘hold on’ to their bowel motions. This makes bowel motions firmer and the constipation cycle continues.

Management of constipation is relatively simple but not necessarily quick. A long term approach to treatment is essential to prevent relapses from occurring. Constipation can lead to daytime poo accidents, known as encopresis. Here is an informative handout and video below explaining what happens in constipation & encopresis and outlines management strategies.

You may be asked to complete a training diary – a helpful way of keeping track of your child’s bowel pattern and associated symptoms.

Bedwetting (nocturnal enuresis)

There is great variation regarding when children achieve overnight continence. Some may become dry soon after day time training has been achieved; some become dry by 7-8 and others may take many more years to get there. Constipation may impede overnight bladder function so active management of any constipation is important. The RCH has information with associated links, podcasts, videos and more on bedwetting and it’s management.