Constipation is one of the most common gastrointestinal complaints that bring kids into the doctor’s office. Constipation can lead to frequent abdominal pain and pain while having a bowel movement. The unpleasant experience with bowel movement creates fear around toilet time and causes further withholding, stools more backed-up in the colon, and more pain. This vicious cycle is both frustrating to the kids and to the parents.
Most constipation in children is functional and related to food introduction, failure of toilet training, stress, or a transition at home or school. They are often treated with fiber, Miralax, Milk of Magnesia, magnesium citrate, or glycerin suppository, but one area that parents should focus on is behavior modification. I would like to offer three tips for parents to start implementing at home with their constipated child.
Postpone Toilet Training
When a kid’s constipation starts around age 3, it is very often associated with failure or fear of toilet training. Some kids feel a lot of pressure from their parents or caregivers. They are scolded when they soil their underpants or bed. The discomfort of passing hard soils can also exacerbate the fear of bowel movement. If your toddler is constipated, postpone the training because it will not be successful until your toddler can pass stools without pain or welcome the bowel urgency. Once the toddler is able to pass soft stools without pain, you can start or resume toilet training.
Get into the Habit of Toilet-Sitting
Bowel movement is a habitual activity by nature. Many of us experience constipation when we travel or when our morning routine is interrupted. To retrain the bowel for movement, we need to re-establish the habit again. Create a toilet-sitting schedule for your kid. The child should sit on the toilet for 5 to 10 min after each meal regardless of whether he or she has an urge. It should be at the same time every day and timed with a watch. Use a potty stool so that the child’s feet can be comfortably supported and they can get situated in a squatting position rather than a sitting position. Parents should utilize music, toys, or reading time to make the experience fun, relaxing, and enjoyable.
Create a Reward Program
Children love to be praised and will thrive on encouragement, especially when it comes to correcting constipation. Implement a reward system that is tailored to your child and reward for effort rather than success. For young children, you can give them a sticker every time they sit on the toilet for 5-10 min. For older kids, the reward can be coins that can be redeemed for small prizes.
Behavior modification takes time, patience, and persistence. It may take a few years of effort for children to stop relying on medication, but it can be done.