Diet: Constipation can be one of the causes of bladder/bowel accidents. It is important for children of all ages to maintain a balanced diet. Fiber intake and enough fluid are important to help with bowel movements. To determine the appropriate amount of fiber a child should consume is to add the child’s age plus 5. For example, a child that is 4 years old should be consuming an average of 9 grams of fiber daily. Remember to increase fiber intake gradually and never increase fiber intake without increasing fluid intake.
Posture: The position children assume on the potty is also very important to help the appropriate muscles relax to make peeing and pooping successful. Make sure your child uses a stool to support his feet. Their knees should be slightly higher than their hips and the child should lean forward with their arms rested on their knees. Encourage your child to say “shhh” or “grr” instead of straining. This will help to relax potty muscles.
Exercise: Children with poor postural and breathing control have increased chances of having “accidents”. Exercising helps to increase the strength of muscles responsible for posture and breathing. Some exercises that can be done to strengthen these muscles are: frog jumps, sit ups, squats, diaphragm breathing and breathing into a straw.
Voiding schedule: On average, a child that is 1-2 years old voids urine every two hours. At age 12, voiding is 5-7 times per day. Children should have a bowel movement at least every other day, depending on what he/she eats. Parents can keep a log to determine frequency of voiding during the day. Record the number of Bristol Stool Scale, if there was pain with poop, and the number of daytime and/or nighttime accidents. Using a schedule helps to track progress, motivates the child, and increases communication between parents and children.
Colon Massage: Colon massage helps to stimulate the gastrocolic reflex. Children who have constipation may have a delayed response to this reflex. The best time to perform colon massage is a few minutes after a meal, ideally at the same time every day. Colon massage is performed in the direction the poop moves in the colon. Start by having your child lay down, place your fingers in the right lower abdomen, and apply firm pressure (NO pushing down). Then move your fingers upward toward the ribcage, towards the left side, and downward to left lower abdomen. You can repeat this movement 10-15 times.
If your child continues to have bowel/bladder accidents after trying these strategies, therapists at BDI Playhouse In Orland Park and Naperville, IL are here to help your child and family have an accident-free day and night.
Hodges, S.J. It’s no accident: Breakthrough solutions to your child’s wetting, constipation, UTI’s, and other potty problems. 2012. Lyons Press; Guilford, Connecticut.
Keishla Gonzalez-Acosta, MSPT, DPT