Potty Training Problems? 5 Strategies to Help your Child Avoid Bladder or Bowel “Accidents”

Written by Janis Bautz on April 14, 2020. Posted in Uncategorized.

Is your child still having potty training problems? Bowel and bladder accidents that persist after training or make potty training difficult, could have an underlying cause.

Researchers have found that 40-60% of children complete toilet training by the age of 3 and 25% of 5 year old children experience day or night accidents. Experiencing “accidents” in potty-trained kids is not a normal part of development. Constipation, discomfort with restrooms at schools, poor diet, and lack of exercise are some of the most common reasons a child can experience bladder or bowel accidents.

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. Picky eating can impact children’s ability to consume enough fiber and fluids.

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 the 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.

Reference:

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.

Winter Blues? GET UP AND MOVE!

Written by Janis Bautz on February 25, 2020. Posted in Preschoolers, School Aged Children, Uncategorized.

Do your kids have the Winter Blues? Once the cold weather hits, it’s easy to make excuses for missing opportunities to get out and play outdoors. But, soon we notice our kiddos in a rut: feeling moodier, not sleeping well, disengaging, increased screen time, etc. However, research shows that physical activity can actually turn these frowns upside down!

WHY IS IT GOOD TO MOVE ANYWAY?!

Self-esteem
Communication
Balance
Muscle strength
Coordination
Endurance
Memory
Problem solving
Emotional regulation

Here are some suggestions to beat the winter blues and get up and move!

INDOOR

Yoga (Cosmic kids yoga videos are a top choice!)
Workout videos (GoNoodle has millions to choose from!)
Family game night (charades!)
Animal walks
Rearrange furniture
Push/pull laundry basket
Freeze Dance
Musical Chairs
BDI playhouse offers low cost classes
Local Library (Naperville, Aurora, Orland Park)

OUTDOOR

Make a snowman
Make a snow angel
Pull someone/something in a sled
Shovel snow
Bury your legs in the snow
Make a snow fort
Push or pull something through the snow
Dust the snow off the of the car
Dig a hole in the snow
Jump into a pile of snow
Sweep snow off of the sidewalk
Have a snowball fight
Make snowballs and stomp on them
Make a snow maze
Carry buckets filled with snow

Don’t let your kiddos succumb to the winter blues! Try out these awesome indoor and outdoor activities! If you feel like your kiddo still can’t beat the blues and might need some help from a therapist, please set up a free screening at BDI Playhouse!

Written by Jamie Blough, COTA/L

Fixing a Flat (baby head): What is Plagiocephaly and what can I do to correct it?

Written by Janis Bautz on February 7, 2020. Posted in Uncategorized.

What is Plagiocephaly (pronounced play-jee-oh-sef-uh-lee)?

Sometimes infants are born with or develop plagiocephaly or brachycephaly, a flat spot on the back or backside of their heads that is noticeable and may raise questions or be a cause of concern.

Understandably, you may ask:

Will my baby’s head shape stay like this?
Is there anything I can do to prevent or fix this?
Will this affect my baby’s brain growth or development?

In the early 90’s the American Academy of Pediatrics advised parents to put babies to sleep on their backs to reduce the risk of SIDS. This increased the time spent with increased pressure on the baby’s head from the surfaces they rested on. This also increased the incidence of plagiocephaly (a.k.a. “flat head syndrome”). In addition, there are dozens of baby positioning “containers” such as infant car seats, swings, and bouncy chairs that keep babies resting for longer periods on the back of their heads. Flat spots can make it challenging for babies to keep their heads in midline and they can develop a preference to turn or face toward a particular side. These babies may be resistant to or even refuse tummy time because lifting their little heads up against gravity can seem difficult and stressful. Although this will not typically cause problems with brain development, babies that have a flat spot may experience movement preferences to one side, may not latch on for nursing as well as expected, will experience reflux or digestive issues, and may be extra fussy, colicky or more difficult to calm.

How can I tell if my baby has a flat spot?

No two babies have the same head shape but asymmetries or flat spots are usually easy to detect if you know what to look for. Most areas will round or even out as a baby moves her head side to side, up and down, and begins to roll over in the first few months. Take a look at the baby’s head in several positions. If Baby has a lot of hair it is good to do this while the hair is wet, such as after a bath.

Look at your baby “face to face.” Are both eyes the same size or is one wider or narrower than the other? Is one cheek puffier than the other? Does the back of his head appear unusually wide or does the head slant sharply upward from his forehead to the back of the head? Do you notice that one ear is higher or in front of the ear on the other side?
Look at the baby’s head shape from behind while supporting him in sitting. This is often the first place a flat spot is detected. Are the ears level? Does the head tilt to one side? Is the top of the head very wide compared to the area just above the neck?

Now, look at the baby’s head from the top. Is one side of the forehead more forward than the other? Can you see one cheek puffing out more than the other? Is one ear significantly positioned in front of the other?
Finally, look at the baby’s head from the side. Is there a slope from the forehead that rises to a point in the back?

Notice if your baby’s head is moving freely with his body or is the head “planted” on the surface? Is he beginning to lift his shoulders and arms off of the surface and is the baby beginning to bring hands or toys to his mouth? Does the baby constantly only put one hand in his mouth or does he turn his head to mouth a toy instead of bringing the toy toward his middle. When Baby is on his belly, can he lift his head easily up in the middle or does he usually turn it fully to one side or the other to lift it up. These are all signs that there may indicate a muscle imbalance or be present as a result of the flat spot on a baby’s head. While none of these seem particularly alarming, they can keep your baby from developing movement and visual motor patterns that will advance him more naturally toward rolling, crawling, walking and gross motor play.

What Can I do if I notice a flat spot?

Provide lots of opportunities for Tummy time.
Limit time in baby carriers, car seats, bouncers, swings, and containers
Carry baby when you can but change positions often to keep hips healthy
Alternate the ends of the crib for sleeping so baby will face stimulating sights or light during waking times
Provide visual stimulation in front of the baby that moves side to side
Consult your pediatrician or a pediatric physical therapist if a flat spot persists for more than a few weeks. A baby’s head shape can change quickly from birth to 6 months.

What if the flat spot won’t go away?

If your baby’s head is held unusually still, he has a distinct head-side or position preference, he is having difficulty nursing, bottle feeding is stressful, or he is resisting positions like tummy time contact your pediatrician or a pediatric physical therapist who specializes in treating infants. It is best not to take a “wait and see” approach because most of a baby’s head growth happens between birth and 6-8 months and this is the best time to make big changes in head shape and mobility. Most consultations are free and professionals can offer advice and solutions that can help you and your baby.

BDI Playhouse Children’s Therapy offers free screenings and consultations through Telehealth or at one of our child-friendly therapy gyms in Orland Park and Aurora, IL

Written by Sheri Ireland-Berk, PT
Physical Therapist

Pacifier Weaning

Written by Janis Bautz on January 14, 2020. Posted in Uncategorized.

Every parent who has a child who loves their pacifier dreads the day when it’s time to start pacifier weaning. Here are 8 ideas to help you navigate this big transition!

1. Prepare your child for the eventuality that pacifiers are not forever.

Bring up pacifier weaning whenever your child asks for the pacifier or reaches for it. Talk about how one day soon the pacifier will go away. There are some great books to read with your littles about the transition out of pacifiers – “Pacifiers are not forever” – By Elizabeth Verdick, “Bea gives up her pacifier- the book that makes kids want to move on from pacifiers!” – By Jenny Album, & “Florrie the paci fairy “– By Mr. Anthony J Crosbie.

2. Replace the pacifier with a more appropriate means for oral stimulation.

The act of sucking is very calming and soothing for babies. This need for your child to calm with oral stimulation can carry over into the toddler and childhood years. You may want to consider replacing pacifier use with another appropriate mouth behavior. Taking sips of water, chewing on a Chewy tubes, biting a Chewing necklace , using the Z-grabber, or chewing on a z-vibe are great alternatives. In her book, “Nobody ever to me (or my mother) that!” infant feeding expert Diane Bahr recommends gently offering the replacement item whenever your child asks for the pacifier. Focus on giving your child attention and praise when they are using an appropriate replacement item in place of the pacifier.

3. Consider a visit from the pacifier fairy.

In this strategy, the pacifier “fairy” visits at night time when your child is asleep. The “fairy” collects all of the pacifiers in the house and gives them to little babies who need them. As a thank you, the pacifier “fairy” will leave a present. This gift will be a new transitional item to provide calm and comfort as they work through pacifier weaning.

4. Change the feel of the pacifier.

Using this method, parents change the shape or structure of the pacifier so that it no longer works the way the child is used to. This is achieved by cutting a hole in the pacifier so the child is no longer able to suck on the pacifier very efficiently. You can progressively cut a larger hole, or cut the tip off the pacifier all at one time. It is important to make sure the pacifier does not have any pieces that can come off into the child’s mouth or be bitten off which might become a choking hazard. Parents also want to make sure the pacifier is not getting dirty as it will be easier to collect particles in the open nipple. More often than not a child will notice the difference right away and will not want to use it anymore since it doesn’t work right.

5. Visit Build-a-bear

Visit Build-a-bear and talk to your child about how you are going to create a “pacifier bear”. Your child will be make a bear, and place the pacifier inside the bear so that the pacifier will be enclosed within the stuffed animal. Your child will always know that the pacifier is inside the bear and he/she will have created a new comfort item and a pleasant memory.

6. Have your child give the pacifier away

You and your child can talk about how since your child is a big kid now it’s very kind to give the pacifier away to babies who need them. You and your child decorate a bag or a box and gather all of the pacifiers in your home and place them in the container. Together you can present the box to a new baby who will need them. Encourage and praise your child all throughout the process for making a thoughtful, kind, and “big kid” decision.

7. Use a WubbaNub pacifier.

WubbaNub pacifier have a small animal attached to the end of them. Babies quickly learn to associate the stuffed animal with the comfort of the actual pacifier. When it’s time for your child to say goodbye to the pacifier you can cut the pacifier portion off and are then left with the stuffed animal portion. Your child will still be able to seek comfort from the stuffed animal that was attached to the pacifier long after the pacifier is gone.

8. Go cold turkey.

Sometimes after preparing our children for it we just need to take the pacifier away. The days following might be rough, but be loving, attentive, and consistent and the attachment to the pacifier should fade.

Pacifier weaning is a major life transition for our little ones. No matter what methods you choose to get rid of the paci remember your child will need extra soothing, quality time, attention, love, comfort, and consistency from his/her family to help him/her feel safe and secure during this time of change. If you are struggling with pacifier weaning or have concerns regarding feeding or speech development please follow the link to schedule a free screening at BDI Playhouse. BDI Playhouse Screening Registration

Written by: Amy Stumpf, M.S., CCC-SLP/L, CLEC

Do Babies Really Need to Crawl?

Written by Janis Bautz on November 19, 2019. Posted in Uncategorized.

That glorious moment when your baby is mobile, crawling around your house at hyper-speed is both joyous and terrifying. Time to baby-proof your house! Do babies really need to crawl? Crawling is essential for your baby’s development. The coordination and strength that are attained while your baby is exploring the world through crawling is irreplaceable, and sets them on the path to success!

This side/that side: Crawling requires the perfect unison of arms moving in alternation. This skill is important for future coordination of hand movements for play with toys, walking/running, climbing and pulling, home skills like taking off the toothpaste cap or opening containers, and academic skills like cutting!

Getting ahold of it: Putting weight through our hands forms the arches in the palms of our hands. These arches allow for our hands to grasp items of various sizes and shapes, and allow for our fingers to move in coordination with the objects we hold. We need these arches to play with baby blocks and balls, grab a paper cup without smashing it, and use our thumb to pinch thin objects within our fingers.

Show me your muscles: Bodyweight through our arms develops the muscles in our shoulders and arms. The shifting of a crawling movement helps strengthen these muscles and allow for stability at our shoulder, which we need for later fine motor manipulation tasks like completing buttons, writing/coloring and lifting heavy items.

Tummy time upgrade: The crawl position tilts our body horizontal with the ground, requiring that our head work against gravity to look around. This strength and control in our neck is used for balance and stability for the rest of our life!

Look at it this way: As baby crawls around, they can look at the floor, up at you, and back at the floor. This is an extremely important motor pattern for the development of eye movements. Looking at something near the eyes, then turning focus to something farther away requires our eyes to work together to focus and adjust eye position quickly. Your baby will use this important skill later for play activities like catching and throwing, learning tasks in the classroom, and even driving!

So, do babies need to crawl? If your baby has skipped the crawling phase, they may be missing out on the development of some of these fundamental skills. BDI Playhouse Children’s Therapy offers free screenings to give you the tools to help your baby “crawl” their way to a strong and play-filled life!

Written by: Maggie Lord, MS, OTR/L