As a Continence Nurse Consultant in a Perth hospital, Kerry Murphy’s job is educating parents and teaching children what is not normal when it comes to bladder and bowel symptoms. “A lot of issues are preventable,” says Kerry. “But your children might not tell you about their toilet problems. They might even deny them. So you have to do a bit of detective work and pay attention.”
“You don’t just potty train your child when they are a toddler and then forget about it. Even once they are at primary school and high school you should try your best to monitor how much fluid they drink, what type of food they are eating, how much exercise they do. They are the key things to maintain healthy bowel habits every day.”
Seven signs your child is constipated
- Skids in their underwear. Parents often think this means this child isn’t wiping properly. But it can be a sign of constipation.
- Taking too long or not long enough on the toilet; if your child takes longer than ten minutes to do a poo they are most likely constipated. If they hop straight off it could mean they aren’t emptying their bowels completely.
- Complaining of a sore tummy, sore bum, or feeling nauseous.
- Extreme emotional reactions to doing a poo such as refusing to poo on the toilet and only going in their nappy. Being worried or scared of the toilet could mean it is painful for them to pass hard poo.
- Too much or not enough poo. This refers to volume and frequency. Kids should be aiming for once a day, a similar amount each time. Several small poos a day or one very large poo every few days could mean they are constipated.
- Bad breath, lots of wind or very smelly poo.
- Poo that is not a smooth long sausage (small pebbles or loose diarrhea). See the Bristol Stool Chart for pictures and descriptions: continence.org.au/bristol-stool-chart.
“We recommend children who are constipated sit on the toilet after each meal. It teaches the child to take time and listen to their body.”
Talking about toilet habits while maintaining your child’s dignity
Kids don’t just learn healthy habits by themselves, we have to purposefully teach them and model the behaviour, while ensuring we don’t embarrass or humiliate them or knock their self-esteem in the process.
“Nursing is all about building a relationship with the child,” Kerry explains.
“Getting creative with solutions to their problems. Being culturally aware. Partnering with families and helping make it fun. Get books about farts and then talk about it so they know that farts can be a sign that they need to go and do a poo. We have to tell them that they should be pooing once a day, and we should tell them that their wee should be light yellow so that they know when something is wrong.
They need to know if they are up more than once a night for a wee, that is a problem. Teaching them life skills to help themselves be healthy.”
“Constipation in kids is more than a one-off medical intervention, it is a permanent adjustment to lifestyle.”
“Continence nursing is also about empowering our patients,” Kerry tells us. “It doesn't matter if you work in paediatrics or aged care. If you can empower patients to make decisions and do things for themselves using aids, or sticking to their abilities, you will have much better results.
Working with small children and adolescents is a little bit different, older kids tend to be good in appointments but then not stick to the work you give them, take a few more risks, and the parents are a lot less involved.”
Making poop fun!
Books, apps and videos to help you discuss going to the toilet with your children
All kids and adults learn differently and making sure you communicate about toileting in an age-appropriate way that suits your child is important to make sure the message about what is normal for their body gets through. Think about what their interests are and how they like to consume new information. Look for something to read, watch, or play together to get the conversation about bladder and bowel habits started.
1. BOOK: Constipated Koala: Dealing with CONSTIPATION in kids by Abraham Thomas https://www.amazon.com.au/Konstipated-Koala-Dealing-CONSTIPATION-kids/dp/B0BDXVT99B
2. APP: Potty Time: videos, songs, books, and rewards chart. https://pottytime.com/app/
3. VIDEO: Constipation in Kids | What Your Poo is Telling You (YouTube) https://www.youtube.com/watch?v=_5ZHvQLv2dM
4. BOOK: It Hurts When I Poop!: A Story for Children Who Are Scared to Use the Potty
by Howard J. Bennett https://www.amazon.com.au/dp/1433801302
5. CARD GAME: Who Did This Poo? https://www.amazon.com.au/Who-Did-This-Boldt-Claudia/dp/1786273721
6: BOOK: Everything I Know About Poop by Jaume Copons https://www.amazon.com.au/Everything-I-Know-About-Poop/dp/0228100836
7. VIDEO: Constipation in Kids | Poop Withholding and What To Do When Kids Won't Poop! (YouTube) https://www.youtube.com/watch?v=C8C01oDKSFY
8. BOOK: The Gas We Pass by Shinta Cho https://www.amazon.com.au/Gas-We-Pass-Story-Farts/dp/0916291529
Get help with constipation in children
If you relate to the issues discussed in this article, but don’t know where to get help, phone the free National Continence Helpline 1800 33 00 66 8am-8pm AEST Mon-Fri to speak to ask a nurse continence specialist any questions you have relating to toilet training, constipation, bladder or bowel health.
Read more from Bridge: https://issuu.com/continence.org.au