As a potty training consultant, I hear from parents every week whose toddlers and preschoolers are constipated, anxious about using the toilet, and having most of their bowel movements in their pants, sometimes pooping less than once per week! Most of these parents have sought help from their family doctor only to be told that constipation is normal for kids and nothing to worry about. How many of you have had a similar experience?
I would like to share something with you that you probably already know… childhood constipation does occur frequently, but it is not “normal”. It is a sign that something is not right, whether that is an undiagnosed health issue, a food intolerance, an emotional upset or something else. Your poop, to quote Dr. William Sears, is window to your health. Problems with poop, whether too hard and infrequent or too loose (diarrhea), therefore should never be dismissed as “normal”. Even in babies, digestive issues show up as "colic", upset tummies, gassiness, and frequent spit-up.
Often a multi-faceted approach must be taken to overcome chronic poop problems in children, including dietary changes, supplements, ergonomic considerations and improving a child’s relationship with their eliminations. This is because it is imperative that we consider the WHOLE child in order to solve this complex issue. The goal is not to “make them poop”, it is to create the conditions in which they can maintain their optimal health, by having healthy poops and feeling comfortable about eliminating in a place that is appropriate for their age and ability.
Today I want to share with you several non-invasive, gentle, modalities that affect systemic change in the WHOLE BODY, and have been proven to be extremely effective in managing digestive issues in children in both the short and long term. These include, acupuncture, cranio-sacral therapy and chiropractic therapy.
Please note that the information provided here is not medical advice. This post is intended to inform and educate parents about approaches that can be used as part of an overall program to support their child’s healing. Consulting with your family doctor is always recommended when your child is experiencing a health issue.
I have been a fan of acupuncture and Chinese medicine for many years, having used it myself for women’s health and pregnancy support as well as immune system support and overall wellness. Acupuncture, described by local pediatric acupuncturist Catherine Woodlock, is the insertion of very fine needles into specific points on the body that engage the body’s natural healing mechanisms. Like all the modalities I am going to talk about today, acupuncture doesn’t treat just one symptom; it affects change in the whole individual to promote healing.
Does that sound confusing, or too “woo woo” for you?
After years of experience as a patient, I can tell you that I don’t totally understand the mechanics of it myself, but I CAN tell you that it works. According to the acupuncturists that I interviewed, it works even more efficiently in children than it does in adults!
Acupuncture is very effective for bowel issues, both constipation and diarrhea, according to Cathrine Woodlock and Kelsey Shaw, registered acupuncturists at Whole Family Health. “Acupuncture stimulates the parasympathetic nervous system, also known as the “rest and digest” system. This helps to calm the nervous system and improve digestion. It can also help to increase peristalsis (the contraction and stimulation of muscles) in the intestines, which can relieve constipation”. Anecdotally I have been told that many kids will take a big nap and a have a large bowel movement following treatment.
Eldyka Simpson, registered acupuncturist at Ripple Effect Wellness Centre, highlights how acupuncture relaxes the body and mind, which in turn relaxes the bowels. One of her patients, a girl of around 10 years old was suffering from stomach aches and what appeared to be IBS-like symptoms. The girl was visibly anxious, her body quite rigid and hands clenched at the start of their meeting. Within minutes of starting treatment the girl became visibly relaxed on the treatment table, a common response to the immediate effects of acupuncture. After a few treatments she was no longer in pain, and her symptoms began to improve.
Acupuncture can be a wonderful tool in any parents repertoire, and aside from digestive issues, it is very effective in treating many common parental concerns including bedwetting, colic, sleep issues, behavioural issues, eczema, and allergies as well as silent reflux and excessive spitting up in babies.
Hold the phone… babies?
How old do kids need to be to be treated with acupuncture? Eldyka Simpson is a certified doula as well as an acupuncturist and has treated babies as little as 2-3 hours old in the delivery room! Though at that age treatments are extremely gentle and she relies on more acupressure and cranio-sacral therapy (which will be discussed below). All of the acupuncturists I consulted with agreed that there is no minimal age to start.
A common issue that I see are young children withholding their bowel movements intentionally, often because of a previous painful potty experience. This creates a vicious cycle where the more they withhold, the more backed-up they get and the more painful and large their poops become! One of the acupuncturists at Whole Family Health recently worked with a family whose 2 year old daughter was doing just that, and it was causing a lot of distress in both the parents and child. Together with the acupuncturist, they developed a treatment plan that included dietary changes as well as acupuncture. After the first treatment, the parents reported that there was already a significant improvement in her bowel movements. After 3 weeks of acupuncture treatment twice per week, her bowel movements had returned to a regular, healthy state.
According to all of the acupuncturists that I interviewed, some improvement can usually be seen after only 1 treatment, and because children respond so well to acupuncture, significant change often occurs after only 3 or 4 sessions.
Understandably, many parents are apprehensive about the thought of taking their kids in to be poked by needles, especially when their own experiences with needles, such as receiving injections or having blood drawn, have been uncomfortable or downright painful! However, acupuncture is performed with needles that are super-tiny, only about 1/6 of the size of a hypodermic needle and the pediatric needles are even smaller!
Whereas in adults acupuncture needles are usually left in place for a long time, in children they are inserted very briefly and then removed. Oftentimes children do not even notice. However, most acupuncturists use a variety of modalities and tools available at their disposal to stimulate the acupuncture points, so if needles are a deal-breaker for you, call around and find out what else they have to offer! Acupuncturists who specialize in pediatric acupuncture will be flexible and work with you to find treatment options that are the best fit for your child and family. The photo below, for example, shows an acupuncturist using tuning forks to stimulate acupressure points.
Cranio-Sacral Therapy (CST) is another modality that can be very successfully used to treat constipation. It is a hands-on therapy that uses really light pressure touch to look for restrictions within the body and release those tensions to create balance. Because it is so very subtle and gentle, it works very well for young babies, especially helping them recover from any birth trauma, car seat discomfort, gassiness and excessive spitting up.
I spoke with mom Ashley Da Silva about her experiences using Acupuncture and CST for her now 20 month old son, who shared that she started taking him for acupuncture and CST when he was 4 months old. At that time he was exclusively breastfed but suffering from constipation as he would only have a bowel movement about every 2 days. “I would take him for these treatments (his acupuncturist does both) and typically within an hour after the treatment he would have a bowel movement.”
Unfortunately her son's constipation increased when they started supplementing his diet with formula, but these issues were helped immensely through continuing his visits for acupuncture and CST as well as adding probiotics to his diet. “After his first treatment, we noticed a difference in his mood. He was starting to get more on the cranky side. We did realize afterwards that it was also his lack of long naps that was leading to the crankiness. The acupuncture did help with his sleep, constipation and gas.” Ashley finds that continuing with treatments on a monthly basis has also helped them manage a variety of common childhood ailments from teething to digestion as well as eczema.
My personal interest in Chiropractic therapy began early in pregnancy with my son. Until then, like many of you probably, I thought of Chiropractors as back-crackers. It was my (very limited) understanding that you went to a chiropractor to put your bones back in place after a car accident or sports injury or something. I clearly had no idea, really. But… as it turns out my sister had taken her kids to a pediatric chiropractor for a few non-bone-related issues, and a friend of mine was going as part of her fertility journey. So I gave it a shot as I was having terrible back pain.
It was then that the chiropractic doctor opened my mind to how manipulation of the spine impacts the health of the whole nervous system, promoting overall health. Like acupuncture and CST, chiropractic is not a treatment for digestive issues specifically, however when your nervous system, which controls vital components of your digestive system, is functioning well optimal health is achieved.
As with acupuncture, parents are often apprehensive about having their kids adjusted. They may have had a poor experience themselves in the past, or hold on to a belief that adjustments are rough and painful. This view couldn’t be further from the truth! In fact, chiropractic adjustments for kids are nothing like the adult ones (which aren’t painful either in my experience). The doctors make kids feel very safe and secure, use very light touch and are very mindful of how your little one is feeling. I have been taking my son for regular adjustments since he was only a couple of weeks old, and the adjustments are very relaxing for him. At age 2 he LOVES to visit the chiropractor, and completely melts on the table while being adjusted.
According to the chiropractic doctor that I interviewed, digestive concerns including colic, gas, spit-up and constipation are some of the most common reasons that families bring their kids to be adjusted. Life inside the womb as well as the birthing process can actually cause trauma to the spine of babies, so having them adjusted as soon as possible helps ensure that their nervous system is communicating and functioning as it should. He reports that parents usually notice significant changes with their child’s digestive issues within 2-4 weeks of starting chiropractic care.
A mom of twins, Elda Havlin, shared her chiropractic journey with me, “My twins were born at 36 weeks, 2 days - my girl was 4 lbs even and my boy 5lbs 10 oz at birth, but we were lucky and had almost no NICU time. When they were around 8 weeks old (4 weeks adjusted), I felt like something was wrong - my girl especially seemed super uncomfortable all the time - we tried burping, Ovol, gripe water, foot massage, tummy massage, etc. but nothing seemed to relieve her (what I assumed was) gassiness. My boy was in a similar state but not as extreme.” A friend suggested she try taking her babies to a chiropractor, and though she was hesitant, she needed to find a way to ease her babies discomfort!
At the appointment, the doctor had Elda lie on her back, on the chiropractic table, with her still tiny baby on her chest, face down. The doctor talked her through everything she was doing, while slowly and very gently feeling along her daughter’s spine and making small adjustments as she went. Elda says she didn’t hear or even feel the adjustments being made to her baby, but as the doctor worked the baby started passing gas. Like A LOT. “I honestly had never heard her toot as loud or as long! It was like she’s had this gas stored up inside her for her whole life!” Within a few minutes after the adjustment, her baby girl had a huge loud poop which her mom called a “mega blowout”! Unfortunate to clean-up (we’ve all been there!!), but what an amazing experience! Elda reports that her son’s adjustment had a similar outcome but not quite as extreme as her daughter’s.
Elda was even more amazed when they returned home, “she was honestly like a whole new baby! She was clearly happier, more comfortable, and enjoying life again!” She continued to take her babies for adjustments, first twice then once per week for a couple of months. Her twins are now busy toddlers and she reports that they are rocking potty training!
Thankfully both of the mom’s I spoke to were able to find help using alternative medicine when their babies were very young. Unfortunately many parents don’t find these alternatives and their kids digestive issues are not taken seriously by their doctors. This leaves parents with irritable, uncomfortable babies, and constipated toddlers, wreaking havoc on potty training and causing distress for the whole family.
In terms of constipation and other digestive problems, these modalities are extremely effective but they are often not the only solution that parents need to consider. You can be assured that after a few treatments your child’s body is now communicating optimally but if they are still experiencing symptoms, there might be an issue that acupuncture, CST or chiropractic can’t address. These would include things like poor diet, food allergies, life stress and other underlying health issues. When we are considering a holistic approach to healing, we must remember to consider the WHOLE child, a multi-faceted approach will lead to the best outcomes.
For parents whose kids have already been through the gamut of western medicine, alternative approaches are safe and work very well in conjunction with the approaches that your doctor might recommend, including pharmaceutical stool softeners and laxatives. Many families see improvement while using pharmaceuticals, but their child’s troubles return as soon as they wean off the drugs. All of the modalities I have written about in this post have been very effective as well for helping kids reduce their dependency and eventually stop using pharmaceutical products while maintaining healthy, regular bowel movements.
Have you tried acupuncture, CST or chiropractic to overcome your child's digestive issues? If so, please share your experience with us in the comments.
For information on overcoming potty refusal and poop withholding, check out my previous post, Top 3 Tips for Getting Poops in the Potty. And, definitely download my free recipe book with tasty recipes that will help your child have healthier bowel movements.
Note: This post contains affiliate links. If you click on the links below and make a purchase, I will receive a small commission, at no extra cost to you. Thank you so much for your support.
In almost every class I teach, I have one parent who asks me whether they can just teach their child to use the big toilet, and not use a floor potty. The reason behind the question varies; some parents fear that their child will become dependent on the little potty and not want to use the toilet, others are reluctant to have to clean-up the little potty and would rather everything go straight into the toilet bowl, some are minimalists who just want to reduce the number of "things" and might not see the point of this particular potty training accessory.
First I want to ask you...
IF having a little potty that sits on the floor, in the middle of your
living space (for a short time) were the determining factor in your
success or failure with potty training, would you get one?
The cost is minimal, $10 (second hand) to around $40. You can even just borrow one from a friend for free. I am not at all overreaching here... despite a little "extra" clean-up of the little potty after use, it will save you time, effort, and very likely money on diapers since potty training will go more smoothly be more likely to stick if you have a little potty. Let's break down the reasons why:
1) The little potty goes where you go. If you are starting potty training the way I teach it, you would start with a day of naked teaching. On this day, your child is naked from the waist down and you are waiting and watching for him or her to pee. Once they start to pee, you airlift your little one onto the nearest potty aiming to catch at least 1 drop of pee in the potty each time. This is the quickest way to teach your toddler how it feels to need to pee, what happens when you do, where pee goes, and how to get there. This method encourages independence too, as your child is learning from day 1 how to recognize when they need to pee, and not relying on a caregiver or a timer to tell them its time to go. So, using this approach, you need to have a potty close at hand at all times since you don't want to have to run down the hall or up the stairs to the bathroom with a peeing child in your arms! Playing in the living room? Bring the potty. Eating lunch in the kitchen? Bring the potty. Spending time in the back yard on a sunny day? Bring the potty.
2) Your child is easily able to mount the floor potty without assistance. Speaking of encouraging independence, a floor potty allows your child to get up onto it easily without assistance, unlike a toilet that requires a caregiver to lift the child up, a toilet seat reducer so that their little bum won't fall in, and/or a stool or steps that your child needs to climb up on. Any extra steps in the potty process (asking for help, putting the reducer on the toilet seat, or climbing precariously up onto the toilet for example) can make it less likely that a child will bother using the potty. Or, best case, they try to get there in time, but these extra barriers make it more likely that the pee accidentally lands in their pants or on the floor.
3) Let's talk about ergonomics... A floor potty is more comfortable for your child to sit on than the toilet. They are designed to fit a child's tiny bum and short stature. If you have heard of the Squatty Potty, a toilet stool designed to get you body into a better alignment for bowel movements, you may know that a deep squat position puts our colons into the best position to poop in, and that modern-day toilets actually make pooping more difficult.
When your toddler or preschooler is sitting on the big toilet, with their legs dangling, it makes elimination much more difficult on them. It might mean that they are straining more, or not fully emptying and these can create more accidents, and even reluctance to use the potty/or toilet for bowel movements. At the beginning of potty training you want everything to run as smoothly as possible (no pun intended), and the floor potty ensures a better, more ergonomic fit for your child, especially for pooping. You can also fit the potty to your child, so if you child is smaller, choose a potty that is smaller too! Colour, shape and fancy gizmo's are far less important than simply choosing the most comfortable option for your child. Once they are accustomed to pooping in the potty, by all means use the toilet too. But make sure to have, in addition to a comfortable toilet seat reducer, a nice high stool for your child to rest their feet on and to keep their knees elevated above hip level.
4) Pottying on-the-go, playgrounds, car trips and more... the title kind of says it all, sometimes you don't have a toilet to go on! So, rather than worry that your child will not want to use the toilet, I would worry that my child would never want to use the potty! Floor potties are designed to be portable, you don't have to get one that looks like a real toilet and is 3 feet high. There are plenty of small, portable potties that can be stashed under your stroller, strapped to the back of your bike or semi-permanently stored in the trunk of your car to make potty use convenient at any time and place.
5) Potties can serve multiple functions. This fact is alluded to above, but I'll take it a step further here. What if you could buy just 1 potty that would serve all the functions? It had to be the main floor potty at home, the toilet seat reducer, the travel potty and the car potty. Would you be surprised if I told you that such a thing exists! They are these incredible, sturdy travel potties that are multifunctional and in that way actually grow with your child. There are two different versions out there, the Potette Plus Travel Potty and the OXO Tot 2-in1 Go Potty. Some day I will dedicate a post just to comparing these two brands, but for now I will say that the main advantage of the Potette Plus is that it is possible to purchase a silicone liner for it so that you can use it as a floor potty indoors. The main disadvantage of the Potette is the "pee guard" is not very high. Both potties can be use with disposable liners or any container inserted underneath. The OXO seems to be a better fit on most toilets.
6) Keeping a floor potty in your child's room helps with night-time potty use too! Now, you're probably not quite ready to think about night-training, and that is perfectly fine. However, some day you will want your child to stop wetting their diapers at nighttime. At that time, you can take your floor potty out of storage, and make a little potty station in the bedroom. Place a folded towel or foam mat on the floor with the potty on it. If your child is still in a crib, it makes taking them to pee during the night a breeze! And, when your child graduates to a big-kid bed, it encourages them to get up in the night if they need to and use the potty without waking you up in the night. The Night Potty board book read each night before bed also helps to reinforce the notion of waking up to pee in the night.
7) Dumping the potty contents into the toilet is a perk! I don't recommend using bribes and rewards in potty training, things like candy, stickers and toys actually take away from the focus of potty learning (getting pees and poops in the potty, whooo hoo!!!) and can derail the process in many cases by creating a power struggle over the treats. However, there are plenty of internal motivators in potty training that act as natural rewards. Things like pride after getting to the potty in time, keeping undies and pants dry, getting to choose undies to wear, and flushing the toilet. Kids LOVE these things. They are rewards that keep on giving and never need to be taken away. Dumping pees and poops in the potty is another fun motivator for kids. The best potties for dumping are the ones with the bowl insert that can be removed, since pee is less splashy when coming out of the bowl compared to the rounded 1-piece potties. Also, if you have a child that is having accidents because he or she refuses to leave their play to use the potty, having a potty in the main space can be a good reminder and allows them to feel like they are part of the action rather than being sent to another room each time they need to eliminate. Being taken away from activities, even for a good reason, can feel like a punishment.
Still worried about cleaning your potty? It's so simple and takes only a minute or less. After your child eliminates into the potty, pick up the bowl insert (assuming you have a 2-piece potty) or the whole potty and dump the contents into the toilet. Rinse the potty with water and dump that into the toilet. Spray the potty with some non-toxic cleaner, wipe it dry with a cloth for this purpose, or toilet paper. Flush the paper along with the other contents of the toilet, and put the potty bowl back into the potty. Now its ready to go for next time! A 50%-50% vinegar to water solution will work for this purpose, I prefer to add some D-limonene cleaner to this solution for mega cleaning power and a nice orange scent.
So... I think I've covered it. 7 excellent reasons for you to make a very small investment in a small plastic potty that will encourage potty learning and independence, make clean-up easier, allow you flexibility to use the potty wherever you are and help your child to stay dry at night. Its win-win-win!
The following visual list contains convenient links to some of my favourite potties. Just click to be directed straight to all the product details on amazon.ca. Let me know in the comments if you have a favourite that I have not included and why you love it!
Note: This post contains affiliate links. If you click on the links below and make a purchase, I will receive a small commission, at no extra cost to you. Thank you so much for your support.
Ah... mid-summer. For many families, this time of year provides the perfect opportunity to help their child break-free of the diaper habit for good. However, when potty-training isn't going very well, this time of year can become a count-down to fall and all of the changes that season brings. For some, potty-training is essential for starting pre-school, or parents might be going back to work and will no longer have as much time to commit to EC or potty training. For families dealing with poop challenges - from fear and anxiety of using a toilet to poop, to daily or weekly accidents, to chronic withholding that can lead to serious health issues - the stakes at this time of year can be very high indeed.
The road to going from poop-in-the-potty resistance to confidence is often not easy, and typically requires a week or two of vigilance on the part of parents or daytime caregivers. There may be tears, desperate attempts to get away, even violent outbursts on the part of the child, but it is essential for parents to approach this behaviour with complete empathy and understanding.
Tip 1: Get Closer
Work on re-building your relationship with your child. When potty training doesn’t come easily, there is always frustration, its natural! But when this frustration goes on for weeks and months it can definitely cause a rift to develop between parent (or caregiver) and child. So first its essential to reduce the drama and frustration surrounding the issue before beginning the process again. If you have been using rewards, stop immediately and instead find ways to connect with your child whether it’s a game of tag around the house, or a trip to the ice cream shop or swimming pool. These types of activities may have been used as bribes or rewards for potty training in the past so this time make sure there are no strings attached.
Physical, rough play and laughter can be a great way for parents and kids to connect, but can also help to dispel fear and release tension. Any type of wrestling, pillow fights etc… can give your child the positive parental time and attention that they crave while also acting as a safe way to release their worries. Additionally, during playtime the parent should allow the child to exert some control over the parent, so that the child does not feel dominated. Games where the child is stronger, faster and/or smarter will have them laughing their worries away.
Books can also help to increase understanding, add an element of humour and normalize pooping on the potty. Look for books that are appropriate to the age and attention-span of your child. Some of the books we love include What is Poo?, Everyone Poops, and Toot.
Tip 2: Think About Food
Consider your child’s diet and how this could be contributing to potty training issues. If your child is sometimes constipated, fiber is often the first thing parents attempt to increase in their child’s diet. And while fiber is important, too much can actually contribute to the production of too much stool, which is not very helpful in this situation.
It is however, very important to ensure that your child is adequately hydrated, as well as ensuring that they have a good amount of healthy fats in their diet. Healthy fats include avocado (think of it fresh on toast or guacamole), coconut (shredded, or coconut milk in a smoothie, overnight oats or soup) and oils like coconut, avocado, olive and butter. Try the recipes in my free download, Toddler Approved Recipes for Constipation Relief.
There are certain foods that you may also want to avoid if constipation is a recurrent issue including green (unripe) bananas and dairy products.
Tip 3: Go Cold Turkey
At a certain point diapers (or pull-ups, which are still diapers!) act like a security blanket, especially for kids who are over 30 months of age. Pooping outside of a diaper feels WAYYYYYY different that pooping in one, and since its probably the only place that your child has pooped in the last few years, its important to understand what a huge change this is for them. Though as parents, at a certain point we might decide that our child pooping in a diaper is no longer acceptable; the poops are larger, maybe smellier, we think our kids must be developing the same aversion to it as we are. But guess what? Most kids don’t care at all. The diaper is the only toilet they have ever known and a very convenient one at that! They are used to the feeling and the smell, and overall the part they start hating the most is probably getting changed and cleaned-up! Very inconvenient for parents who start to resent these clean-up battles.
If your child seems afraid, or just unwilling to sit on the potty to poop, it is so, so tempting to hand them a pull-up and let them go in the place where they feel most comfortable. But unfortunately, the diaper habit is a hard one to break, and handing them a diaper each time is not going to resolve this issue. It can in fact make them even more resistant in the future when they are older and even more set in their ways.
On the other-hand, taking away the diapers completely can lead to a child just pooping in their undies or even withholding poop until they are given a diaper to poop in at nap or night-time. So what is a parent to do?
2 things actually… first, you have to say no to diapers, all day and all night. Second, you need to make catching poops your main life-goal for a few days. Watch for signals, the typical times of day that your child poops or places they tend to retreat to. When you see the signal, take your child into the bathroom and wait it out, giving them all of the empathy and love you can muster, but see it through. For most kids, once you get 3-5 poops in the potty, a new habit is being formed, and their fear of pooping has subsided.
For many parents, following these 3 tips will be enough to solve the poop problem. If you require a more personalized approach, or you feel that your child may not follow typical withholding behaviour, please contact me for a consultation. Sometimes poop withholding and accidents are a sign of a medical condition that needs to be monitored by your family doctor, and cannot be corrected by simple food changes and non-coercive techniques. Watch for a future blog post that will outline the signs to be on the lookout for.
Let me know... did your child struggle with getting poops in the potty? Which tips or techniques helped them to get over their hesitation and regularly use the toilet or potty for poop?
Hi! I'm Danielle, your friendly neighbourhood potty specialist.