Constipation in children

The biggest difficulty for some children, during toilet training, is learning to "poo in the potty". While many children achieve this without any great difficulty there are a few who, for a variety of reasons are reluctant to part with solid matter. This may be related to a fear of the toilet or to discomfort at something weighted dropping away. Refusing to "poo", over a prolonged period, can cause constipation.

Children who have had difficulty in passing a bowel movement may have passed a hard stool which has resulted in a tiny tear in the anus. This can be painful and sting, consequently the child is reluctant to repeat the experience. Again, this leads to further difficulty and can compound the problem.

While it is important to have a good amount of fiber in the diet to help with the elimination of waste from the body, it is also important not to give children a diet too high in fiber as this may cause other problems. Children who are constipated may complain of abdominal pain, they may soil their nappy/underpants and may even have diarrhea as a symptom. This happens because the hard impacted stool blocks the bowel and some of the waste above this blockage is passed as fluid.

Encouraging the child to drink more water and eat more fresh fruit and vegetables, or drink more smoothies made with fresh ingredients, will certainly help alleviate this condition. Some children may require medication from the family doctor to soften the stool and allow this to be passed.

Prevention is definitely better than cure. Ensure that your child is encouraged to drink plenty of water and to eat more fresh fruit and vegetables will help in making elimination a lot easier. Praise your child when he/she uses the toilet. Encourage good toilet behaviour. Avoid allowing children to postpone toilet visits. If the child needs to go, they need to go.

Toilet Training (Getting ready)

Here are some things you should consider when you are thinking about starting to potty train your child;-

• Get the right equipment. Getting the right equipment for potty training is always a good start. A child-sized potty or a special seat to attach to your regular toilet is a must. Whichever you choose, make sure your child can sit comfortably.

• Extra help. You may also want to buy a picture book or video all about potty training that you can look over with your child. That way, you’ll both be prepared for the training ahead.

• Time it right. Pick a period when you have plenty of time on your hands and be consistent – don’t chop and change from nappies to underpants during the day. If your child’s just about to start nursery, you’ve just moved house, you’re going on holiday, you’ve just had another baby or you’re going through any other upset it’s probably best to leave potty training until things are less hectic.

• Let your child one set the pace. If you know when your child is likely to want to use the potty, encourage them to sit down. But make sure he/she feels that they’ve made the choice – you’ll know by now that your child likes to feel in control.

• Create a routine. Try sitting your tot fully clothed on the potty seat once a day – after breakfast, before bath time, or whenever else suits you both. This will allow your tot to get used to the potty and accept it as part of the daily routine. If he or she doesn't want to sit on the potty, that's okay. Don’t force the matter. Put the potty away for now and try again in a month’s time.

• Be prepared… If you live in a two storey house, keep a potty upstairs and one downstairs. Be sure to have a potty with you when you’re out and about. It’s a good idea to keep one in the car too and to take a set of spare clothes out with you.

• Be prepared… for accidents! Lots of accidents are par for the course at first. If your tot has an accident, change him or her straight away and calmly encourage use of the potty or toilet next time. Your child may start having accidents again, after a period of thinking you had it sorted, if he or she is tired or busy. Just deal with it calmly as before.

• Encourage your little one with praise. As always, praise is your child’s best teacher so say something like ‘Well done’, ‘You were a big boy or girl to use the potty’ when your child uses the pot. But don’t make too big a thing of it. For example, don’t reward your tot with food or toys. Ignore the odd lapse and never tell your child off for failing to use the potty or having an accident.

• Don’t hang about. At first, when you child needs to go they need to go now, so don’t ignore it when the call comes. As your tot gets older, he or she will be able to wait longer.

• Make it easy on yourself. The summer months can be an easier time to try potty training, as your little one can run around without nappies. Make a note of when your child goes to the toilet so you can pick the best times of day to suggest using it.

• Get the clothes right. You don’t want to spend ages changing your toddler’s clothes, so make sure what he or she is wearing is easy to remove. You can try using training pants. Some toddlers like them, while others just think of them as a different type of nappy (which is confusing). Most toddlers are encouraged by having real underwear instead: it makes them feel grown up.

If you would like help or have questions please contact us at Dream-Angus.com

Toilet Training (Basic Principals)

Toilet training can begin when your toddler demonstrates an interest in the process. This is usually somewhere between 24 and 27 months.

Simple signs to look for;-

1. Your child may tell you they’ve done a wee or a poo. At first this may be after, rather than before, the event! But never mind – it’s a sign they are becoming aware of their bowel and bladder movements.

2. The child's nappy needs less frequent changes as there are longer periods between wet nappies. They have a wet or dirty nappy after a meal or drink and then can be dry for a few hours.

3. They demonstrate awareness of bodily functions. They imitate you going to the toilet or show some other sign that they are aware of what’s going on inside their body, such as stopping what they are doing, grunting or holding their nappy.

4. You notice they’re becoming more independent in other areas of life. For example, they are feeding themselves and can follow simple instructions

You may be able to recognise your child's need to toilet and then encourage them to sit on the potty, or an adapted toilet seat. When they are successful, praise them, but don't make a big issue of mistakes. This is a learning process and it takes time. Some children manage this more quickly than others.

Note the times when your child is most likely to need to toilet and encourage the use of the potty at these times. Some children will happily potty before or after a meal. You should be able to read your child's signals and act upon them. If your child is not ready for this then don't push them to accept a toileting routine. This is more likely to exhaust and frustrate you and upset your child.

If your child follows you into the toilet do not become upset and push them away. Children can become confused about the use of the potty or toilet if we demonstrate upset about being seen, accompanied or surprised there.

There are a variety of training pants and diapers which can be useful in teaching your child how to use the potty. There are some books which you may find helpful to read to your toddler which explain what is involved. These too can boost the child's self awareness and be an aid to successful potty training.

If you would like some help with potty training, Contact Dream-Angus.com

Transitional Objects

Transitional objects are usually soft toys. They are chosen to help a child cope with separation from the parents, situations which may be unfamiliar and to provide a level of reassurance. Some children become very attached to a soft toy that has been with them since they were babes in arms.

Sometimes these objects are chosen by the parents and sometimes they are chosen by the child. Some children never need a "transition object", they have enough confidence to master any social situation without recourse to a soft toy that reassures them with it's presence.

Transition objects should be small and washable, but do remember that it is not just the shape and form of the object, the texture and the smell of the object also matter.

For this reason some children may reject the object of their affection immediately after it has been washed. Parents are concerned that the toy is dirty, smelly and sticky, the child is unperturbed. Certainly for reasons of infection prevention, and basic hyigene it is important to be able to clean the toy.

These much loved toys travel with the child and can help in settling a child to sleep.

These toys are important for a particular stage in a child's life. They will grow out of their attachment, but, while it lasts, having a particular cuddly toy is very important and can be a positive support to a less confident child.

Positive Reinforcement/Praise

How often do you praise your child/children?

Parents spend a lot of time and energy trying to get their children to behave well and appropriately in social and domestic situations. Children want to please their parents and look for a reaction to their actions. Too often they are met with critisism. "why did you do that?" "you shouldn't do that!" etc..

Yet, when they are playing quietly with friends or relatives parents seldom think to tell the children "I'm so proud of you, you are doing x so well!" A little positive reinforcement builds a child's confidence in themselves and pride in accomplishments.

All too often we see how noisy adults can be when they are angry. Yet, when they are happy and things are going well, people keep very quiet about it. One powerful antidote to our unfortunate orientation in this regard, is to give positive verbal reinforcement. Praise should be given early and often. It should be genuine, or it will fail to achieve the objective. Positive interactions with children should outnumber the negative by about three to one. Unexpected praise can be very powerful for a child. Praise in front of other people is also a really powerful way to demonstrate to your child that you appreciate their efforts.

Children up to the age of five or six respond very well to almost any kind of encouragement. As they get older, and they better understand how well or how poorly they are doing, they are much more aware of when praise is fake or genuine. Praise should be tailored to your child. Becoming more aware of your child's acheivements, and praising them as they do their best to impress you and to push their own limits, can improve the relationship you have.

The child who lives with critism learns to condem. The child who is praised, tries harder and has more self confidence.

While you think about this, also think about how often you praise your spouse. Think of all the little acts of kindness and support that you receive. How much more difficult life would be without these supports.

Praise more, thank more, smile more. It is surprising how much you receive in return.

Altering a sleep pattern

While most children manage to soothe themselves to sleep, and to sleep through the night without the need for any intervention, there are a number of children who take a long time to learn to do this.

Some children have never learned to put themselves to sleep. They rely on a parent holding them, rocking them, feeding them or simply being with them until they fall asleep. These children come to believe that this is the only way to get to sleep and the parents are often very tired and frustrated. There is no time left to be an individual, to maintain a healthy relationship with a partner. Every evening is spent with the child, just as the day has been. There is no quiet time, no time to exchange comments about the day and often no private time between parents at night. Someone must remain with the child so that the child will sleep.

Altering a child's sleep pattern is possible. It requires an understanding of exactly what has happened to cause the difficulty. A sleep history helps clarify this.
What is the pre bed routine like, how do the parents react to the difficulty and what priorities do the parents have in mind when they want things to change? Sleep diaries illustrate exactly where the difficulties are, and completing these throughout the work to change things can also show what is working, and what is not.

Once the issues have been clearly identified, and the parents priorities decided, it is possible to work using graded techniques to improve the child's sleep. Cry it Out, a method that allows a child to cry with a parent checking at extending intervals, has long been discredited by sleep professionals.

This method does work but it teaches the child that being upset is not going to be met with comfort. The child learns to suppress such emotions and this is not healthy. Cortisol, the stress hormone, floods the body systems of parents and child so neither are happy with the situation. The parents may have been told that this is the way it has to be, but this is not so.

There are other ways to support a child who is afraid, who lacks confidence in their ability to fall asleep or remain asleep without mum or dad being nearby.

Altering a sleep pattern can be really hard work for both parent and child. It requires consistent repetition and demonstration of behaviour and consequenses so that things can and do improve. Most sleep difficulties can be resolved within a few weeks. Perseverance, persistance and calm confidence are atributes which are vital to success.

Once a child has learned to sleep and to remain asleep, their appetite and mood imnprove and parents find things so much easier.

If you would like help to improve your child's sleep, Contact Dream-Angus.com

Teaching our children

I am often asked if resolving one sleep issue, means that there will be other issues to be worked on later.
Most pre school children who have a difficulty in getting to sleep, or staying asleep, and who then learn to sleep and to remain asleep have no further difficulties. Learning to sleep independently is a gift for life. Children who have difficulties and do not have them resolved often continue to have difficulties with sleeping.

Do children "grow out" of sleep difficulties?
Sometimes, but this depends on the reason for the difficulty. Children whose imagination is particularly active, and who cannot differentiate between dreams and reality may "grow out" of sleep difficulties if this is the cause. For many children the causes are multi factorial. Sometimes there is an obvious reason, and sometimes there is no obvious cause of the child's difficulty.

We teach our children many things, and teaching them to sleep is often done without being conscious of it. If we always allow a child to fall asleep on the couch in front of the television, then move them into a bed, that child comes to believe that this is what he or she needs in order to relax and fall asleep. Teaching this child that they can, and should fall asleep in their own room, in their own bed can take some time and perseverance. However, once the child has learned a new behaviour and repeated it on successive occasions it becomes the new norm. This is what altering sleep behaviour is about. It is about altering the perceived needs and demonstrating a better way to achieving a good nights sleep.

There are many ways to alter children's behaviour. Sometimes this is about giving the child confidence in ourselves as parents. Sometimes it is about giving confidence in the child's independence or in the child's ability to cope in new situations. Often the pace of change has to be slowed or hastened depending on how well the child copes with the changes.

Just as every adult is an individual, so is every child. What works well for one may not be as effective for another. Your child has to grow up within your home, living with your ideas and this has to be taken into account. No one knows your child as well as you do. Professionals can indicate good practice and direct your efforts.

The biggest single thing that parents need to identify is the difference between what your child needs and what your child wants. Children's needs should always be met unconditionally. This gives children a secure base, a belief in their parents ability to nurture and protect. We all want our children to have faith in our abilities to protect and care for them.

We all have "wants". Children who are secure can cope with wants not always being met as long as their needs are addressed. In the wider world we do not always get what we want, we hope we always get what we need. This is a difficult lesson for children and often it is difficult for parents to identify when something is needed, and when another thing is desired.