Urotherapy Book

21  How to sit on a toilet is also important because this can vary a lot between children. If sitting badly (the pants too far up, sitting with legs not enough apart, too much forward-leaning etc.) can make it harder for the child to poop effectively. By sitting with the pants lowered under the knees, with legs apart and feet on the ground or a stool, the pelvic floor can relax properly making pooping more efficient.  How the child pushes the poo out is also important to assess. If the child when straining pulls the stomach inwards, they tighten their pelvic floor and prevent the poop from coming out. If they push their belly out when straining the pelvic floor relaxes and the poop pushes out more easily.  According to the ESPGHAN guidelines, there are 3 advices about food that are recommended:  Eat breakfast, lunch, and evening meals. This is the best way to activate the gastrocolic reflex.  Do not eat too much bread and pasta. This needs a lot of water to make the poo soft which children could have difficulties drinking.  Drink a normal amount of water, 6-8 glasses a day. There is no evidence that an increased fluid intake could solve constipation but if the child drinks too little it could affect the softness of the poop.  The child should be encouraged to be active in their spare time and not sit still all the time e.g. playing video games.  Practice Support the child during treatment, helps when the child understands that he/she needs to practice. Clear instructions and a bowel diary helps the child to stay motivated. The aim of toilet training is that the child learns to recognize the urge to poo and eventually understands that he must go to the toilet and not postpone it. Erreur ! Source du renvoi i ntrouvable.