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Parenting
with Gary & Anne Marie: Toddlers
Potty Training Bowel and Bladder Muscle Control
Two distinct muscle groups
control our ability to manage bowel and bladder retention. These are the sphincter
muscles, which control the bladder, and the anal muscle, which closes the colon
and controls bowel elimination from the rectum. (The rectum is the last part
of the large intestine that connects to the anal canal. It is where the fecal
material is stored before it is released by the anal muscle.) But how does a
toddler learn to use these muscles voluntarily? After all, they are invisible
and not subject to a toddler's contemplation. One sure way to train is by creating
opportunities that connect the sensation to relive bowel or bladder, with the
desired place to go, the potty seat or toilet. Here is how to help your toddler
make this connection.
Because the mastery of elimination skills follows a pattern of predictable development,
parents need to decide which skill to target first. For example, by the time
most toddlers are about 20 months old, bowel elimination often is highly regular
and predictable, while bladder functions remain erratic. Because of that fact,
some moms prefer to start with bowel training first, followed by bladder training.
Is this always the best way? Well, not always, but it is one viable option,
and because others have found it successful, it is worth noting here.
By and large parents who are interested in potty training have as their objective
a single goal: a dry and clean child. But these are two different physiological
conclusions. Do not assume that success in both is equally achieved. Elimination
is not a single activity; it involves the use of two independent muscle groups.
Consider the contrast between the muscle sequence for bladder elimination and
that of bowel elimination.
Like an adult, a child uses a release-then-push sequence for bladder elimination,
and a push-then-release sequence for his bowels. With the bladder, sensation
is experienced first, followed by a release of the sphincter muscle. The child
only needs to release the muscle, and his urine comes out. Only when his bladder
is nearly empty does he sense a need to push those few remaining drops out.
His bowel action is opposite. In bowel control, pushing is the first activity,
followed by release. And sometimes, such as with diarrhea, release is the only
function, although this is not the norm. Therefore, bladder training and bowel
training are different as they relate to a child adjusting to the sensation
of release and push. What part does this play in a child's refusal to use the
potty seat for his bowel movement or bladder elimination? On the surface, it
may not seem as if it has any bearing. But who can remember back that far to
absolutely rule out some influence?
Footnote:
Content of the
article references information from Potty Training 1-2-3 written
by Gary and Anne Marie Ezzo. All rights reserved.
Article
by Gary Ezzo / Anne Marie Ezzo
