By Guest Blogger Karen L. Smith, PT, MS- Owner of Peace Physical Therapy LLC

“He’s 5 and not pooping in the toilet? You haven’t tried hard enough.”– Your mother-in-law

“Sorry she missed out on the spend the night party, the girls had a blast!” – The mother of your daughter’s BFF

“Just do another Miralax cleanout and we’ll see you next year.”– Your tween’s medical provider

“Mom, I didn’t know I had pooped in my pants.”– Your teenager

Do any of these toileting issues sound familiar? As a mom of three children, I understand that bowel and bladder issues can affect your whole family. Did you know that kids, just like adults, have pelvic floor muscles? (You know those muscles you squeeze when you are jumping on the trampoline with the kids.)  The pelvic floor helps control when pee and poop needs to come out. We want to avoid problems starting in the first place, so here are some tips to try and set them up for success with toileting.

  • When starting potty training, make sure they have interest and avoid pressuring them. Keep the mood light and be positive!
  • Avoid potty training before the age of 2 or when there has been a recent change like a move or a new sibling – around age 3 is typically the best.
  • Use a small toilet seat that fits on your toilet and have their legs supported with a stool so they feel safe and can relax their muscles.
  • Remember daytime dryness comes before nighttime dryness, and it is normal to wet the bed through age 5.
  • Make sure they are getting plenty of water, this can include things like watermelon and popsicles.
  • Avoid constipation, avoid constipation, avoid constipation!

Despite our best efforts, our kids can still end up with toileting issues. Sometimes kids have poor coordination between their pelvic floor muscles, their breathing, and their core muscles and just need a little help.

Signs Your Child May Need More Support with Toileting Issues

  • Your child is older than 6 and is wetting the bed.
  • Your child has giant poops that could clog the toilet. (“How did such a little body create something so big?”)
  • You have been told your child “withholds” or has encopresis.
  • You find poop smears or leaks in their underwear that aren’t due to poor wiping.
  • Your child can’t go to summer camp, sleepovers, or even start college due to toileting issues.
  • Your child has been given a medical diagnosis that will impact their bowel or bladder.

So Now What?

Well, just like there are pelvic floor physical therapists who see adults, there are also physical therapists that work with kids and their pelvic floors, so they can pee and poop easier and move forward in their lives.  At Peace Physical Therapy, we specialize in pediatric bowel and bladder issues from toddlers to teens in the Triad. As a pediatric clinic, we utilize a different approach in assessing the pelvic floor muscles compared to how we evaluate adults. Not only do we address the pelvic floor muscles, but we work on your child’s posture, core strength, and even their breathing. We use an ultrasound to assess your child’s bladder and see if they could be withholding. We have video games that can be controlled by the pelvic floor muscles to work on strength, coordination, and overall awareness of what their body is doing.

But beyond the exercises and the technology at Peace PT, we provide one-on-one support to help guide you on this journey with toileting issues.  It can be frustrating, overwhelming, and isolating as a parent when your child has an issue with toileting, and you don’t know what to do.  So many of our parents tell us that we have been the only ones to truly listen and help them along the way.  At Peace PT, our goal is to help bring peace back to your life and bring peace to toileting.

If you are interested in learning more, please email to schedule a free 15-minute phone consultation with the “Pee and Poop PT” to discuss what is going on in your child’s life and how Peace PT can work with your family.

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