Keeping your child’s bowels healthy

This page from Great Ormond Street Hospital (GOSH) explains how to keep your child’s bowels healthy, reducing the risk of constipation and other problems with pooing.

The digestive system is essentially a very long tube that stretched from the back of the mouth to the anus. When we eat, food passes down the oesophagus to the stomach, squeezed by regular contractions – this is called peristalsis. When the food reaches the stomach, it is broken down into a mushy liquid called chyme by acids and enzymes. The chyme then passes into the small bowel, which is about 2 metres (7 feet) long in newborn babies and grows to about 6 metres (20 feet) long by adulthood.

It is made up of three parts. The first section is called the duodenum which is connected to the stomach. The next section is the jejunum which makes up about one third of the entire length of the small bowel. The last and longest part of the small intestine is called the ileum which leads to the large bowel or colon.

The small intestine is where all the goodness from our food is absorbed into the bloodstream. The remainder that cannot be used passes into the colon, where water is absorbed to form solid faeces or poo. This passes out of the rectum and anus.

How often people go to the toilet to pass faeces varies – it can depend on what you eat and your bowel habits. There are lots of ways to encourage your child to have healthy bowels – here are some suggestions:

Help your child to get into a toilet routine – the most important thing is not to rush. There will be times of day when your child’s bowels will open – teach them to listen to their body and go to the toilet when they need to – holding in poo can cause problems. You might find keeping a bowel diary helpful – perhaps with small rewards when your child has a poo. The Bladder and Bowel Foundation produce one,

There are techniques your child can use to encourage their bowels to open – ask for a copy of the Rock and pop leaflet from ERIC – details at the end of this information sheet.

Get comfortable on the toilet – if your child’s feet can’t touch the floor when they are
sitting down, buy a small stool or step to raise their knees above hip level. Sitting in this position makes it easier to poo.

When your child has had a poo, teach them to wipe from front to back as this reduces the risk of germs in poo being transferred to the urethra and then into the urinary system. This is particularly important for girls as there is a shorter distance between the anus and urethra.

Try to avoid constipation as straining to have a poo can weaken the muscles supporting the bladder (pelvic floor muscles). If you are concerned about your child’s constipation, talk to your family doctor (GP) or local community pharmacist (chemist).

Fluids are vitally important in keeping healthy so encourage your child to drink plenty of liquid throughout the day – more if the weather is hot. It is better to drink small amounts of fluid frequently throughout the day rather than lots in one go when thirsty. Guidance from the National Institute for Health and Care Excellence (NICE) suggest the following amounts for children and young people.

• 7 to 12 months – 600ml
• 1 to 3 years – 900ml
• 4 to 8 years – 1200ml
• Boys aged 9 to 13 years – 1800ml
• Girls aged 9 to 13 years – 1600ml
• Boys aged 14 to 18 years – 2600ml
• Girls aged 14 to 18 years – 1800ml

Everyone benefits from eating a balanced diet so can easily introduce this to the entire family. Have a look at the Eat well plate and the proportions of each food group.
Teach your child to chew each mouthful well before swallowing – the chewing action stimulates the body to release the acids and enzymes needed to breakdown food in the stomach.

Some people find that having a probiotic drink or yoghurt helps to keep the ‘good bacteria’ in the colon well balanced.

Being active helps your bowels to stay active as well. The Government recommends that children and young people exercise for at least an hour a day. This does not have to be organised sports – just playing tag around a local park counts. If your child gets hot and bothered, remind them to drink plenty of fluid to replace what they lose through sweating.

When your child is learning to listen to their bowels, they may have the occasional accident. Try not to make too big a thing of it – this could lead to problems in the future.