“He holds it in, Doc. He goes off by himself in a corner and you can see him cold-sweating and straining to keep it in.” These are typical statements of parents whose children are constipated. This is the opposite of the verbal diarrhoea characteristic of politicians who do not “hold it in” and certainly never go off by themselves. With elections in the air, yesterday’s budget should be a good example of “not holding it in.” Already we have been told that “poor” newborn babies will be given a grant of $500 a month for the first year of life. That should last until elections. How “poor” is to be defined remains to be seen. Anyway this grant will keep mothers dependent and stop them from breastfeeding.
Most children who are constipated are between the ages of three and four and all of them would have appeared to the untrained eye to be normal, healthy kids until they began to be potty-trained.
In reality a majority have probably been taught by their parents to believe they are the centre of the world and that their every wish is the law. Quite the little politician, really. Spoilt is the overused word. In the overwhelming majority of cases, these children start potty training before they are ready. Potty training! Training is defined as “to teach (a person or an animal) a skill or type of behaviour through regular practice and instruction”—a word better suited to the military mind or to making animals do tricks. Most of the time parents start to train their babies because they want to put them into a nursery and the nursery insists that the children be potty-trained. Since it has become fashionable in Trinidad over the last 20 years to put children into nurseries at the age of one or two, we have people trying to teach children to control their bladders and their bowels before they are that old. Many of these children develop serious constipation of the sort described above.
This is a not-unexpected reaction. Some children react strongly to being pressured, before they are physiologically or emotionally ready, for bowel control. They initially respond by trying to please their parents and may even appear to be in control of their bowels. After all, it’s quite possible to train a parrot to talk. In the same way it’s possible to train a one-or two-year-old to sit on a potty and defecate. It’s a new game. The children have no understanding of what they are doing. It’s fun and everybody is pleased. The child is congratulated and rewarded. Too much rewarding can be a setup for trouble in children. After the first flush of victory, the parents decrease their congratulations and the child soon realises that the fun is over. Everyone expects her to continue doing this thing. Since this is the classical age of independence and selfishness (“the terrible twos”) the child reacts by holding onto its stools. A couple of days go by, the household is pressuring the child to be “nice” and “do too-too.” Attention is once more being focused on the child. “This is lovely, I won’t go off.”
After a week, the water in the original stool has been absorbed and what you have there is a little piece of rock which the child now passes with great difficulty and discomfort. This consolidates the child’s decision not to have a bowel movement. A vicious cycle is about to be set up: hold in...hard stools...discomfort...refusal…hold in, etc. If this cycle is not interrupted quickly it will become very difficult to break. A variant of this scenario is the child who, after initial success in the potty-training stakes, refuses to go to the potty and insists on doing his “thing” in the diapers. Some of these children are four and five years old. The background is invariably the same: too-early bowel training, either because of social pressure or because of the mistaken belief that early or first in children means the best.
In fact children, like adults, are all different. Some children may be ready to learn to control their bowels at age two. The majority become ready some time between two and three years old. During this year the child’s rectum becomes anatomically capable of holding a larger volume of stool. At the same time the child’s brain becomes capable of understanding the social need for not defecating in public. The combination of both these things as well as the child’s innate need to try to become like mummy or daddy makes it easy to teach, not train, a child to control its bowels without any stress, punishment or rewards. Just a normal day-to-day thing. It is when the child begins to show interest in the toilet, in what the parents or brothers and sisters are doing, that the moment should be seized and gentle encouragement given. In this way, without any sweat, you will find that your child has been “toilet trained.” Now if we could only do the same thing with some “money training” for politicians.
