NVFP Presents:

What to Do When Your Kid Can’t Poop (Or Hold It In!) 

Pediatric Bowel and Bladder Challenges and Toilet Training Readiness With Physical Therapist, Dr. Amy O’Malley

Continence is a developmental skill, which is achieved by children through a combination of factors, such as neuromuscular, musculoskeletal, cognitive, and sensory skills. If there is a disruption in continence, there may be disruptions in or more of these systems.

Join Dr. Cecily Havert, Dr. Maria Castillo-Catoni, and Physical Therapist, Dr. Amy O’Malley as they review statistics, clarify what “the pumping station” is, explain the “Soda Can Model of Respiration”, typical bowel/bladder function and expectations, and more.

Event Highlights:

  • 0:12 – 3:27 – Dr. Maria Castillo-Catoni introduces her co-host, Dr. Cecily Havert, as well as their special guest, Dr. Amy O’Malley. Dr. Havert then provides background on her relationship with Dr. O’Malley, as well as a short biography of Dr. O’Malley.
  • 3:30 – 8:50 – As Dr. O’Malley states – “Unfortunately, bowel and bladder issues in children are pretty prevalent and they have been prevalent for a while. They have been increasing in prevalence and they have increased triple folds since the Covid pandemic.” Dr. O’Malley introduces her topic and then discusses the number one issue with pediatric incontinence.
  • 8:53 – 11:30 – “When we talk about constipation, we’re talking about any age, even with infants – I would rather meet infants that are not pooping more than once or twice a week while they are infants, so it doesn’t develop into a toddler and older issue.” Dr. O’Malley discusses chronic constipation and infrequent bowel movements.
  • 11:33 – 17:30 – Dr. O’Malley introduces the term “encopresis,” or involuntary repeated passing of stool into clothing. She then provides information on encopresis, including how it happens, statistics, and more. She then shares how this affects the bladder and multiple other bladder complications.
  • 17:45 –30:36 – “We start with my favorite new phrase, which is, constipation is the root of all evil and most toilet challenges – You’ve got to clear constipation before you can do anything else.” Dr. O’Malley shares how constipation happens, what happens to our bodies when we are constipated, and how to clear constipation.
  • 31:32 – 36:44 – “How are you sitting on the toilet? Is it the right size? Are you able to use the muscle patterns necessary?” Dr. O’Malley discusses why proper toilet positioning and posture are extremely important to continence.
  • 36:50 – 42:10 – The providers talk about the “soda can model of respiration.” Dr. O’Malley states this is where she finds most of her posture deviations, which means the pumping station structure is not supporting the pelvic floor.
  • 42:25 – 54:22 – How do I know if my child is ready to begin potty training? What does proper toilet posture look like? The providers discuss.
  • 54:50 – 59:09 – “So once we get constipation clear, then we work on bladder retraining because that’s overstretched as much as anything else and not feeling its signals.” Dr. O’Malley shares the correlation between encopresis and bedwetting, and the approaches she takes for both.
  • 59:30 – 105:12 – The panel answers questions from attendees, and then Dr. Havert closes the town hall event by thanking Dr. O’Malley for her time.
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