Why is my child bloated? If you are looking for information and tips for how to fix bloating for your child, read on.
At Purple Mountain Physical Therapy we specialize in bladder and bowel rehabilitation for children and adults. Our licensed physical therapist is specifically trained in pediatric bladder and bowel development and many times children have bloating that is one symptom of their problem. We also work with adults who have bloating as well as urinary incontinence, pelvic pain or constipation. Our work with children is different because their developmental needs to improve bladder and bowel function are not the same as adults. If you would like to learn more about our pediatric bladder and bowel PT, or you’re asking “why is my child bloated?”, contact us here or call us at 616-516-4334.
Bloating is often a sign that there is dyssynergy or discoordination in the pelvic floor muscles. The digestive tract may have dysfunction, as well.
Digestion is a complex process that begins with chewing at the mouth, churning in the stomach, absorption of nutrients in the small intestine, final processing in the large intestine, sensing the urge to defecate in the rectum, and finally defecation at the anus. Dysfunction in any of these areas can impact function up and down the digestive tract and cause bloating. We help parents and children uncover potential contributions to your child’s bloating by assessing and treating many the many components of digestion and defecation that may be impaired. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Below we highlight a common reason why your child may be bloated.
What is pelvic floor dyssynergy or discoordination in the digestive system? And why might this be the cause of my child’s bloating?
Pelvic floor dyssynergia is a fancy way of saying that a person’s pelvic floor muscles, that should be holding in urine and stool and releasing urine and stool at the appropriate time, are uncoordinated. Symptoms of pelvic floor dyssynergia, in adults and children, can include a number of things, such as:
- Difficulty when having a bowel movement.
- Straining during a bowel movement
- Hemorrhoids or anal fissures
- Abdominal pain and bloating
- Cramping
- Incomplete emptying of the bowels
- Reduction in the sensation that we need to have a bowel movement.
How can the pelvic floor muscles become discoordinated? And could this be why my child is bloated?
Every person has a series of muscles and connective tissue that line the base of your bony pelvis. These muscles and connective tissues are called your “pelvic floor”. They support your bladder, rectum and other pelvic organs. If you would like to learn more about how our pediatric bladder and bowel PT helps kids who experience pelvic floor dysfunction, contact us here or call us at 616-516-4334.
The pelvic floor muscles:
- The pelvic floor muscles are postural muscles and they have slight activation at all times. In their postural role they ensure that we don’t unexpectedly leak urine or stool as we are going about our daily activities. The baseline activity built into these muscles renders them easy to develop issues with relaxing or lengthening when we need to urinate or defecate.
- The pelvic floor muscles should lift and squeeze by tightening or contracting to prevent urinary, fecal and flatulence incontinence. A child who experiences enuresis (urinary incontinence) or nocturnal enuresis (bedwetting) often has poor awareness of and control over these muscles.
- The pelvic floor muscles should be able to relax in a coordinated manner with relaxed breathing and anal sphincter opening when a person is attempting to have a bowel movement and to successfully eliminate stool from the rectum. When urinating, these same muscles relax to open up the urethra and allow for the bladder contraction to expel urine.
If the muscles cannot relax at the appropriate time, a person (whether child or adult) will have pelvic floor dyssynergia: a tightening of the pelvic floor muscles, instead of releasing. This is a particular type of pelvic floor dysfunction. Dyssynergia causes bloating, constipation straining or pushing during bowel movements or urinations. When this happens there is often incomplete emptying of stool and abdominal bloating. Often we find the children we treat who have enuresis (daytime unexpected loss of urine) or nocturnal enuresis (bedwetting), have underlying constipation and bloating, even if their bowel control isn’t a primary complaint. These children also may experience encopresis, which involves fecal incontinence occurring because stool has collected in the colon and rectum and ultimately they experience a “blow out.” Adults and children often tell us that they are not constipated because they have daily bowel movements. However, you can be constipated and still be having daily bowel movements. In this case, the movements may be incomplete, they may be old stool that’s coming out, they may be hard, they may be too large, they may cause abdominal bloating or cramping and they may cause pain with defecating. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
If your child has abdominal bloating, he or she may have trouble with these key features related to potty training and keeping their digestion and elimination optimal:
- Knowing when you are ready to have a bowel movement
- Passing stool through your rectum
- Completing a bowel movement
Bloated kids often do not correctly perceive the urge to defecate. Knowing when you need to have a bowel movement is a critical moment that children who struggle with urinary incontinence (enuresis), bedwetting (nocturnal enuresis) or constipation often cannot detect.
We work with your child to teach them how to listen and perceive the urge to defecate. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
- By using toilet practice activities, developmentally appropriate play-based games, exercises that teach them to coordinate their muscles and gentle hands-on abdominal massage, we are able to help your child understand and perceive their urge to defecate.
- We also work with getting buy-in from your child so they will make the good choice to stop the fun thing they are doing and to go to the toilet.
- For some children, having a bowel movement causes stress and anxiety and, therefore, they avoid it. If this is your child, we work with a positive and affirming method that helps ease your child’s toilet avoidance and fosters good habits with your child. We also practice being on the potty and teaching them how to listen to their body and no longer fear the toilet.
- We help kids who withhold poop. Many times kids are simply holding it in, creating a back-up of stool. We help these children stop this habit of holding in their poop. Our therapy is effective, developmentally appropriate and the kids return with pride at their progress.
Our pediatric bladder and bowel physical therapist helps support kids and parents who experience chronic constipation, including witholding stool or lack of perception that they need to defecate.
Parents are often frustrated by the repeated need for a bowel clean-out program at home. You will find our therapist can guide you and your child through an effective treatment program to resolve chronic constipation and promote potty training, healthy bladder habits and resolution of bloating. A child who withholds stool needs to learn the complicated neuromotor skills to better control their bladder and bowel. If you need an experienced and licensed PT who can help you and your child navigate the complexities of chronic constipation, contact us here or call us at 616-516-4334.
Passing stool through the rectum is a complicated moment that requires relaxing the pelvic floor and coordination with breathing, abdominal muscles and the urge to defecate.
Pelvic floor dyssynergia means that instead of relaxing, to open the gates and allow a stool to pass into the toilet, the muscles are tightening. This can be a painful condition that affects your child’s quality of life, contributes to potty training-avoidance and causes stress for the household. We will work with you and your child to determine if your child has pelvic floor dyssynergia. If they do, we use biofeedback, practicing on the toilet and gentle exercises to teach them and reward them for relaxing their muscles. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
The bloating can contribute to abdominal wall elongation and weakness, resulting in difficulty with other motor skill accomplishments.
We often find the children that we work with have underlying abdominal wall weakness that is affecting their motor development and capacity to complete a bowel movement effectively. This weakness may be related to the continual bloating that is lengthening the abdominals. So, if you are a parent and notice that other children can easily climb the monkey bars, for example, but your child struggles with abdominal bloating and achieving play based activities such as this, we can help you. Our pediatric bladder and bowel rehabilitation program will also work to strengthen your child’s core muscles and enhance motor planning and motor control. To get your questions answered about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Experiencing a complete bowel movement takes practice, patience and repetition
It is our goal that each day your child will learn how to fully empty their rectum. Some child get a portion of their stool out, then hop off of the toilet and declare success. This is not what we are trying to achieve. When you work with our licensed physical therapist, you and your child will begin to understand what it feels like to relax and complete a full bowel movement. We can even teach parents how to palpate their child’s abdomen to feel if there is stool remaining after a child thinks they’ve emptied fully. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
We provide a wide range of developmentally appropriate treatments for kids who have abdominal bloating and constipation.
These include things such as:
- Teaching your child how to correctly relax and tighten their pelvic floor muscles
- Practicing and teaching how to breathe effectively by getting the diaphragm engaged, the rib cage moving and the vocal folds properly working.
- Practicing chewing habits and educating you and your child on good choices for dietary intake, so that your child can be rewarded for demonstrating progress.
- Teaching your child how to identify the signals from their body that they need to defecate or urinate
- Practicing toileting strategies including the correct posture, breathing and techniques to relax the pelvic floor.
- Biofeedback to help your child learn how to control the abdominals, pelvic floor and other core muscles
- Gentle abdominal and visceral massage to promote intestinal motility. This is very helpful for kids who have a lot of backed-up stool. Often our children receive treatment and are able to complete a bowel movement either during and appointment or afterwards.
- Dietary suggestions for your and your child to optimize gut health and motility
- We practice chewing food and educate your child on the importance of chewing, because this helps digestion to begin.
Tip 1: Monitor your child’s fiber intake. Most kids are not eating enough.
If you are serious about figuring out why your child is bloating, knowing their daily fiber intake is important. Go easy increasing their fiber, because too much fiber, taken too soon will cause gas, discomfort and bloating.
The children we see often have a preferred diet that includes chicken nuggets, crackers, gold fish, cheese sticks and yogurt. None of these foods have much fiber and, in fact, the excess cheese consumption for their little bodies can be a direct cause of bloating and constipation. Bloating can occur after a significant increase in dietary fiber.Fiber, particularly soluble fiber, is a wonderful source of nutrients for the healthy gut bacteria in your child’s digestive tract. As your child’s gut bacteria digest fiber, the fiber ferments and gas is produced. If the microbiota in your child’s gut are not accustomed to digesting that type or amount of fiber, then excessive gas can build up. This contributes to bloating. If you would like to inquire about cost and availability of our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Add fiber into the diet gradually. To prevent excessive bloating, as you add fiber to your child’s diet, start with adding around 2 grams of fiber/day for 2 weeks and see how your child responds.
For example, if your child is currently getting about 8 grams of fiber/day, you would increase to 10 grams of fiber/day for two weeks to allow their gut time to adjust. Anytime you attempt to add more fiber, allow another 1-2 weeks for your child’s microbiota to respond adequately. If you increase too rapidly they will have bloating, gas and possible cramping.
Your child’s system should be able to handle progressively more fiber as the biodiversity in their gut improves. And, you will notice that bloating and constipation reduce.
Ultimately, a diet that is high in fiber and diverse in variety of foods is the most beneficial for your child’s overall health, in most cases. This ensures that your child is getting a variety of nutrients that they need to be strong and healthy from sources that are most bio-available. Bio-availability describes how well your digestive system is able to absorb and your body is able to use the nutrients that your child takes in. Supplements can be wonderful and critical to health, but in most cases your body is best able to absorb and use nutrients that are present naturally in food. To learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Tip 2: Keep good hydration!
Good hydration is essential as you increase fiber. The fiber needs to soak up water to help reduce bloating, constipation and dyssynergic defecation.
Fiber acts like a sponge in the gut, so it needs water to absorb to be most beneficial. Water is the best fluid for your child to drink. If your child is sweaty or active or you are having a hot day, you will need to increase water consumption.
How much water should my child drink? Here’s a general recommendation:
To be well hydrated, kids from 1-3 years old need about 4 cups of fluid/day, including water and milk. Kids 4-8 years old should drink about 5 cups/day, possibly more. Children over 8 years of age will need more fluid intake, 7-8 cups of water a day may be right. Our licensed PT who specializes in pediatric pelvic health can encourage your child to consume the proper amount of water. Sometimes it helps to have someone outside of the family, talking to your child and explaining to them, using motivational interviewing methods and developmentally appropriate language, how important something like drinking water can be to their health. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
How much fiber should my child eat? We look to the guidelines:
As you progressively increase fiber in your child’s diet, you may wonder how much fiber is enough? How much fiber is too much for a growing child? Fiber helps maintain bowel regularity. Fiber in the diet promotes gut motility, stool bulk, and stool softness. This ensures regularity, appropriate sensations or urges to have a bowel movement, and soft easy to pass stools. When a child is eating, it is also important that they fully chew their food. Our pediatric bladder and bowel PT wrote an article about the importance of chewing, as it relates to bladder and bowel control. You can read it here.
The American Heart Association recommends that children eat 14 grams of fiber for every 1,000 calories they eat.
The Institute of Medicine has the following guidelines: age 1-3: 19 grams, age 4-8: 25 grams, age 9+: 30 grams.
As you can see, there is a wide variation in the amount of fiber recommended for a child based on their age! Every kid is different and you and your family will have to determine what works best for your child. When trying to determine why your child is bloated, looking at dietary intake is a good place to begin. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Our suggestion is to begin increasing fiber gradually, with a goal of first meeting the lower-fiber recommendations of 14 grams/day, from the American Heart Association. If that goes well, continue to progressively increase fiber slowly.
Tip 3: You need to look at their stool to monitor its shape, consistency and whether it looks complete. Keep notes, they will help you figure out why your child is bloating.
Ideally, the stool will be soft and formed. They should have an easy time eliminating this stool, if it is painful or hard for them to get a soft and formed stool out, then this can be a sign of pelvic floor dysfunction. In particular, they may be tightening the muscles that need to relax.
A banana shape for stool is ideal. Stool that is a circle, small balls, hard or bumpy are signs of constipation. Loose stool that is liquidy can also signal constipation because the body is so determined to rid itself of the backed-up stool, it makes watery stools around the blockage. This is a sign of severe constipation and sometimes is called overflow diarrhea. If your child fluctuates between hard stools and loose stools, our pediatric bladder and bowel PT can help you; contact us here or call us at 616-516-4334.
Tip 4: Answering Yes to these questions is an indication that your child’s bloating and constipation are improving:
- Are they very regular with a consistent “pooping time” everyday?
- Are their stools soft, but formed and easy to pass?
- Does it take them less than 5 minutes to have a bowel movement?
- Is their abdominal bloating improving? Some parents measure their child’s abdominal circumference as a way to note progress.
- Is your child letting you know that they feel the urge to defecate?
If you answered “yes” to the above, then these are all signs your child is progressing towards healthier gut health and ability to complete a bowel movement.
If not, then you may want to continue to work on adjusting fiber intake and continue practicing what your pediatric pelvic physical therapist taught you, monitor their fluid intake. If you are not seeing any progress, it is always advised to speak with a member of your child’s healthcare team to further evaluate their toileting and what options may be available. We know it is difficult to figure out why your child is bloating. By partnering with licensed physical therapists who are specifically trained in pediatric bladder & bowel control, parents tell us their stress and worry eases. If you would like to learn more about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Tip 5: Troubles with potty training, even if it is isolated to urinary control, are often due to underlying constipation
If your child experiences difficulty with potty training, have you considered that constipation is also going on? So often parents tell us that their child is not constipated, but when we do a detailed inquiry, constipation is actually chronic. When children struggle with potty training, whether it is bowel control or bladder control, they would benefit from a skilled bladder and bowel physical therapist to help them improve this skill. Here at Purple Mountain PT, our care is holistic, trauma informed, developmentally appropriate and effective. We partner with kids and parents to discover and resolve the many underlying things that are often contributing to your child’s difficulty with potty training. If you are a parent who is worried or frustrated by toilet training setbacks, give us a call (616) 516-4334 to learn more about our program. You can also reach out to us here. Parents tell us that this PT eases their household stress and their child’s frustration.
Our best tip, which comes from other parents and clinical practice guidelines: See a qualified pediatric bladder physical therapist, sooner rather than later!
The reasons why your child is bloated are complex. We understand it takes more than eating fiber to resolve constipation, withholding, and a child’s lack of perception of the need to void. We’re here to help!
Kids also experience reductions in stress, withholding, fear of toileting, pain and anxiety related to bladder & bowel control.
Children who have difficulty with potty training and never doing this on purpose. They need expert support to learn the difficulty and complicated neuromotor control necessary to effectively control your bladder and bowel. Pediatric bladder and bowel physical therapy will improve toileting compliance, teach optimal bladder/bowel muscular coordination for the rest of their lives, and improve their core strength and coordination. Parents also need support from a professional. We have heard many stories from parents about how stressful it is to help their child’s daily bowel and bladder to function well. We know some of you experience negativity or outbursts when your child refuses to use the toilet. We are here to help. To ask questions about our pediatric bladder and bowel PT, contact us here or call us at 616-516-4334.
Here are other resources we have on Pediatric bladder and bowel:
*Why is my child’s poop so big?
*How much bedwetting is normal?
*Why does my child keep wetting their pants?
Purple Mountain Physical Therapy is a specialty pelvic health clinic located in Grand Rapids, MI. We offer specialized care to help children overcome bloating, constipation, enuresis, bedwetting, encopresis, pelvic floor dysfunction and bladder, bowel or pain related problems.
Many of our parents and pediatric patients come to us frustrated due to lack of urinary control, bedwetting or constipation. We have advanced training and experience helping children improve their bladder & bowel control using a combination of exercises, external treatments, biofeedback and play based therapy. Our pediatric PT helps children’s bladder and bowel control, potty training, bedwetting, core strength, diastasis recti abdominis, stool withholding, pelvic floor dyssynergia, encopresis and more.
We partner with parents to help you know how to best help your child. We also work with adults who have any pelvic floor problems, such as chronic pelvic pain, postpartum recovery, incontinence and dyssynergic defecation. If you may be interested in PT for your child’s bladder/bowel control call us at 616-516-4334. Alternatively, feel free to fill out this online inquiry and we will be in touch to see if we can help you. We offer telehealth visits, also, for parents and kids to receive expertise from the convenience of your home.
