When it comes to potty training, most of us think about timing, consistency, and praise. But one factor that’s often overlooked is toilet posture, how your child actually sits on the potty or toilet. Continence specialists increasingly recognise that good toilet posture can make it easier and more comfortable for children to fully empty their bowels and develop healthy toileting habits. Poor posture can even contribute to constipation, and because a backed-up bowel can press on the bladder, this sometimes links directly to bedwetting.
Research has consistently shown a strong link between constipation and bladder problems in children, with many children who experience chronic constipation also experiencing daytime wetting or bedwetting. Continence experts now consider bowel health to be one of the first things to assess when a child is struggling with persistent bedwetting. Sometimes it can seem like your child is pooing regularly, but they may not be completely emptying their bowels. Toilet posture is just one of several factors that can contribute to incomplete emptying, alongside hydration, diet, routine, and withholding behaviours. Before treating your child’s bedwetting, it’s worth making sure constipation isn’t playing a role. A buildup of poo in the bowel can put pressure on the bladder, reducing its capacity and triggering accidents.
The good news is that the right potty posture can support healthy bowel movements, ease constipation, and in turn, help reduce accidents. Here we’ll dive into why potty posture matters, the role of the puborectalis muscle, and how you can set your child up for success during this big developmental milestone.
Why Toilet Position Matters
Toilet training is not just about learning when and where to go, it should also be about learning how to go. However, this topic is often missed and never really taught or thought about, even for adults. The body tends to empty the bowels more efficiently when the hips are flexed and the knees are slightly higher than the hips a position that mimics a natural squat. Standard adult toilets, and even some potties, don't always support this posture for small children.
If your child is sitting awkwardly, with dangling legs or hunched posture, it can make it harder for them to fully relax, which can lead to straining, incomplete emptying, or even constipation. Over time, this can create negative associations with using the potty as well as positional health concerns. What’s more, constipation doesn’t just affect the bowels, it can also place extra pressure on the bladder, which is one of the common links between constipation and bedwetting.
The Puborectalis Muscle
To understand why position matters, we need to understand the importance and role of the puborectalis muscle. This muscle acts like a sling around the rectum. Its role is to maintain a bend, an angle called the anorectal angle, between the rectum and the anal canal. If you imagine a garden hose pipe with a slight kink in it, that's a bit like how the puborectalis muscle works. It helps keep stool in the rectum until the body is ready to empty the bowels.
In different positions the muscle contracts or relaxes. For instance, when standing or sitting upright, the puborectalis pulls the rectum forward, keeping the “kink” in place. This helps with continence, making sure poo doesn’t come out at the wrong time.
Although, when in a squatting position or leaning forward, the puborectalis muscle relaxes and the angle straightens, making it much easier for stool to pass without straining. Which explains why some people find that using a footstool or leaning forward makes pooping more comfortable. This position mimics the natural squat position and allows the puborectalis muscle to do its job in releasing the poop more comfortably.
But it’s not only the bowel that benefits. When stool builds up in the rectum due to constipation, it can put pressure on the bladder that sits just in front of it. This pressure reduces bladder capacity and can trigger urgency, frequency, or even bedwetting. By helping your child adopt the right toilet position, you not only make it easier for the puborectalis muscle to release stool effectively, but you also reduce the likelihood of constipation related bladder problems.
Toilet Position Tips for Potty Training Success
Getting toilet position right during potty training can make the process easier and more comfortable for your child. Here’s how:
1. Support the Feet
Children should never have their legs dangling when they’re on the potty or toilet. Dangling legs mean they can’t push effectively. If using a potty, make sure it’s low enough for your child’s feet to be flat on the floor. Or alternatively, if using the family toilet, use a small step stool so your child’s feet are supported.
2. Knees Above Hips
Aim for a position where the knees are slightly higher than the hips. This mimics the natural squat position and helps relax the puborectalis muscle.
3. Lean Forward
Encourage your child to lean forward slightly, resting their elbows on their knees if they like. This posture helps open up the angle of the rectum, making it easier for poo to move through.
4. Relaxation is Key
Encourage your child to take their time. Reading a short story, singing a favourite song, or simply chatting together can help them relax without making toilet time feel pressured.
5. Don’t Rush
Ideally, encourage your child to sit comfortably for around 3 to 5 minutes without feeling rushed. This gives the bowel time to empty properly without turning toilet time into a chore.
6. Use a Toilet Insert if Needed
Until your child’s bottom is big enough, use a toilet insert to reduce the hole down to a child’s size. This provides comfort, security, and helps them feel more stable when sitting.
Signs That Potty Position May Be a Problem
If your child is struggling with going to the toilet, consider whether posture could be contributing. Some signs can include:
- Straining or pushing hard to poo
- Complaints of tummy pain or discomfort during toilet time
- Withholding poo because it feels uncomfortable
- Frequent constipation or very hard stools
- Standing on tiptoes, crossing legs, or hiding when they need a poo (common signs of withholding).
Further Advice and Support
If your child struggles with constipation alongside bedwetting, there are additional steps you can take beyond the basics of water and fibre. Dr. Kiley Gibbs explains the importance of potty posture in one of our YouTube videos, showing how positioning can ease constipation and improve bowel habits. Sometimes, constipation and bedwetting are closely linked when the bowel is backed up, it can press on the bladder and trigger nighttime accidents. If constipation persists despite simple changes to posture, hydration, diet, and routine, it's worth speaking to your GP or health visitor. They can assess whether your child may benefit from additional support or treatment and help rule out any underlying causes.
Waterproof Bed Sheets
Even with healthy toilet habits and great potty posture, nighttime accidents are a completely normal part of many children's development. Having simple, practical backup in place can help take the pressure off both you and your child while they build confidence. That’s where our waterproof bed sheets come in. Made from soft, durable, and fully waterproof material, they protect mattresses from leaks, bedwetting, or unexpected accidents, giving both parents and children peace of mind. Easy to clean and gentle on sensitive skin, these sheets make nighttime accidents less stressful and help your little one wake up comfortable and dry, so potty training and healthy habits don’t have to mean sleepless nights for anyone.
Building Healthy Habits for Life
Potty training is a big milestone for both parents and children. While patience, routine, and encouragement are essential, don’t underestimate the role of toilet position. By supporting your child’s feet, encouraging knees-above-hips, and allowing them to lean forward, you’re helping the puborectalis muscle do its job properly and making pooping as stress-free as possible.
Even if your child seems to poo regularly, poor posture can mean they aren’t fully emptying, which leads to a backed-up bowel pressing on the bladder. By improving toilet posture and supporting healthy bowel habits, you’re not only making potty training smoother but also helping reduce the chance of nighttime accidents.
