Top Testers' Clinic with Dr Philippa Kaye: Overcoming poo anxiety and tips for post-natal weight loss

Q: "I'd love some advice to help a toddler with poo anxiety please. Following a bad bout of constipation, my little boy now stiffens his entire body when he needs to go. He’s currently prescribed lactulose, which softens his stools, but this doesn’t help his ability to relax his body to be able to go. He’s 20 months old and not quite ready for potty training as he doesn’t recognise at all when he needs to go." Jodie Leigh

A: "Constipation is unfortunately extremely common in both young children and adults. It can be uncomfortable and painful when you do go and, just like you describe, some children then hold onto their poo and find it difficult to relax and go to the toilet. At just over one and a half he is likely too young for potty training, but if he were older, often one sign of holding onto stool is that they don’t do it in the day on the toilet and wait for the night-time nappy to be put on.

"Try to ensure that he is getting enough fluids and fibre in his diet and keep up with the laxatives that he is given. If lactulose isn’t sufficient or working then there are alternatives that your doctor can prescribe. The aim is for the stool to be soft and easy to pass, and you may be advised to use the laxatives for a longer period of time to get things moving.

"We don’t want him to be sitting and straining to do a poo, but for it to be easy to pass. It can take time and support until he learns that it is ok for him to go. If you see him, for example, toddling off to a corner to go in his nappy, perhaps some distraction with a book might help him relax. A nice warm bath or even some gentle tummy rubs can also be helpful. If he is still struggling please see your GP." Dr Philippa Kaye

Post-natal weight loss

Q: "I’d love any tips to help ditch the mum weight please. I'm also experiencing numbness along my C-section scar and would like help to reduce the apron overhang if possible?" Katie Winfield

A: "Pregnancy involves a huge amount of change to your body, changes that took nine months to occur and somehow, society expects that you to ‘bounce back’ to exactly how you were before, within days of giving birth. This is not realistic and adds to the huge amount of stress and pressure that women are put under. You and your body have done an absolutely amazing thing – you grew an entire mini-human and are now looking after your baby. Be kind and look after yourself as well.

"There are two separate parts to your question. The first is around weight loss and the second is around the management of the C-section scar. Weight loss is actually often far more difficult than social media would have you believe, and if you are breastfeeding you actually need to increase your calorie intake in order to make milk. Weight loss takes time and while a healthy diet and exercise are vital, if you have obesity there are other treatments also available.

"With regards to your Caesarean section scar, numbness is often temporary and is related to the nerves in the skin being cut during the operation. Scars can remodel over a period of many months and the ‘apron’ or ‘overhang’ related to a C-section scar is often due to tethering of the scar itself, where the scar becomes stuck down to the tissues underneath.

"Mobilising the scar with massage is helpful to both prevent and treat this. Once you have healed from the surgery you can start to gently massage above and below the scar, moving the skin up and down around the area. Please ask your post-natal team when you can start to do this. In time you will be able to massage directly on the scar and more deeply in order to keep the scar mobile and hopefully prevent complications. A women’s health physiotherapist may be able to give you further advice." Dr Philippa Kaye

Please note: this advice is not personalised or meant to replace individual advice given to you about your child by your doctor or medical team. As always, if you are concerned about your child’s health then please seek medical advice.