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Incontinence in Children

Children are not little adults when it comes to addressing continence concerns.  They require a different approach, and techniques to get them on track with improving continence.  The impact of incontinence can impact the child and the family hugely. Maybe school camp is coming, your child wants to have their first sleepover, or just wants to get through a day of school without wetting or pooping their pants, we are here to support the process, and avoid reoccurance.

We help your child to understand how the body works and where the pee comes from and were urine is made in the body.  Incontinence is not usually your child’s fault, but the good news is that your child can do something about it! It’s not your child’s fault but it is their responsibility to do something about it.

3-4% of children between the age of 4-12 years old present with enuresis (day time wetting) but it tends to be twice as common in girls (Lane and Robertson, 1997).  Two-thirds of day wetting children also wet the bed at night, and it is important to correct daytime wetting first.

Leaking urine in the day is considered a problem over the age of five years. Children usually feel the urge very suddenly and last minute and they may use a range of techniques to stop the flow of urine, including using the heel of the foot pressed up to stop the flow of urine.

Urinary infections need to be ruled out by the child’s GP. To manage this problem our Pelvic Floor Physiotherapist may request you to keep a drinking and voiding chart which measures the volumes of fluid going in and urine going out. Treatment involves addressing any constipation, education about fluid intake, good bladder, and bowel habits, bladder retraining and timed toileting. Our Physiotherapists will help guide you through treatment and answer questions you may have.

Conditions we treat

Normally the brain tells the bladder to squeeze, you nip off to the toilet, you pee and done!

In the night time, it is doing the same thing, but your child’s brain and your child are too busy sleeping.  There can be a number of different reasons for bedwetting. Through our assessments, we will tailor treatment once we have found the ‘why’.  Not all kids will grow out of it, so best to address it so it does not continue to cause the child and family stress.

Bedwetting is very common in children and can be effectively treated.  It affects approximately:

  • 15% of 5-year olds (about 4-5 children in a class of 30)
  • 5% of 10-year olds
  • 2% of 15-year olds
  • 1% of adults may still have occasional problems (Continence NZ)

The causes can be varied but it tends to run in families.  It can be caused by constipation, the bladder does not hold enough during the night, certain drinks, an overactive bladder or undeveloped waking response to the bladder signals.  If your child has been dry for 6 months and then starts to wet again, has daytime wetting, or is wetting over the age of 7, then you should seek help.

Treatment involves addressing any constipation, education about fluid intake, good bladder and bowel habits, daytime bladder retraining and daytime timed toileting, and if necessary a supported bed alarm program.

It is important to remember that bedwetting is not the child’s fault or caused by anything the parent or the child may have done or not done in the past.  This problem can be helped.

Urine (wee) is made in the kidneys and stored in the bladder, which is like a stretchy balloon.  When the bladder is full it sends a message to the brain telling
you that you need a wee.

An ‘over active bladder’ your bladder will try and empty before it is full, rather than waiting to fill properly before you get the message that you need to empty.

A child may have a problem with ‘frequency’ which means they feel like they need to wee very often or ‘urgency’ which means you get very little warning that you need to wee and have to dash to get to the toilet in time. Sometimes this message comes so strong, and fast, that wetting can happen before getting to the toilet.

It is a very common problem and affects lots of children over the age of 5 years (about 1-2 children in a class of 30). We need to figure out the cause, and therefore the best course of treatment required to help your child get dry.

Having poo accidents is not fun.  If a child is soiling, it may mean that they have been constipated for many months without anyone really knowing about it. The problem can be helped, but the treatment needs to be continued in the long term (12 months) to prevent relapse.  We can support you to talk about this problem.

Constipation for kids means they are not doing enough poo, the stools have become hard, difficult or painful to pass.

When a child gets constipated, the poo sits in the bottom, often forming a bigger blockage.  Eventually, softer poo from higher up can leak past the clog of poo in the bottom, causing soiling in the trousers.

Services related to kids continence

Addressing constipation in children

There are many simple self help measures that can be started to address constipation for a child.  We will help educate your child about how to improve fluid and fibre intake, how to sit on the toilet properly, for how long and when.  It is also important the child does not put off going to the toilet  when they need to poo.

Things like fear of sitting on a toilet, or sensory aversions around toileting can also be discussed and addressed.

Sometimes medication or fibre supplements are required to help with constipation and breaking down the poo stuck in the bottom.  We work closely with our trusted team of doctors and pharmacists to ensure your child is getting the best treatment .

Education about fluid and fibre intake, good bladder and bowel habits

Trying to get kids to drink water and eat vegetables can feel like an uphill battle!  Drinking adequate fluid helps to keep poo soft and easy to pass, as well as stretch the bladder so it holds the right amount so that child can hold urine through the day and the night. Drinking too much or too little of certain drinks can also irritate a bladder, which may increase wetting.

Eating vegetables helps to keep the poo the right consistency for passing easily, as well as a host of other health benefits for kids.

Learning how the bladder and bowel works helps kids to understand what a good pattern is.  Teaching children to pee and poo properly is of vital importance to a healthy, happy life, and can avoid many problems we see in adults.  We are on your child’s team to help develop normal and sustainable bladder and bowel habits that will last a lifetime.  No more using the toilet just because you are leaving the house!

Bladder retraining for kids
Daytime bladder retraining

Sometimes we see kids dance around instead of going to the toilet, with that fear of missing out on play time!

We can help your child learn how to get their bladder to stop from mis-behaving, and how to get it to be able to hold more urine.  We also work with our local GP’s if medication may be required to help relax the bladder.

We may request your child to do a drinking and voiding chart that measures every wee and drink over 2 days.  This helps us identify certain drinks and drinking patterns that may be making things worse, and also the capacity of the bladder.  We are then in a great position to be able to guide drinking and peeing, and develop good habits.  Guiding kids on how to sit properly (girls), and not to rush a pee can be very important steps to getting dry.

Supported bed alarm program for kids bedwetting
Supported bed alarm program

A bed alarm may be introduced after the child is  doing well with the simple self help measures to get dry such as drinking, good toilet habits, no constipation with regular bowel motions, and day time wetting has been addressed first.

The alarm helps the brain to recognise when the signals coming from the bladder say it is full, and the need to wake to empty the bladder.  As soon as the child starts to wet, the alarm sounds. The child wakes, turns the alarm on, then finishes the wee on the toilet. The child will need to change the PJ’s, and any wet bedding, reset the alarm again and go back to sleep.  Parents / caregivers may need to help facilitate the process to begin with.  It can take several months to get dry.  Once a child has been dry for 14 days, they can try without the alarm.

Book an appointment

Take the first step and book your appointment 60 minute appointment, which is always 1:1, and involves a treatment tailored to you exact needs.

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