Davina Richardson, RGN/RSCN Specialist Children’s Nurse at Bladder & Bowel UK, outlines the different continence problems children can have and what can be done to help. Find out why bedwetting and other associated continence problems happen and how you can help your child.
It is well known that older people and women who have had babies may become incontinent. However, if a child does not have control of their bladder or bowel, it is often thought that this must be due to a failure of their parents or carers to toilet train them properly, to laziness, or to disability. However, any child can have continence problems.
Children can wet or soil (poo themselves) for a variety of reasons:
There are different reasons why children struggle with toilet training. If a child has a disability or sensory difference, families are often advised to wait until the child appears ready to toilet train. However, these children often do not realise that they are meant to say when they are going to wee or poo, so it is assumed that they do not know and therefore are not ready to toilet train. Some children may not want to lose the convenience of their nappy. Some children may have a problem with their bladder or bowel that is affecting toilet training (see sections below). Many children only develop signs for toilet training when the process is actually started.
There is information on toilet training, including for children with disabilities, on the Bladder & Bowel UK website at http://www.bladderandboweluk.co.uk/children-young-people/children-resources/
The commonest problem in children is constipation. This may result in soiling (pooing in the underwear). It can be hard for adults to understand that children are not being lazy, rarely know when they have soiled and are not deliberately making a mess. If they are constipated, the soiling is outside their control. Constipation can be difficult to diagnose and treat in children and families are often unaware of it. Children with disabilities are even more prone to constipation than children who have typical development.
Constipation can cause day or night time wetting. Sometimes treating constipation makes daytime wetting or bedwetting go away.
There is information about constipation on the Bladder & Bowel UK website at: http://www.bladderandboweluk.co.uk/children-young-people/children-bowel/
Children can have problems with the amount their bladder is holding, or with their bladder not holding onto urine (wee) for long enough. This can cause children to have to get to the toilet quickly, or to not be able to get there soon enough. Sometimes children do not appear to notice they are wet, which can lead adults to think they are not bothered, or not trying to use the toilet properly. However, this is very rare and getting cross or punishing the child may make the problem worse.
Children may also have problems making too much urine at night and having difficulty waking up to bladder signals which results in bedwetting. None of these problems are caused by anything the family or child has or has not done and treatment is available.
There is more information about children’s bladder problems on the Bladder & Bowel UK website at: http://www.bladderandboweluk.co.uk/children-young-people/children-resources/
There are lots of options to improve continence in children who have difficulties. Many children will need individual support. In the first instance, this may be available from their GP, health visitor, school nurse or other healthcare professional. If necessary, they should be able to refer to either a local continence service or paediatrician who can offer further assessment and support. If your child has a problem with wetting or soiling in the day or at night them speak to their healthcare professional.
Bladder & Bowel UK also provide a confidential helpline service at email firstname.lastname@example.org or on telephone 0161 607 8219
Date of preparation: October 2019