Incontinence is the medical term for when you suddenly lose control of your bladder. This can happen during the day or at night. When daytime incontinence is left untreated for a long time, it can cause other health problems. If your child is dealing with daytime urinary incontinence, see below how you can manage this problem.
Method 1 of 5: How the bladder works
Step 1. Understand how the bladder works
The bladder is essentially a muscle sac for storing urine. Typically, the muscles in your bladder can remain relaxed and expand to accept urine for several hours (which is good, because otherwise you will be using the toilet all day).
- The muscle that forms the bladder sac is called the detrusor muscle and is also responsible for emptying the bladder.
- Another major muscle in the bladder is the sphincter. It is a ring of muscle that surrounds the outlet through which urine exits. There are actually two sphincters: one is involuntary (you did not know about it), and the other is under control (voluntary). The latter is a muscle that you can hold onto your urine with until you go to the toilet.
Step 2. Learn bladder control
There are nerves in your body that make your bladder feel full. This is an early warning system that the bladder is ready to empty. When you urinate, the nerves on the detrusor muscle signal contraction, and at the same time, the nerves of the involuntary sphincter force it to relax. All you need in this case to free your voluntary sphincter is to allow yourself to release urine.
- Children about two years of age have a feeling of having to empty their bladder. This allows them to express the need to go to the toilet.
- After about a year, they develop the ability to hold back until they can get to the toilet.
Step 3. You must be aware of what can go wrong when the child learns to hold back
While most children develop the ability to "hold" their urine and go to the toilet when they can, sometimes problems arise that can undermine the child's ability to control their bladder. Such problems may include:
- A bladder that cannot store the usual amount of urine.
- An organism that produces more urine than is normal.
- Irritation of the bladder from infections or other irritants of the bladder.
- Excessive patience (or holding urine for too long).
- Chronic constipation.
Step 4. Some myths about incontinence need to be debunked
If your child has been incontinent for a long period of time, this is most likely due to a lot of problems and is simply too lazy to get to the toilet. Many parents tend to think that daytime incontinence is the cause of laziness, but it's important to keep in mind that there may be other reasons as well. Common thoughts that parents have, should probably be cleared away after reading this article:
- Children who are simply too lazy to go to the toilet.
- Children who urinate are too busy playing or watching TV.
- Children who urinate do not want to go to the toilet and urinate on purpose.
- Children who urinate try to wait until the last minute.
- The phlegm does not bother them too much.
Method 2 of 5: Parenting Problems
Step 1. Consider the problem of filling the bladder
Filling occurs when the bladder is unable or unable to receive a normal volume of urine. Think of filling as an umbrella for the most common causes of incontinence. Reasons for filling include:
- When your baby just has a small bubble size (in the first place).
- When the bladder receives unexpected and premature nerve signals to empty.
- When there is something in the bladder area that prevents the bladder from filling up completely (this is when the child is constipated).
- When something causes bladder irritation (most commonly a urinary tract infection), it can also lead to unexpected contractions.
Step 2. Look for signs of a filled bladder in your child
Signs that your child has a problem with fullness include:
- Your child runs to the bathroom, shifts from foot to foot, fidgets or rolls on the floor because it is difficult for him to sit (the latter symptom is so common that it has its own name - Vincent's curtsy).
- If you ask the child, he admits that he "lets" in his pants a little while he goes to the toilet.
- There is a variability in the volume of urine. Many children also admit that sometimes they run to the toilet just to release a small amount of urine, even though they feel like they want to go to the toilet.
Step 3. You should be aware that overfilling of the bladder can be caused by infections
Urinary tract infections (UTIs) are most common in primary school girls. A UTI can cause urinary incontinence as well as frequent urination and pain in the lower abdomen. UTIs can be treated with antibiotics.
Some children who have frequent UTIs often have a condition called asymptomatic bacteriuria. These are most often girls who have bacteria in their bladder (similar to those that can live comfortably on our skin). An increase in these bacteria in the urine can sometimes be the cause of frequent UTIs
Step 4. Remember that incontinence can be caused by constipation
With large volumes of stool that does not leave the body, the space for the bladder may decrease. This prevents the walls from expanding and causes unpredictable contractions, which leads to urinary incontinence.
Constipation is infrequent bowel movements (3 days or more), hard stools, too much stool ("I can't believe it came out of him"), or pain in the intestines on movement
Step 5. Understand that some children have a difficult time going through the “urge to go to the bathroom” phase
Some children, when they grow up, find it horrible that they suddenly (without warning) have to go to the toilet. This underdeveloped management, resulting in incontinence, often resolves over time as the child matures.
It can also be a symptom of a small bladder. There are some medications that can actually increase the retention of the bladder. You should talk to your doctor about options for dealing with a small bladder
Step 6. Be aware that an oversized bladder can also lead to incontinence
This is a less common condition that can lead to incontinence. This happens when the bladder is unable to release urine or is releasing too much of it due to its large size. Symptoms of an abnormally large bladder capacity include:
- The release of large volumes of urine often throughout the day. This can happen if the kidneys are producing huge volumes of urine. You should bring your child to the doctor if you notice that the child is releasing a ton of urine every time he goes to the toilet.
- Infrequent urination (less than 2 or 3 times a day). This could be a sign of a spinal nerve problem, such as spina bifida, or cerebral palsy, but if the child does not have these problems, it is unlikely that this is the cause of urinary incontinence.
Step 7. Be aware that holding urine for too long or, on the contrary, going to the toilet too often, can lead to overflow of the bladder
The bladder may enlarge if the child is a chronic holder of urine (which means that he avoids going to the toilet even if he really wants to). When this happens for a long time, the muscles associated with urination become "more trained", which means that the muscles relax poorly, leading to bladder dysfunction, like incontinence.
Method 3 of 5: Treating Urinary Incontinence
Step 1. Consider therapies to help your child with urinary incontinence
Most experts today advocate the use of drugs as the first line of therapy for nearly all types of daytime incontinence. Behavior modification is a method of re-learning skills such as bladder control. The therapy must be done very consistently to get the desired results (for example, your child is able to control his bladder). Child psychologists can give good advice on how to go about creating a schedule.
Behavior modification therapy works best in children over five to six years of age. This is because young children usually lack the self-discipline to adhere to a therapy schedule. However, each child must be analyzed on a case-by-case basis
Step 2. Create a chart for a child with urinary bladder incontinence
When your child goes to the bathroom in the morning, you start to have a strict urination schedule. Usually, parents need to urinate every two hours. Your child has to go to the bathroom every two hours, even if he says he doesn't want to. That is, in fact, he must go to the toilet before receiving the signal to urinate.
If you are expecting a spasm of the bladder, you are reinforcing the lack of control. If your child tries to go to the bathroom for nothing, or even only a little, he or she increases urinary control
Step 3. Create a graph for a child with a more filled bladder
Due to large bladder volumes, irregular urination, or frequent incomplete emptying, you need to create the same schedule (where your child tries to urinate every two hours) with the addition of steps. Your child should wait 4-5 minutes after going to the toilet and then try going to the toilet again (this is called double urination) in an attempt to reduce this lingering bladder volume. The goal is to change your urinary habits and allow the bladder to carry out a more normal volume of urine.
Step 4. Use the alarm to help your child remember to go to the bathroom because it can be hard to remember to do it every two hours
Therefore, it is important to create an alarm system. When your child is at home or somewhere with his grandmother, set an alarm that will ring every two hours. You can set a similar alarm on your smartphone or alarm clock.
You can also wear a watch that chimes or vibrates silently every two hours, as a reminder when at school
Step 5. Increase the time to urinate after 4 to 6 weeks
Typically, you will see improvement during this time. However, this does not mean that you should stop using the schedule. What you can do is extend the time it takes for your child to go to the toilet. Now let it be 3 - 4 hours, and not 1 - 2 as before.
Method 4 of 5: Treating a urinary tract infection
Step 1. Minimize irritation
Many children, especially girls, with a UTI will experience irritation in the inflamed urethra and vaginal opening. You can use certain creams to help relieve irritation. In particular, you can use a zinc barrier cream or ointment (Desitin or triple paste).
You can purchase these creams at your nearest pharmacy. Follow the directions on the cream bottle or box
Step 2. Change your child's clothes when they get damp
The bacteria that the UTI creates thrive in wet areas. When your child experiences incontinence and a small amount of urine leaks onto clothing, it is important to change into dry clothing to help heal and prevent the infection from recurring.
You can explain to your child to do it himself, or ask him to tell you when it happens so you can help change clothes
Step 3. Treat recurring urinary tract infections with low doses of antibiotics
If your child is prone to recurrent UTIs, you should talk to your doctor about which antibiotics are best for you. Your child's doctor will be able to tell you if they are right for your child.
The most common antibiotics used for prophylaxis are the sulfur-containing nitrofurantoin and trimethoprim. They are usually taken once (at bedtime) about ¼ of the usual dose for a full treatment
Method 5 of 5: Treat constipation
Step 1. The doctor should find out how much stool is in the child's body
This can be done using X-rays or by physical examination. Knowing for sure if your child is constipated can help them overcome their incontinence problems.
Step 2. Ask your child to drink plenty of fluids throughout the day
Many children with incontinence problems tend not to drink a lot of fluids, which in fact makes their constipation worse. Try to get your child to drink at least 8 glasses of water every day to stay hydrated.
If your child doesn't like drinking plain water, you can give fruit juices, milk, and sports drinks
Step 3. Increase the fiber in your child's diet, which will help fight constipation
Fiber is one of the best ways to make your bowels work properly. There are many foods that are high in fiber. Try to introduce some (or all) of these into your child's diet. These products include:
- Fresh fruits and vegetables, including raspberries, blueberries, green peas, spinach, kale, pumpkin, kale, and broccoli (among many others).
- Whole grain bread (at least 3 to 4 gm of fiber per serving).
- Cereals that are high in fiber (raisin bran, fiber, chopped wheat, all bran)
- Beans, including black beans, lima beans, chickpeas, and spotted beans. Lentils are high in fiber.
Step 4. Give the child a laxative
Adding fiber-rich foods to your meals probably won't be enough. Because of this, you should also try to give your child a safe laxative. Propylene glycol (MiraLax) is often used as a safe drug. MiraLax causes water to be transported into the intestines, thereby softening the stool and improving its movement.
You can talk to your doctor about the dose. Most children are prescribed ½ cap to 2 caps a day, and this dose can be adjusted as needed
Some children complain about the sudden need to go to the toilet after drinking citrus fruits or sodas. While there is no research to prove this to be true, you may want to avoid giving your child these drinks
- To better understand how your child is feeling, take him or her to a pediatrician who can help you get to the bottom of incontinence.
- While oxybutynin (Ditropan) was often used to treat urinary incontinence in the past, it fell out of favor with most doctors due to side effects.
- Talk to your doctor if your child's pelvic muscles are "overtrained." The therapist will work with your child and teach you how to relax the muscles so that he can go to the toilet comfortably.