Bladder and bowel problems are estimated to affect up to 28% of all children at any one time. Unfortunately, a large proportion of these children continue to suffer from incontinence into adulthood.
One way we can work to prevent this is through early intervention of childhood incontinence. Early diagnosis and treatment for incontinence are critical to avoid damage to a child’s kidney and bladder function. Talking about the problem early on can also prevent damage to social well-being later in life. Experts now assert that it is vital to provide your child with knowledge and understanding about how their body and bladder works. This can reassure them that their incontinence problems are not their fault and are something they cannot control.
Why is Preventing Adult Incontinence So Important?
There is a large amount of evidence suggesting that adolescents experience more severe incontinence than children. A cross-sectional study of 5-19-year olds found a greater proportion of frequent bed wetting, accompanied by daytime wetting and other lower urinary tract symptoms, in older (11-19years) compared with younger children (5-10). This can serve as evidence that frequent bed wetting with daytime LUTS, referred to as non-monosymptomatic nocturnal enuresis, is less likely to respond. Incontinence in adulthood can also have a heavy psychological impact. Adults have the responsibility of working and often providing for others, which can be slowed down or affected by severe incontinence. The anxiety incontinence adults face is likely due to the lack of independence and possible isolation. An adult’s self-esteem can be rapidly reduced by the disability to control the bladder or bowels. One study by Frida Olsson and Carina Bertero aimed to understand the experience of people living with incontinence. All informants admitted that their lives are “limited in one way or another” due to incontinence or bladder or bowel problems. It was also reported to have an impact on social life and even relationships.
When Should You Be Worried?
The National Association for Continence asserts that most children should have achieved urinary control during the night and day by the age of 6. If your child is aged 6 or older and is having problems with staying dry, it is recommended that you talk to a professional. Urologists are medical Doctors with specialist training and skills in problems related to the kidneys, bladder and genitalia. They can give your child a medical assessment and find the root cause of the incontinence. Remember that your child is not alone in having this problem, however getting the help from a professional is vital.
What to Look Out For
Problems such as incontinence are most frequently seen in children diagnosed with behavioural and neuropsychiatric disorders such as ADHD. However, there are many underlying health aspects that could cause your child to be incontinent. Ensure you look out for the following symptoms:
- Frequent trips to the bathroom. If you child urinates more than 8 times a day, this is a sign that they have an overactive bladder
- Infrequent urination. If your child visits the toilet only 2 times a day, this can be a sign that your child has a condition causing wetting
- Sitting with crossed legs or heel sitting. This can be sign of avoiding leaking urine
- Frequently wet underwear. Your child may try and hide the fact that they have leaked by not putting their underwear in the laundry. You might also notice them acting or looking embarrassed
- Not fully emptying the bladder during bathroom visits
- Wetting the bed 2 to 3 times a week over 3 months or more
- Continuing to wet the bed after at least 6 months of dry nights. This is called secondary nocturnal enuresis
- Visiting the toilet frequently during the night
Remember that bedwetting is normal in very young children (aged 5 or younger). Continuing to wet the bed at an older age should prompt you to seek help.
Preparing for a Medical Assessment
Most children with incontinence experience nocturnal enuresis or day and night-time incontinence. During a medical assessment, a professional should question both you and your child. Keeping a voiding diary can be useful, which determines a child’s voiding frequency. You can also include assessment of bowel function. Ensure that you have kept a record of familial disorders, neurological and congenital abnormalities. Take into consideration any previous infections or surgery that may be causing your child’s incontinence. You should also expect a professional to formally evaluate the child’s psycho social status and family situation. As R. Jim Nijman states, “although it is uncomfortable to talk about, factors such as child abuse are often signalled first by symptoms of bladder-sphincter dysfunction”.
With the help of proactive thinking, we can help prevent children developing adult incontinence whenever possible. Increased understanding of childhood incontinence during routine check ups is also needed to prevent incontinence.