Urinary Incontinence in Children and Teenagers
While most common in adults, urinary incontinence can also affect children. Commonly referred to as “bedwetting” at night and “accidents” during the day, these events usually disappear as the child grows up. During those potty-training weeks and months, it is very normal for accidents to happen. However when episodes are more frequent, it could be incontinence.
This article will explain some reasons that children experience incontinence, and inform parents how they can help, what treatments are available and what products can help in the process.
Bladder Overview
We’re not born potty-trained. An infant’s bladder fills to its capacity, then automatically contracts and empties. Oh- and then they cry to signal parents or caregivers to change the diaper! As the baby becomes a child, the nervous system begins to mature. The brain begins to get messages that the bladder is full, and the brain tells the bladder to hold on until child can make it to the bathroom. When there are failures in this control mechanism, incontinence can occur. There are many reasons for this, some simple and some a little more complex.
Why Incontinence Occurs in Children?
We do know that nighttime bedwetting affects boys more than girls, while girls have more daytime accidents. There are differing reasons between nighttime and daytime incontinence in children.
Nighttime Incontinence
Bedwetting or Enuresis is a problem that has been around forever. In a large majority of the cases there is no disease or abnormality that causes bedwetting. It is simply the brain does not wake up the enuretic with the normal message that the bladder is full, and needs to be emptied. The signal is present because we know the child obeys it and eliminates while awake. It is normally a case that the bedwetter is deep sleeper, and will sleep right through the subconscious signals. They then end up urinating in the bed, their pajamas, and have new load of guilt. If enuresis this goes unchecked it can plague far into the teens, and some into adulthood.
Enuresis affects 1 out of 6 children starting around the age of 5. This is when treatment should begin, because the self-curing starts to decrease afterward. Studies indicate that ˝ of bedwetters at age 5 will continue to do so through the age of 10 unless treated. In most cases the bedwetting habit is a result of deep sleep and the lack of reflex.
- Slower Development
Between the ages of five and ten, small bladder capacity mixed with more time sleeping can be the cause of nocturnal incontinence. Plus if development is slower, the body’s ‘alarm system’ may not yet be able to signal that the bladder is full. As the bladder grows and the ‘alarm system’ develops this problem will begin to disappear.
- Excessive Output of Urine During Sleep
It’s amazing how the human body can work. We actually produce a hormone that can slow the making of urine at night (ADH). Sometimes the body may not be making enough ADH, which can cause the bladder to overflow. The child may very well not sense this and not know to wake up, thus wetting occurs.
When children experience anxiety-causing events between ages two and four, incontinence could occur. Once the child has reached age four and is dry, the problem could occur again at the onset of more anxiety. Some examples are angry parents/guardians, new and unfamiliar social situations (starting preschool or daycare) or overwhelming family events like a new brother or sister or divorce. It is almost a vicious cycle in a way because incontinence itself can cause anxiety.
If both parents were bedwetters their child has an 80% chance of also becoming one. A 1995 Danish study actually found a link on human chromosome 13 that is responsible for bedwetting. Other experts say there are likely to be more genes that could cause incontinence.
Your child’s incontinence could by a symptom of a sleeping disorder. Obstructive sleep apnea is a breathing/sleeping disorder where breathing is interrupted during sleep, usually due to enlarged tonsils. If you think your child may have this rather than just going through a bedwetting stage, look out for other symptoms such as snoring, breathing through the mouth, choking and daytime drowsiness.
While not very common, nighttime incontinence could be caused by physical problems in your child’s urinary tract. If the bladder or urethra is blocked, it could cause the bladder to overfill at night. Nerve damage from birth defects (like spina bifida) can also cause incontinence.
Daytime Incontinence
Many of the same factors of nighttime incontinence can cause it during the day as well. Here are two additional causes.
Infrequent Urination
Kids like to play. Kids may also not want to use the facilties at school or daycare. This could lead to holding in urine for prolonged periods of time. After a while, the bladder muscles will contract causing leaking, or even wetting their pants. Hold in urine for excessive periods can also lead to further problems such as a urinary tract infection. The best thing to do to prevent this is to encourage your child to use the bathroom when they have to go, even if it means interrupting a game, television show or asking the teacher for permission.
As a result of a UTI, the bladder can contract without warning, which does not give the urethra time to use its muscles to the urine in. This can result in leakage.
Children with Medical Conditions
Sometimes bedwetting is not caused by any of the problems listed above. Instead, it is a result of a medical condition. In this case, incontinence becomes part of the child’s lifestyle. And when this is the case, there are plenty of support and products available to help the child cope and grow up learning how to be independent. The Mentor Corporation has a wonderful guide called Teens Who Self-Cath for this purpose. Please contact us for information on this.
Living with Incontinence
As stated above, unless there is a medical concern, your child should grow out of his or her incontinence. But, there may not be a bigger issue among today’s youth than self-esteem. So, there are many things you can do to cope with this physically and mentally.
- External Catheters- can be comfortably worn to help prevent leaks. This would be ideal for kids who suffer from daytime incontinence.
- Bladder Training- there are exercises that can be performed that can strengthen the bladder and urethra muscles. Along with this, children should find out what their own capacity is and how often they have to go.
- Scheduled “Potty Time”- if your child has a problem during they day, you can set up times for them to use the bathroom at school. Perhaps, if you feel comfortable, the teacher could also help with this. Also, simply making sure your child uses the bathroom before bed can help make sure the bladder is empty before bedtime. This process goes along with bladder training.
- Medications- there are medications that can increase the levels of ADH at night. There are others available that can help control the bladder muscles.
For general information, visit our FAQ. Also, you can visit our Resources page for some helpful links for more information.
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