After toilet training your child at a very young age, it can seem shocking and confusing when they become incontinent later in life.
The practical and social problems of coping with incontinent children is largely dependent upon the age of the child. Incontinence becomes less and less socially acceptable with age. If your child is younger than 5, you should not worry about incontinence during the night, as most young children do grow out of wetting the bed. However, once a child is aged 7 or older and wets the bed more than two or three times in a week, this should be a cause for concern. As David Wilkin states, “mothers of younger children tend not to identify it as a major problem. However, for the families of older children, life inside and outside the home often revolves around the problems of changing nappies, washing, getting rid of smells and finding toilets”.
Difficulties associated with continence management can also be dependent on the child’s ability to communicate. One mother who takes care of her disabled son claims “his not understanding us is the worst thing. You don’t know what he wants from us or what he is trying to tell us”. Mothers of younger children and older children who are ambulant however do not perceive physical care as such a problem. Taking care of a child with incontinence can not only create a financial burden, but can interrupt the routine of everyday life. This can mean a lot of time and attention is spent purely on trying to understand incontinence and how it affects the child. Being incontinent means a child does not make the expected progression towards independence. Williams (1996) interviewed 2,962 children from primary schools in Sheffield, and found a substantial association between bedwetting and bullying. The educational system does play an important role in children’s upbringing, however, most children of school age spend only one-seventh of their lives in school. The responsibility borne by parents for the child’s welfare far outweighs that borne by the school environment.
When it comes to treating your child, it is important to first understand which type of incontinence they are suffering from. If your child leaks frequently throughout the night, they have Nocturnal Enuresis. This is the most common type of urinary incontinence in children over 5 years of age. This kind of incontinence is often the result of nonorganic factors such as development issues, overproduction of urine and an inability to respond to physiological signals. If your child has good daytime bladder control but has never had a dry night, they are suffering from Primary Enuresis. Diurnal Enuresis, on the other hand, is when children have accidents during waking hours. Daytime wetting is more likely than bed-wetting to occur after a child has had bladder control for at least 6 months to a year. This pattern of wetting is usually related to a medical condition, such as an infection or defect in the urinary tract. It can also be caused by emotional stress. If this condition occurs after a child has had consistent bladder control, consider the possibility that stress could be the cause. Secondary enuresis is incontinence in an individual who has been dry for at least six months and then develops symptoms after that period.
Managing Daytime Incontinence
Children will often gain control over daytime wetting sooner than nighttime wetting. Treatment for daytime wetting that is not caused by a serious condition can include over-the-counter medicine, surgery or counselling. You can also try physical therapy and intervention of lower urinary tract rehabilitation to treat daytime wetting. A study in 2008 followed an 8-year-old girl who had daytime urinary incontinence and was referred for physical therapy with a diagnosis of pelvic floor muscle hypertonus and dysfunctional voiding. The intervention included age-appropriate education, biofeedback, behavioural modification and performance of “roll for control” exercises. Normal levels of voiding frequency occurred by the third therapy session, with a complete continence occurring by the eleventh therapy session. Timed voiding is a common solution for daytime incontinence, which is urinating on a schedule, such as every 2 hours. Diet wise, ensure your child stays away from sugary drinks or caffeine, which are known culprits of incontinence. The majority of children with daytime incontinence have abnormal elimination habits, the most common being infrequent voiding and constipation. Muscles surrounding the urethra may not be able to keep urine from passing. This often happens as a consequence of urinary tract infection and is more common in girls. Many children voluntarily hold in urine for prolonged intervals through reasons such as distraction or preferring to do something other than visit a toilet. This can lead to the bladder overfilling and leaking urine. Often, incontinence can simply fade away as the bladder grows and your body’s alarms become operational.
Managing Incontinence during the night
Nighttime incontinence, on the other hand, is often caused by a complication with the production of the antidiuretic hormone. A child’s body should produce a hormone called antidiuretic hormone, which slows down the production of urine. Whereas the body is supposed to produce more of this hormone at night, there may be a problem with the production of this hormone in children with Nocturnal Enuresis. Nighttime incontinence also often occurs in children with a strong family history of bedwetting. It can additionally be the result of a small bladder capacity, longer sleeping periods and underdevelopment of the body’s alarms that signal a full or emptying bladder. Some factors that contribute to nighttime incontinence may act together with infrequent voiding to produce daytime incontinence. These factors include a small bladder capacity, structural problems, anxiety-causing events, constipation or an overconsumption of caffeine. Incontinence during the night is commonly treated by increasing ADH levels, ensuring children recognise the need to void. This hormone can be boosted by a synthetic version known as desmopressin. A medication called imipramine is another common method used to treat nighttime incontinence. It acts on the brain and the urinary bladder. Researchers estimate that these medications help as many as 70 percent of children to achieve short-term success. A Doctor may also prescribe a medicine that helps to calm the bladder muscle. This medicine controls muscle spasms and belongs to a class of medications called anticholinergics.
If medication is unsuccessful for treating your child’s incontinence, you may want to try a bladder training method. This consists of coordinating the muscle of the bladder and urethra, helping the control of urination. These techniques teach the child to anticipate the need to urinate and prevent urination when away from a toilet. Techniques may include determining bladder capacity by taking note of your child’s liquid consumption, drinking less before sleeping and developing routines for waking up. Moisture alarms can awaken a person when he or she begins to urinate. These devices include a water-sensitive pad worn in pyjamas, a wire connecting to a battery-driven control, and an alarm that sounds when moisture is first detected. The child must awaken as soon as the alarm goes off, go to the bathroom and change the bedding. Using alarms may require having another person sleep in the same room to awaken the bedwetter. Getting your child’s problem evaluated by a Urologist or Doctor is important if you are suspicious that a medical condition is the cause. A kidney infection is a common condition that can cause incontinence. Symptoms of a kidney infection are having cloudy or pink urine or bloodstains on clothes, urinating more than usual and pain during urinating. Taking your child to a Doctor can result in a medical and physical exam to discover whether the wetting is the result of a serious condition. Your child’s abdomen, rectum, spine and genital area will be examined. In many cases, a child’s incontinence can fade away naturally.
A relieving fact about incontinence is that the natural body alarms become activated with age, meaning the majority of people do become more continent as they grow older. The bladder capacity can increase and production of ADH hormone often becomes normal. A child can also learn to respond to the body’s signal that it is time to void. Stressful events in a child’s life often pass, meaning bladder control becomes normal again. It is estimated that the number of cases of incontinence goes down by 15 percent for each year after the age of 5. However, you should still consider methods of treatment as early as possible. It is estimated that 95% of children grow out of bedwetting at 10 years old.
Investing in Products
Incontinence can be an embarrassing condition, therefore it is vital to find a children’s incontinence product that will make your child feel confident and protected. Choosing products with effective absorption is essential to their happiness and confidence. You should look for products that provide the right fit for their needs based on their:
- Level of incontinence
- The activity of the child
For younger babies and children, you should invest in incontinence nappies of the appropriate absorption and size. Libero Up and Go 7 Pants are available in the market for babies weighing between 16-26kg. They are designed with a breathable, non-woven material and feature tear-away side seams for easy removal. Libero Comfort 7 is also a good option of protection for babies and feature leg elastics that flex with the baby’s body and allows the product to adapt to the baby’s movements. This addition makes the product smoother for babies with more sensitive skin. For older children, incontinence pads and children’s incontinence pants are appropriate to help the child feel more grown up. Incontinence pants for older children are designed to look like regular underwear and not be visible under clothing so that the child feels comfortable and secure. They feature a built-in pad that absorbs any leaks, and they are easily machine washable. The pants are available in the style of briefs, boxers, and in a variety of patterns to satisfy any child’s style requirements. You can purchase pants for boys that are designed in a stylish modern look boxer short for a grown-up appearance. Alternatively, there are boy’s products designed in a traditional pant style in the market. If your child is younger, padded pants with featuring patterns may be ideal to make the product feel interesting and encourage your child to wear them. For example, starships pattern pants are attractive to younger boys in particular. For girls on the other hand, you can purchase pants designed in a hearts pattern for younger girls, and plain white pants for girls of an older age.
You can shop our full range of children’s incontinence products here.
Investing in a mattress protector such as an underpad can help ease the stress of night-time accidents in children. Mattress protectors are useful for preventing any damage to mattresses during night-time incontinence. They are highly absorbent and easy to clean, so work well for preventing damage to mattresses. Mattress Covers come in several sizes. Fitted covers fit the same way a fitted mattress sheet fits, with elastic to hold the cover onto the mattress from underneath. Deep mattress covers are sized to fit mattresses that are especially thick, such as pillow-top mattresses. It is a good idea to use protective bed pads as well as mattress protectors. Protective bed pads sit on top of the sheets in order to catch any leaks. They are available in both washable and disposable varieties.
Using the correct vocabulary is important when talking to children about their products. Avoid using the phrase “nappy” around older children as this can give the impression that they are using products designed for babies. It is useful to put yourself in your child’s shoes and select a product that you would feel comfortable in at their age. This can help them to lead a happy and active lifestyle. With lifestyle changes, the correct product and help from a professional, managing incontinence in children can be much less of a hardship.