How to Care for Your Child's Condition : Laughing Incontinence in Children
Urinary Incontinence in Children
Toilet training is not an exact science, and many kids have bedwetting episodes. Learn about the causes of urinary incontinence in children and when to be concerned about a bladder problem.
By Marie Suszynski
Medically Reviewed by Pat F. Bass III, MD, MPH
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Potty accidents are part of growing up for every child, and most children’s bedwetting will go away on its own as the child gets older. But how do you know the difference between a child who’s simply learning how to control his bladder and true incontinence in children?
In part it depends on the child’s age, but it also has to do with what’s actually causing the urinary incontinence, says Anthony Atala, MD, a spokesman for the American Urological Association and director of the Institute for Regenerative Medicine at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.
Urinary Incontinence: The Brain’s Connection
Whether your child can control her bladder has to do with her nervous system. As the nervous system matures, the child’s brain is able to get messages that her bladder is filling up. Rather than allowing the bladder to empty on its own as it does in babies, the brain sends a message to the bladder not to empty until the child is ready, giving the child a chance to get to the bathroom.
By the age of five, about 90 percent of children are able to get through the day and night without experiencing urinary incontinence. By age 10, only about 5 percent of kids have bladder problems and by age 18, that number is down to 1 percent.
What’s Behind Daytime Incontinence in Children
As a child’s nervous systems is maturing, some things can get in the way of potty training. Here’s what may contribute to accidents during the day:
- Suppressing the urge to go.The most common reason for daytime incontinence in children is that the child gets distracted with what she’s doing and suppresses the urge to use the bathroom.
- Overactive bladder.Sometimes a child can hold the bladder so much that he exercises the muscle and makes the bladder stronger, which isn’t a good for the urinary system. The bladder can become so strong that it overpowers the muscles around the urethra (the tube that empties the bladder), and the urethra can’t hold back urine.
- Urinary tract infection (UTI).More common in girls, UTIs can also cause an overactive bladder.
What’s Behind Bedwetting
Getting through the night without an accident can take a little longer to master than daytime incontinence. It’s more common for children to wet the bed after age five than it is for them to have accidents during the day. Here’s what could be happening if your child is experiencing bedwetting:
- It’s in the genes.If both parents experienced bedwetting, a child has an 80 percent chance of having problems staying dry at night.
- Deep sleeper.Nighttime incontinence is also related to a child being a deep sleeper.
- A smaller bladder.Your child’s bladder may simply be smaller than other children her age, which makes it easier for the bladder to become full and spill over.
- Fluid retention.Children who wet the bed tend to retain more fluid than other children, Dr. Atala says. Our bodies retain fluid for our organs, such as our heart. But when you lie down, your heart doesn’t need to work as hard and your body gets rid of the extra fluid. Children who are more active during the day retain more fluid than children who aren’t as active.
- The internal alarm is still developing.We all have an internal alarm that wakes us when our bladder needs to be emptied. The alarm becomes stronger as the child gets older.
- Hormones aren’t lowering urine levels.Antidiuretic hormone is released at night to slow down the production of urine, but some children may not be producing enough of the hormone to stay dry while they sleep.
- Anxiety.Anxiety and stressful events, such as a new baby sibling, can cause a child to take a longer time to potty train at night or cause a child who’s already potty trained to start having bladder problems.
- Sleep apnea.If she’s having trouble breathing at night due to inflammation or an enlargement of her tonsils or adenoids, it could be causing nighttime incontinence. Often, treating the sleep apnea can also help keep her dry.
- Physical problems.For only a small number of children, the cause of nighttime incontinence may be a blockage in the bladder or the urethra. For children with spina bifida, a birth defect of the spinal cord, nerve damage can also result in bedwetting.
How to Treat Incontinence in Children
Luckily, bladder problems tend to go away on their own — if you give them time. Here’s what you can do in the meantime:
- Schedule potty visits.If your child is suppressing the urge to go during the day, Atala recommends taking your child to the bathroom about every two hours. To prevent bedwetting, have your child lie down to read a book to help mobilize the fluid, and then have her get up to use the bathroom before going to sleep. Also, limit the amount of fluid she drinks at night.
- Reset the clock.If your child has an overactive bladder, a doctor can prescribe medication that will help get the bladder back on schedule.
- Consider a “wet alarm.”You can use a wet alarm, or a moisture alarm, in which your child wears a pad in her pajamas that connects to an alarm that goes off as soon as there’s any moisture. It can help your child learn to wake up before wetting the bed. Wet alarms work best for children who are already waking up dry a couple of nights a week and who aren’t deep sleepers, Atala says. You can purchase a wet alarm at a local or online pharmacy.
- Treat conditions that could be causing it.Getting treatment for sleep apnea can help cure bedwetting. It’s also important to be sure your child doesn’t have a UTI or a condition such as diabetes that leads to an increase in fluids.
Where to Find More Information and Support
Although it helps to know the problem is likely to go away over time, incontinence in children can be frustrating for parents.
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