Children’s Bladder Problems

Day time wetting affects about 1 in 75 children over the age of 5 and is more common in girls. Daytime wetting can be embarrassing for your child and can be difficult to deal with, especially at school. It can, in some cases, lead to the onset of bullying and teasing.

What are the causes of this problem?

For younger children, aged 4 – 5 years it can be:

  • A change in routine, a new baby in the family, moving to a new home
  • Forgetting to use the toilet when engrossed in other activities
  • Common childhood illnesses

For all children

  • Being constipated – this puts pressure on the bladder
  • Some drinks; e.g. fizzy drinks, especially those containing caffeine
  • An infection within the urinary system – urinary tract infection
  • Needing to go to the toilet more often – frequency
  • An overactive bladder – the need to go to the toilet straight away without warning
  • Not completely emptying the bladder when going to the toilet – often caused by not having their feet on the floor when sitting on the toilet
  • Result of anxiety or an emotional upset

Bedwetting

Bedwetting (nocturnal enuresis) is a common problem in childhood. It has been estimated that over half a million children between the ages of 5 and 16 in the UK regularly wet the bed.

What are the causes of this problem?

It is not easy to identify why some children develop a problem with bedwetting, but one of the following reasons may provide an explanation:

  • The body’s system to slow down urine production at night is not working yet and your child therefore has to cope with daytime levels of urine production during the night
  • The bladder holds lower than average amounts of urine before giving a signal that it is full. The bladder may also be overactive which gives an urgent signal before it is actually full
  • The signal from bladder to brain to wake up at night and get to the toilet is not getting through
  • Anxieties may also be a factor, such as a new baby in the family or moving to a new home

Stress Urinary Incontinence

Stress urinary incontinence (SUI) is defined as a sudden loss of urine (wee) during normal day to day activities. You may also hear it referred to as bladder weakness or a weak bladder. It’s very common, especially amongst women. Leakage occurs when the bladder is under pressure and when the pelvic floor muscles or sphincter are damaged or too weak to prevent urination.

The pelvic floor muscles are layers of muscle that are like a hammock, stretching from the pubic bone to the bottom of the spine (coccyx) and from side to side. These muscles hold the bladder and bowel in place and help to stop leaks.

How do I know if I have SUI?

If you wee when you;

  • laugh
  • cough
  • sneeze
  • walk
  • exercise
  • or lift something then you may have SUI.

What causes SUI?

SUI can affect women of all ages. For a few women this can be a problem from a young age. For the majority, SUI begins around the child bearing years and can become an increasing problem with age.

If the muscles of the pelvic floor or sphincter are weakened or damaged they may struggle to stop you from weeing when they come under pressure. These muscles can become weakened by;

  • Increased pressure on your tummy for example when you’re pregnant or very overweight.
  • Nerve damage during childbirth due to a prolonged delivery or large baby.
  • Multiple pregnancies (vaginal delivery).
  • Constipation.
  • Persistent chronic cough from smoking, chronic bronchitis or asthma.
  • Certain medications.
  • Hormonal deficiency

What can parents do?

If daytime or nigh time wetting is a problem for your child, try not to get too frustrated. Make an appointment to see your GP or health visitor. They may put you in touch with your local continence service and a continence nurse or specialist physiotherapist. They are healthcare professionals who specialise in bladder and bowel problems.

Before your appointment with a healthcare professional, it is a good idea to make a record of how often your child has been to the toilet, how many accidents that they have in a day and what they are drinking.

Following an initial appointment with a healthcare professional, there are some routine tests and investigations which may be required:

  • Routine urine test to rule out a bladder infection
  • General health check to exclude any underlying problems
  • Measuring your child’s bladder capacity by passing urine into a jug
  • An ultrasound scan of the urinary tract (bladder and kidneys) to check the bladder is emptying properly

There are a number of other things that a parent can do to help daytime wetting including: setting up a toilet routine, encouraging your child to drink 6 – 8 water based drinks over the whole day, making sure your child follows a healthy diet and gets enough exercise.

For information and support about childhood continence issues, you can contact ERIC – Education and Resources for Improving Childhood Continence. ERIC is the national charity that provides information and support for children and young people under 18 years of age with continence issues, and their families.

ERIC helpline – 0845 370 8008 – Monday – Thursday 10am – 2pm

Website – www.eric.org.uk  Email: [email protected]

Where can I get help?

If you are under the age of 16 the first thing you should do is discuss your concerns with a parent or guardian. If you feel unable to do this then maybe you’d feel comfortable talking to your school nurse. We also have a information sheet called ‘Love Your Gusset’ which covers SUI for women and teenagers.

If you are over 16 yrs of age or you are a parent or guardian concerned for a child, the first thing you should do is see your GP for an assessment of the symptoms, or if you prefer you can also self-refer to an NHS continence clinic.