Healthy Bladder Habits

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Most children are completely toilet trained for daytime by 3 years old. There are about 7-10 percent of children who are not completely dry during the daytime after attempts at toilet training. This also means that there is fair number of kindergarteners who are not dry during the daytime. For these children a more structured approach can help to facilitate bladder function and lead to dryness. Before addressing this issue, parents should make sure this is something that is important to the child as it is to them the parents. Discuss the issue with the primary care provide at each well child visit after the age of 3 years. This is also an ideal time to request a referral to a voiding dysfunction specialist who can devote time and expertise to evaluation and treatment.

In the absence of an anatomical issue, the focus of treatment for urinary incontinence in children is usually noninvasive. Begin by noting when your child has wet accidents. Is it when playing outside, playing electronic game or watching television? These are common times that daytime wetting accidents occur in children. The reason is related to inattention to bladder cues and an attempt to “hold” which then result in strong bladder contractions and either dampness or complete bladder emptying. A Simple way to eliminate this is to place your child on timed voiding. What is timed voiding? It is using a watch/clock to get your child to the bathroom in a timely manner before the urge to void is very strong. You can start at every two hours, when your child is dry for 2 weeks at that time interval, then increase to every three hours. This must be consistent, and it must be adult directed. Cooperation can be enhanced by attaching a reward such as stars for completely dry day which can add up to a prize. This works well in younger children. For school age children a watch that vibrates can be used for timed voiding. Another simple step is to improve bladder health is minimize soda/carbonated fluids intake and replace with water. These can be bladder irritant in children.

With early intervention and consistency, the issue can be resolved in most cases and improved in others. Identifying the underlying problem is key to success.

Dawn Diaz Saldano, CRNP, CPNP-PC, MSN

Peds Urocare, LLC

http://www.pedsurocare.com/

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