Struggles with toilet training, bedwetting and constipation can be heartbreaking and difficult for parents and children alike. Sometimes the struggle can be due to a problem over which a child has no control.
Q. What is Child Incontinence?
A. Pediatric incontinence is the lack of voluntary control over urination or defecation. There are different types of incontinence in children; however, the three main areas are daytime humidification, nighttime humidification, and constipation. In all three of these problems, the main thing we see is a dysfunction of the pelvic floor.
Q. Is childhood incontinence more of a physical problem than a behavioral problem?
A. Yes. Many people assume it’s the child who doesn’t want to go, or doesn’t want to slow down and take the time to go to the bathroom, but there’s really more of a psychological and physical component. We often see children with weakness or cramps in their pelvic floor muscles. When that happens, it can lead to reduced signals from the bowel or bladder to the brain telling the child when to go, which can lead to incontinence.
Q. When should a parent be concerned and inform their child’s doctor?
A. Bladder control matures when a child is around 4 years of age. If your child still has significant problems around that age or older, including difficulty urinating, frequent urination eight or more times a day, weak flow, straining, bladder infection, or constipation, discuss this with your child’s pediatrician or doctor.
Q. What treatments can be used to manage childhood incontinence?
A. There are medications that can be prescribed to help with urination or constipation, and your child’s doctor may also refer him or her to a urologist and physical therapist. A urologist can help figure out what’s causing the problem.
Q. What can a physiotherapist do?
A. At a physiotherapy appointment for pediatric incontinence, the child undergoes an evaluation of gross motor skills such as strength, coordination and balance, after which we look at the pelvic floor muscles. We can teach children how to relax their muscles enough to go to the toilet, and how to strengthen the pelvic floor muscles so that they have more control.
Q. What does physiotherapy benefit children?
A. We can help children get rid of incontinence in as little as eight to 12 weeks, with one to two sessions per week. It takes some effort to get there, but with physical therapy and home exercises, we can help parents and children see a light at the end of the tunnel when it comes to childhood incontinence.
It’s important for parents to know that they are not alone in this – many children struggle with toilet problems and need a little extra help.
Becca Thomas, DPT, is a physical therapist at MidMichigan Health.