Children
Bed Wetting
Bed wetting, also known as nocturnal enuresis, is uncontrollable leakage of urine while asleep. It is considered abnormal in children over the age of 5 years of age. This is a very common childhood condition affecting 5-10% of 7 year olds, which if not treated may continue into adolescence and adulthood.
Bed wetting is a medical condition that can have a negative impact on the child’s self esteem, emotional wellbeing, including school and social performance. It is a condition that can be treated.
Children with enuresis will receive a management plan to address their bedwetting, following a comprehensive continence assessment by AABBS.
Daytime Wetting
Daytime wetting is quite common with 1 in 7 children aged 4 1/2 and 1 in 20 children aged 9 1/2 experiencing daytime wetting.
A recent study (1) has found that children who have daytime and nighttime wetting, if left untreated are 23 times more likely to have bladder problems in their teenage years than their peers.
Urinary incontinence can seriously affect a child’s quality of life and self esteem. If left untreated and if it continues into the teenage years, it becomes harder to treat, and being more socially unacceptable at this age, can have serious negative consequences on the mental health of the individual.
Consequently, a wait and see approach it not always advisable and parents are advised to seek medical advice from their General Practitioner as soon as possible.
(1) Heron J, Grzeda MT, von Gontard A, et al. Trajectories of urinary incontinence in childhood and bladder and bowel symptoms in adolescence: prospective cohort study. BMJ Open 2017;7:e014238. doi:10.1136/bmjopen-2016-014238
Faecal Soiling
Constipation
For many children there is no underlying physical reason for constipation, which is called Idiopathic constipation. Idiopathic constipation develops in children between 2-4 years of age.
Possible causes include:
- Withholding poo
- Fear of toilets
- Lack of a toilet regimen
- Resistance to potty training – insistence to put a nappy on to poo
- An unbalanced diet
- Low fluid intake
- Anxiety or emotional upset
- Some medications
Soiling
Children as usually toilet trained by about 3 years of age. Soiling is when the bowels are emptied in places other than the toilet, such as underwear. Soiling can range between skid marks and large deposits that require removal from underwear before washing.
If a child is unable to be toilet trained or has regular poo accidents beyond the ages of 3-4 years, then they should be medically assessed. If a child has previously been toilet trained and then starts to soil, they should also be medically assessed.
About 1-3% of children have soiling and some have both soiling and wetting. It tends to be more common in boys than girls.
Most often soiling occurs as a result of constipation. Constipation can occur in up to 25% of children. Constipation can occur as a result of withholding poo, which then becomes hard, difficult and often painful to pass.
AABBS will conduct a bowel assessment and a toilet program can be recommended often including a laxative regime.
The Children’s Bowel & Bladder Charity is an excellent resource for parents of children with bowel and bladder issues.
Children with additional needs and continence
Autism and neurodiversity can influence the development of continence (the ability to control bowel and bladder functions) in children. Children with autism may experience delayed development in achieving continence due to several factors such:
- Delayed development
- Difficulties with communication and understanding language
- Confusion around what wee and poo is and where it should go
- Becoming used to going in a nappy and finding change difficult
- Parent/carer may have been advised to delay toilet training, by friends or professionals.
- Lack of an assessment or diagnosis – for some children their difficulties may not yet be fully appreciated or evaluated.
- Sensory problems
- Other problems taking priority
- Underlying physical causes such as constipation, withholding and/or bladder problems
- Trouble understanding the signals their bodies send when they need to use the bathroom (interoception issues)
- Finding the toileting process overwhelming due to sensory issues related to the bathroom environment.
At AABBS we can provide a continence assessment undertaken by an experienced continence nurse adviser to identify each child’s unique needs and situation.
This is the first important step in developing an individual management plan designed to assist them to achieve their important developmental milestones.
We are able to provide an NDIS continence report including recommendations as well as a prescription for any annual consumables required.