Reduce Anxiety, Accidents and Bed-wetting: Understand Your Child’s Bowel and Bladder Function

You may notice that most pelvic-floor talk is from, or about, pregnant women. But did you know that men, women and children have a pelvic floor?  And that pelvic floor muscles impact bowel and urination control?

Until 18 months of age, a child’s pelvic floor is not developed enough to control the bowel and bladder. At 18 months, a child may be able to indicate that they have to poop and exhibit some urination control. For most children, it’s still too young to begin potty-training. Potty-training timing is most often started around 23 months. Remember that night time continence will take longer to achieve than daytime continence. 

What should you do if your child is over the age of five and continues to wet the bed after daytime continence is achieved? Talk about this with your child and try making these adjustments:

• Remove or reduce bladder irritants: milk, spicy food, soda, foods with red or blue dye, tomatoes. 

  • If you can’t remove them, adjust the timing. If your child likes milk before bedtime, offer it with dinner to avoid irritating the bladder right before bed.

  • Offer pears, apricots, papaya or watermelon. They are less acidic.

• Change timing of fluid intake: Have your child start drinking fluids earlier in the day. 

  •  The last drink should be 1-2 hours prior to going to sleep.

• Ensure sufficient fluid intake: If there is not enough liquid, the bladder lining gets irritated and this can cause bladder urgency. Ideal daily fluid intake is approx. 1 ounce per kilogram of body weight:

  • 30 lbs. child: 13 oz., 2 1/3 cups 

  • 40 lbs. child: 18 oz., 2 ¼ cup 

  • 50 lbs. child: 23 oz., 3 cups 

  • 60 lbs. child: 27 oz., 3 ½ cups  

• Use these helpful voiding techniques: Children should void 5 to 6 times per day. Less than 3 or more than 8 is considered abnormal. Time between urinating should be 2 to 4 hours. When your child urinates:

  •  Be sure feet are supported. A step stool is a great idea.

  • Have your child lean forward. This will put pressure on the bladder and allow it to empty properly.

  • Urine should come out consistently without starts and stops. If your child is holding their breath, encourage them to blow bubbles or sing songs. This will cause the pelvic floor muscles to relax as the bladder contracts, allowing for full emptying of the bladder.

If changing habits does not improve the situation, constipation may be the problem.  If your child is constipated, there is pressure on the bladder, making your child feel like they have to pee often.  Constipation causes the pelvic floor muscles to work harder, making it difficult for the muscles to fully relax and eliminate urine completely.

How will you know that your child is constipated? This is challenging. Even if your child is having a daily bowel movement, they may be constipated.  Here are some clues:

• Stools are hard, like pebbles, and your child struggles to push them out.

• Stools are loose and diarrhea-like. Loose stools may happen when there is a lot of hard stool built up, requiring softer stool to pass around it.

• Your child experiences abdominal bloating or pain.

If you suspect constipation, ask your doctor to perform a KUB (kidney, urinary, and bladder) Xray. This Xray will show the size of the rectum to determine if it is distended or not distended. A Rectal Ultrasound can also confirm constipation. If the rectum is >30 mm wide, this indicates rectal distension and constipation. 

If constipation has been confirmed, consult a gastroenterologist. They will suggest next steps.  Often times. they recommend MiraLAX or enemas to help your child fully empty their stool. This, in conjunction with proper fluid intake and sufficient fiber, will help soften and form the stool for easy passage.  

Pelvic floor PT is also an option to help your little one. We help with potty posture, stretching, exercises, breathing techniques and biofeedback so your child can fully empty their bladder.

Reach out to us at info@solsticept.com or call 929 269 2505 to set up a free, 15-minute consultation.