Urinary Incontinence in Children
Children typically attain daytime continence – the ability to hold their wee– on average around 3-4 years. The average age is 3.5 years old, however anywhere from 6 months – 6 years is considered typical depending on culture. Daytime wetting issues in children is a concern when it impacts upon day to day activities such as attending school or family activities.
When children are born, their bladder capacity starts at around 10mLs and increases over time. Children who are 3 years old have a bladder size of around 120mLs which corresponds with when most children can toilet train. This is because they have adequate capacity to store urine for longer durations.
When children drink water, it is absorbed into the body and filtered through the kidneys. The waste product is then stored in the bladder as urine. The bladder is surrounded by a muscle, called the detrusor muscle, which can detect when it is at maximal stretch. This corresponds with bladder capacity. Once the bladder reaches capacity, it sends a message to the brain to tell the child that they need to do a wee. Ideally, children will get the message before the bladder is completely full which allows them time to get to the toilet.
Along this process, the main things that can be a barrier to toilet training include:
Reduced bladder capacity
Reduced awareness of messaging from bladder to brain
Reduced ability to get to the toilet and undo fasteners (fine motor limitations)
If your child is 5 years or older and frequent urinary accidents are impacting upon day-to-day life, it may be worth getting an assessment to determine the cause of incontinence.
An assessment will include an in-depth discussion to see what your child’s toileting patterns are and will likely include the completion of a bladder diary which looks at the frequency and volume of urine output over a 48-72 hour period of time.
Depending on what is found on these assessment tools, treatment options can change.
If your child needs additional support, please don’t hesitate to get in contact!
