How to help children with incontinence issues

When Jack was 7 years old, there wasn’t a night when he didn’t wet the bed. His parents, Amanda and Robert, were worried. They knew that if he wasn’t toilet trained by 8 years old his chances of remaining continent throughout his life dropped to just 5 per cent. Something needed to be done fast.

All children can experience nocturia enuresis (commonly known as bedwetting) from time to time, but approximately 1 in 5 Australian children share Jack’s problem – regular bedwetting. It’s a complex condition with many possible causes, from slow development to an underlying illness to heavy sleeping (i.e. not waking up when the bladder is full).

Bedwetting can be a worrying condition for both the parents and child involved; parents are often concerned their child may experience social and emotional effects and children can feel embarrassed and lose self-esteem.

Jack’s parents tried everything – reducing his water intake before bed, waking him up 2-3 times a night and getting him fully checked out by his GP for infections.

A trip to the Children’s Hospital led to trying a night alarm inserted in Jack’s nappy – it’s designed to teach a child to wake up if they start wetting the bed. It worked a treat, just not in the intended way: everyone in the house woke up except for Jack, who kept snoring away.

The solution became clear when Jack’s parents mentioned his snoring to a specialist. A quick look at his tonsils showed one was so large it blocked half his airway, reducing the effect of the anti-diuretic hormone (ADH) naturally produced in the brain. ADH slows down the production of urine – particularly at night. Jack’s lower levels of ADH led to and overfilled bladder and his subsequent bedwetting.

Jack’s story has a happy ending. He was sent to a specialist who recommended a full tonsillectomy and, within a month of the surgery, he was continent. He hasn’t looked back. You can get an equally great result for your child – just be sure to avail yourself of all the help out there and don’t quit until you’ve found the right solution.

What steps can you take to help your patients?

1. Find the cause, treat the problem. Check there’s no underlying medical condition causing the continence issues. In Jack’s case, when his parents mentioned his snoring to a specialist, a quick look at his tonsils showed one was so large it blocked half his airway, essentially preventing his body from properly resting each night.

2. Minimise any potential psychological impact. Advise parents not to make bedwetting an issue at home. If they can treat it like an everyday occurrence, their child will be less likely to suffer self-esteem issues. You can also direct them to the Continence Foundation website where there is a useful guide on the subject. For more information click here.

3. Get them talking online. There are also online forums that provide support and information for parents with children suffering continence issues. In addition to our own site, try the CFA helpline (1800 33 00 66) and support forums where you can speak with a nurse anonymously and confidentially. The Australian Toilet Map can also be a useful resource for them to be aware of.

4. Make use of help available. Direct parents to the wide range of government and not-for-profit bodies that can provide advice, services and financial support in every state. These include:

      • CAPS – for children aged over 5, The Continence Aids Payment Scheme is an Australian Government Scheme to financially assist eligible people who have permanent and severe incontinence to meet some of the costs of incontinence management products - See more about CAPS here.
      • NDIS - The National Disability Insurance Scheme is a new healthcare program that changes the way people with a disability receive funding from the government. Accessing the NDIS funding will depend on the child’s age and individual assessment. For more details, click here
      • Continence support by state. Most states also offer financial support for child continence problems. Click the following to find out more:

Independence Australia carries a full range of continence products and pads to make continence issues more manageable for children suffering from incontinence. Click here to see more.

For more information about child continence, contact our Urology and Continence Nurse by clicking here