Children

I help children who are struggling with:

  • Day and night time urinary incontinence
  • Faecal incontinence
  • Bed Wetting
  • Constipation
  • Pelvic floor muscle training with EMG biofeedback
  • Real time ultrasound scanning to help your child to see where their pelvic floor muscles lie relative to their bladders
  • Bladder and bowel retraining

 

Bed Wetting

On average, bedwetting is an issue for one in six 5 year olds, one in seven 7 year olds, one in eleven 9 year olds and one in fifty teenagers. Between 10 and 25% of children who wet the bed are also accidentally wet during the day.

But while it is relatively common, as these statistics show, it remains a rather unspoken and awkward subject. It is often genetic, and if you were a bed wetter, there is a 40% chance that your child may wet the bed, and if both parents were bed wetters; there is a 77% chance that the child may wet the bed.

Historically, Paediatricians advised that children would ‘grow out of it’. And they do. But only at a rate of 15% of the bedwetting population per year. The research with regards to bed wetting and the psychological implications it can have upon a child – states (unsurprisingly) that it isn’t great for a child’s psychological or emotional wellbeing.

Traditional medical treatment has involved the restriction of fluid intakes before bed time and the prescription of anti diuretics (to make the kidneys produce less urine) and bed wetting alarms. None of these have had consistently overwhelmingly positive results for the bed wetting population as they ‘wait it out’ to be in the lucky 15% who become dry spontaneously each year.

The American journal of Urology stated on 2010, that “treatment (for bedwetting) is not only justified but mandatory”, because of the marked psychological impact that it has on children. Sadly, treatment for these children is not yet the norm.

I have completed my training with Dawn Sadalcidi from the USA, who is a specialist continence Physiotherapist with a special interest in children’s incontinence and bed wetting. Using the protocol developed by her, I spend time understanding the child’s bladder and bowel habits, diet and lifestyle and help to retrain the pelvic floor muscles. I identify potential dietary bladder and bowel irritants, educate the family about the importance of toileting positions and the ability to completely relax the pelvic floor muscles when they are on the toilet.

Almost every single child who bed wets has associated constipation, so dealing with this is a very important part of the treatment program.

I also use biofeedback via electrodes placed on the skin of the pelvic floor muscles to teach the child how to fully relax their pelvic floor. The electrodes attach to a screen that indicates when the muscle is contracted or relaxed and gives excellent visual feedback to the child on how exactly they are contracting and relaxing the muscles that many adults find difficult to isolate. The biofeedback device also has games on it that are controlled by the child activating or relaxing their pelvic floor and is great for making it a bit more fun for children!

Once full daytime ‘dryness’ has been achieved, a bespoke plan is made for the child to help to retrain the bladder at night time. This protocol has excellent results, if closely adhered to, and helps many children in becoming ‘dry’ faster.

Being from a bed wetting family myself, and experiencing first hand the negative emotional effects that it can have upon a child, I am passionate about helping children to achieve ‘dryness’ as soon as possible!

I am passionate about helping children to become ‘dry’, and delighted to be offering this service in my practice.  For optimal results to be achieved in the program, the child (and parents) need to be motivated and committed to making the necessary dietary and toileting habit changes to retrain to the bladder and bowels.  This retraining takes time and I usually advise Parents to expect a time period of at least 3 to 6 months before consistent results are achieved.  I also insist that the child keeps a simple daily record with stickers on a chart regarding their ‘homework’ and that the child sends me a brief voice note each day confirming what they have achieved that day.  I find that compliance in the program and the results we can achieve are optimised through doing this.

Paediatric Incontinence

The majority of children begin ‘toilet training’ during the day between 2.5 and 3 years old, and most children achieve night time dryness around 10 months after they are no longer needing diapers during the day. However the journey to becoming ‘dry’ is not as simple for all children and can be quite distressing for the child. Children who are leaking urine or faeces during the day are likely to be wetting the bed at night, and bed wetting is more common than you may think.

I spend time understanding the child’s bladder and bowel habits, diet and lifestyle and help to retrain the pelvic floor muscles. I identify potential dietary bladder and bowel irritants, educate the family about the importance of toileting positions and the ability to completely relax the pelvic floor muscles when they are on the toilet. Almost every single child who is incontinent has associated constipation, so dealing with this is a very important part of the treatment program. I also use biofeedback via electrodes placed on the skin of the pelvic floor muscles to teach the child how to fully relax the pelvic floor. The electrodes attach to a screen that indicates when the muscle is contracted or relaxed and gives excellent visual feedback to the child on how exactly they are contracting and relaxing the muscles that many adults find difficult to isolate. The biofeedback device also has games on it that are controlled by the child activating or relaxing their pelvic floor and is great for making it a bit more fun for children!

I am passionate about helping children to become ‘dry’, and delighted to be offering this service in my practice. For optimal results to be achieved in the program, the child (and parents) need to be motivated and committed to making the necessary dietary and toileting habit changes to retrain to the bladder and bowels. This retraining takes time and I usually advise Parents to expect a time period of at least 3 to 6 months before consistent results are achieved. I also insist that the child keeps a simple daily record with stickers on a chart regarding their ‘homework’ and that the child sends me a brief voice note each day confirming what they have achieved that day. I find that compliance in the program and the results we can achieve are optimised through doing this.

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