Incontinence in children can be caused by physiological factors such as slower bladder development, hormone deficiency, and caffeine consumption, as well as psychological factors such as anxiety. Daytime incontinence is often caused by an overly active bladder or psychological reasons, while nocturnal incontinence is linked to a small bladder, delayed development of bladder fullness signals, and low levels of antidiuretic hormone. Treatment options include medication, bladder training, and avoiding triggers such as caffeine.
Incontinence in children can be caused by a variety of factors. Physiological causes of incontinence in children include slower bladder development and/or body signals that tell the child he needs to empty his bladder. A hormone deficiency, long periods of sleep and caffeine consumption are also linked to incontinence in children. The main psychological cause of childhood incontinence is anxiety, often resulting from a stressful situation at home. Incontinence in children can be bothersome to both the affected child and their parents, but experts seem to agree that incontinence in children is generally not a problem; for many children, incontinence is just a natural part of growing up.
While infants’ bladders automatically empty when the need arises, babies eventually develop the ability to transmit messages between their brains and other bodily systems, including their bladder. They begin to be able to tell when their bladder is full and can control when and where they empty. Incontinence in children occurs when the child is unable to control the emptying of his bladder.
Incontinence in children has two main categories: diurnal and much more common nocturnal. Daytime incontinence is more common among girls, although boys have been known to experience this problem as well. A common physiological cause of daytime incontinence in children is an overly active bladder. Incontinence occurs when the muscles around the urethra are unable to hold urine when the bladder contracts suddenly and/or forcefully. This type of incontinence can be the result of a urinary tract infection (UTI).
Having a small bladder, having constipation, consuming caffeine, and more rarely, structural problems with the bladder or urethra can also cause daytime incontinence in children, although daytime incontinence is more often attributed to psychological reasons. A child may simply not want to interrupt his or her activities to use the bathroom, may prefer not to use the school bathroom, or may be experiencing some other form of anxiety or stress. Any of these circumstances can cause a child to hold her urine past the point where she needs to urinate, resulting in incontinence. Repeatedly suppressing the need to empty the bladder can lead to a urinary tract infection.
Nocturnal incontinence is thought to be more common in males, although both males and females are affected. A strong family history of bed-wetting may indicate a genetic link to nocturnal incontinence, because the odds of a child being a bed-wetter if their parents were both bed-wetters is 80%. Common physiological causes of nocturnal incontinence in children include a bladder unable to hold more than a small amount of urine, delayed development of the body’s bladder fullness signals, and low levels of antidiuretic hormone (ADH) which reduces the body’s need for to urinate at night.
Less commonly, sleep incontinence in children can be caused by obstructive sleep apnea, a condition in which a child stops breathing during sleep due to blockage by the adenoids or tonsils. Even rarer is the incidence of structural problems such as blockage of the bladder or urethra. Psychologically, if a child is experiencing anxiety stemming from anger or tension at home, from an unfamiliar environment, or from a significant event in the child’s life, such as the birth of a sibling, it can trigger nocturnal urination.
Some physiological reasons for incontinence in children will resolve on their own over time, while medications are available to treat others. Bladder training, which strengthens the muscles of the bladder and urethra, can also help. Following a urination schedule and avoiding caffeine and other foods or drinks that can trigger incontinence are also strategies that can help treat incontinence in children. Parents and caregivers are encouraged to manage a child’s incontinence with patience and understanding to maximize the chances of treatment success and minimize the stress that could make it worse.
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