ANN/THE STAR – Young children are plenty proud of themselves when they’re able to answer the call of nature by going to the toilet on their own.
The transition isn’t always mishap-free though. Some still accidentally wet or soil themselves even after reaching school age.
“This is extremely unpleasant for a lot of children,” said paediatrician Dr Melanie Ahaus.
“They’re usually very ashamed.”
According to the Cologne-based Professional Association of Paediatricians (BVKJ), between 1.5 per cent and three per cent of seven-year-olds soil, boys more commonly than girls.
About 10 per cent of this age group wets their bed at night, boys twice as often as girls.
And roughly two to three per cent wet during the daytime.
“Parents should never scold – let alone punish – (incontinent) children,” Dr Ahaus said.
Rather, they should lovingly reassure them that wetting or soiling at their age is only temporary.
“There’s no medical problem underlying wetting or soiling in most cases,” she noted, explaining it’s often part of a child’s maturation process.
Children frequently sleep deeply and aren’t always awakened by pressure on their bladder or bowel, and then – oops – it happens.
An ultrasound scan of the kidneys can determine whether a medical condition is in fact the cause of a child’s wetting, and perhaps a bladder examination as well.
Wetting can also occur due to psychological problems.
“If a child has been staying dry at night and then suddenly begins bed-wetting, parents should have them examined by a doctor,” advised Dr Ahaus, adding that the cause is often harmless.
If the doctor’s examination shows the child to be fully healthy, changing their drinking habits can be effective.
“The girl or boy should drink sufficient fluids over the course of the day, but nothing after 6pm,” Dr Ahaus said.
And the child should go to the toilet before bedtime.
Avoiding caffeinated drinks such as cola can help too, since they have a diuretic effect that promotes wetting. Going to the toilet at fixed times is a good idea for children who wet during the daytime.
“If necessary, an alarm clock could remind the boy or girl every two hours to go to the toilet,” Dr Ahaus added.
As for soiling, chronic constipation may be the cause, said urologist Dr Daniela Schultz-Lampel, a member of the German Continence Society’s council of experts. While “this sounds contradictory at first”, she remarked, soft or liquid stool can leak out around a clump of hardened stool in the bowel, beyond the child’s control.
The first step in helping these children, she said, is to get to the bottom of their chronic constipation.
“Factors that play a role include a diet with too little fibre and a lack of exercise.”
Certain kinds of behaviour can also lead to chronic constipation.
“Many parents tell their kids to please not use toilets outside the home (eg at school), as they’re ‘dirty’,” she said.
So children suppress their urge to defecate, which at some point can cause their bowel to become overfull and retained stool to get extremely hard, making a bowel movement painful.
To avoid the pain, the child – in a vicious circle – holds in the stool further.