Back to School Bathroom Habits

Here in the United States, it’s about that time for kids to go back to school. This means making those summer school supply lists, back to school shopping and spending the last few summer days at the pool. It’s also a great time to prepare your kids for spending the day at school, which also means talking about bathroom habits.

Often, bladder problems in children are caused from a bad habit that can easily be changed. Constipation is one of the most common causes for bladder control problems in children. This can occur when a child has less than two bowel movements per week. Stools are very firm, dry, small and hard to pass. 

School-aged children with bladder control problems may have:

• Daytime wetting: poor bladder control in children who have been potty trained during awake hours
• Frequency: when a child passes urine more than eight times during awake hours
• Giggle Incontinence: urine leaks out by accident with laughter
• Hesitancy: trouble starting or taking a long time to start passing urine
• Holding maneuvers: the child does things to avoid going to the bathroom
• Infrequency: when a child doesn’t pass urine enough (less than three times during awake hours)
• Intermittent urine stream: the flow of urine occurs in bursts
• Post-void dribbling: leaks of urine soon after going to the bathroom
• Urgency: a sudden, unexpected need to pass urine
• Straining: trouble getting urine out
• Weak urine stream: the flow of urine is weak or slow

 It’s of great value to learn which type of bladder problem your child has so you can address the issue with your health care team. Going to school can sometimes make kids nervous to use the bathroom, or they may not be offered as many bathroom breaks as they would at home.  The first step is to learn which type of bladder problem your child has and why. Managing this issue in children is often successful. If it’s: 

• Constipation: Offer foods high in fiber. Pack lunches with fruits, veggies and whole grains. Drinking more water helps too.
• Infrequency or Urgency: Make a timely bathroom plan with scheduled voiding. Help your child follow a daily bathroom schedule. The goal is to retrain the bladder and sphincter muscles. It may be helpful to speak to your child’s teacher about any bathroom concerns you have for your child.
• Urine Frequency or Overactive Bladder (OAB): Ask your child’s doctor about medication for OAB that helps your child’s bladder to hold more urine, for longer.
• Giggle Incontinence: Ask your child’s doctor about helpful medications, such as oxybutynin or methylphenidate (Ritalin).
• Problems with the way the bladder contracts and the sphincter relaxes:
  • Teach your child to perform Pelvic Floor Exercises that strengthen the area. Your child’s doctor can explain “Quick flicks” (squeezing and relaxing the sphincter and pelvic floor muscles as quickly as possible) and “Kegels” (squeezing and relaxing the pelvic floor muscles more slowly each day). When done many times, these each can make the pelvic floor stronger.
  • Ask your child’s doctor about Biofeedback Therapy. It may be offered in-office or at a physical therapy office. It teaches children how to control their sphincter and pelvic floor muscles.
• Post-void Dribbling: Have your child try opening her legs wider when passing urine. Weight loss may also help. If there are labial adhesions, estrogen cream can heal the area.

It’s always best to talk to your child’s doctor about any concerns to find the best treatment plan for your child. Talk with your health care team before the school year starts if your child is having bladder control problems. There is hope and there are many long-term solutions.

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