Help! I Think My 6 Year Old is Incontinent!


HELP! I think my 6 year old is incontinent! I have received this concern and request for advice a number of times. I know these moms and girls are not alone, and often I hear from them after they have been looking for a solution for months (doctors, internet research etc). This feels like a 911, but a little 411 can go a long way. This solution I learned from a pediatric urologist, can be astonishingly simple and effective. Read on:

Hi Julie,
My 6yo daughter is having some issues with continence. This has been going on for a while, maybe 8 months or more. I already talked to her doctor and also I’ve been reading a lot about this topic.
Her complaint is that, some times, after she goes to the bathroom and she thinks she’s done she still leaks a few drops of urine. Is there anything we can do?
F
Hi F,
Thanks for reaching out. First a few questions to clarify what she is experiencing. Is it that she actually gets up from the potty and leaks a little bit into her undies later? Is she also experiencing “urge”, in other words right after she peed she has to go again?
Here are a couple of things to try. First for the leaks, it can simply come down to potty posture. As little girls begin to transition away from kid-sized potty seats and sit on the big potty seat, it alters their seated posture. They are just barely big enough to cover the hole in the seat, so they are rolled into a bum tucked under position (posterior pelvic tilt) and the dangling legs get rolled in together. Like this:
                 Image 1
For many girls this traps some of the urine between the folds of their labia. So when they stand up and start moving it leaks out. Try this instead: have her straddle the potty like a horse and hold on to the front of the seat while she pees. This position will prevent the urine from being trapped and encourages complete bladder emptying. Like this:

      Image
This position mimics the potty posture we encourage for adults for bladder health, so it is a good habit to get into (See last weeks post regarding potty posture to prevent urinary retention). As she gets bigger, she won’t have to hold onto the seat anymore, which is SO gross, but there is soap and antibacterial gel and she won’t get the distressing leaks anymore.
You didn’t mention urge, but at this age girls often experience this as well. This, according to a pediatric urologist, is apparently a common occurrence for girls between the ages of 5-8 as their bladders grow. Just knowing that is huge! It can help you and your daughter relax, and understand it is just one of many stages in her physical maturity. Obviously, rule out UTIs as well, which could go hand and hand with incomplete bladder emptying related to her potty posture.
If these solutions don’t bring a quick change (she is either trapping urine externally or she is not), then a trip to a pediatric urologist might be a good next step. Let me know how it goes!
J
Hi Julie!
Thank you for your help. We’re trying the new position already and my daughter didn’t complain of any leakage again since then. So I’m very excited!
F
 So now you have the 411, spread the word to moms and daughters everywhere!  Go Potty Posture!
Contributed by Julie Wiebe, BSC, MPT

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