Friday, 30 October 2015

Bladder Control - Holding the pee affects the ability of a child to concentrate on homework!

Recently a mother reported that her 8 year-old son could not concentrate on his homework when he is holding his pee.

The boy routinely held his pee during a variety of activities. Mom could see the typical posturing that signals that a boy is holding his pee. He fidgeted, squirmed in his seat, or tapped his toes on the ground. Whenever Mom saw posturing she reminded her son to pee. She learned to insist that her son pee before he sat down to do his homework so that his concentration skills would be optimal. Smart Mom!

Many parents see these holding postures and most will remind their child to pee. What was different with this Mom is that she could tell that his ability to focus on his homework was impaired when he held his pee.

I hear similar stories every few weeks. I'm sure this is a common problem and that this situation plays out regularly in many homes. Unless a parent recognizes this potential problem and asks the child to pee before they sit down to their homework, the work might not be done as well as hoped.

This situation also plays out in classrooms. Teachers who restrict access to the bathroom clearly do not understand this possible consequence. Picture a busy boy or girl who would like to pay attention to the teacher but whose bladder is full. If the child must wait for a break, their attentiveness suffers, and the teaching lesson might be poorly understood.

To help parents relate to this, I ask them if they have ever attended an early morning meeting after enjoying several cups of coffee. I inquire if they remember ever trying to hold their pee while they wait for the meeting to wrap up so they can politely escape to the bathroom. If the parent replies "Yes," I go on to inquire whether the full bladder interfered with their ability to concentrate on the topics discussed. Most nod a confirming "Yes."

Saturday, 24 October 2015

Bedwetting - Don't Limit Evening Drinking in Your Bedwetting Child!!!!!!!

Limiting what your child drinks after supper does not help and this common recommendation actually perpetuates the bedwetting!

About 75% of the parents who attend my clinic limit fluids in their bedwetting child. Most of the other 25% of parents experimented with this intervention and decided not to continue.

Some of the parents have limited evening drinking for years and their child still wets every night. “Has this helped,” I ask. “No,” they respond. “Ok,” I respond, "time for a new approach." 

I ask the parents to insure that their child drinks every evening. They need the hydration. Optimal hydration is one of the foundations of good health. 

The correct approach to hydration in a child with bedwetting is for the child to wake up in the morning and CATCH UP with their personal hydration by drinking LOTS in the morning. I recommend that a child drink about 40% of their recommended daily hydration before lunch. This works out to about 650 to 750 ml (22 to 25 oz) before lunch for an elementary school-aged child. After a child catches up, they should drink as per thirst or activity and they should
AWAYS DRINK IN THE EVENING. With this approach the amount of overnight urine production by the kidneys decreases even though the child is allowed to drink in the evening.

Many bedwetting children soak through their pull-up even though their parents limit drinking after supper. If these children are allowed and encouraged to drink in the evenings but if they also appropriately catch up with their hydration by drinking lots in the morning, the soaking through into the sheets goes away! Try it and see. 

The reason why limiting fluids perpetuates bedwetting is because this results in poor overnight hydration and this results in solid, pasty or hard poop that the bladder cannot push out of the way. Almost every child with bedwetting has a smaller bladder capacity than average. The bladder is smaller because the bladder cannot push the solid poop out of the way. Mothers understand this concept because during pregnancy their bladder was smaller because the bladder could not push the baby out of the way.