Young children with cerebral palsy (CP) may have problems with bladder and bowel continence for many reasons. It may simply be related to their age. All young children need time to learn how to hold their wee and poo as they develop bladder and bowel control.
For some children with CP, toilet training and continence can take longer. This may be because of movement difficulties, muscle control, communication, learning, constipation, bladder function, or the support they need to get on and off the toilet.
Incontinence can affect your child’s comfort, confidence and quality of life. It is important to get help from your healthcare team about toilet training and how to support your child through the process.
Urinary incontinence means having trouble controlling wee. Your child may:
- feel a sudden need to wee
- need to wee often
- have accidents during the day
- dribble wee after using the toilet
- have wetting that comes and goes.
Sometimes daytime wetting can be linked to constipation, urinary tract infections, stress, or changes such as starting childcare or preschool.
Bowel problems can include constipation, soiling or difficulty doing a poo. Constipation is common in children with CP. It can be linked to reduced mobility, tight or weak muscles, not drinking enough fluids, not eating enough fibre, some medicines, pain with doing a poo, or difficulty sitting comfortably and safely on the toilet.
It is helpful to keep track of:
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how often your child does a poo
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whether the poo is hard or painful to pass
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whether your child has tummy pain
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whether your child has soiling or accidents
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whether your child is holding on or avoiding the toilet.
If your child is constipated, toilet training may be harder. Your healthcare team can help you manage constipation and make toileting more comfortable.
If you are concerned about your child’s continence, talk to your GP, maternal and child health nurse or paediatrician.
Your GP can refer your child to a medical or allied health professional, such as a continence nurse, urologist, occupational therapist, physiotherapist or dietitian. They can assess your child’s needs and help create a plan to manage continence.
This may include advice about toilet routines, constipation management, seating and positioning, equipment, communication supports, diet, fluids and other treatments if needed.
