Hesperian Health Guides
Bladder and Bowel Management
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A child with spina bifida usually does not develop the same control of peeing (bladder control) and shitting (bowel control) as other children do. The child may always dribble urine. Or, as she gets older, she may continue to empty her bladder or bowels without warning, perhaps without even knowing or feeling it. Standard methods of toilet training will not work. Do not blame or scold her for her accidents.
WARNING! In some children with spina bifida, the bladder does not empty completely. This is dangerous because if urine stays in the bladder for a long time, bacteria will grow in it and this can lead to infection of the bladder and kidneys. In children with spina bifida, urinary infections are a frequent cause of death.
|A mother can learn to feel how full the bladder is, and to tap on it gently to see if this makes the baby pee. If not, she can regularly press gently on the bladder to push out the urine.||Later, some children can learn to empty their bladders by crying, rolling over, laughing, or sneezing. Others learn to do it by pressing on the stomach, like this, although this can also be risky (see "Methods for the Limp Bladder").|
|Some children may need to use a ‘catheter’ or rubber tube to get the urine out. By age 5 they can often learn to ‘catheterize’ themselves.|
|As they grow older, boys are often able to use a ‘condom’ connected to a bag that collects the urine.|
|Girls often need to empty the bladder regularly with a catheter, and perhaps use diapers (nappies) to catch any urine that drips out in between.
For girls, a mirror helps in finding the urine hole.
Most children with spina bifida can be helped to take care of both their bladder and bowel so that they stay relatively dry, clean, and healthy. Then they can go to school and do things outside the home with greater confidence. Therefore, it is extremely important that rehabilitation workers and family members help the child work out a good bladder and bowel program.