Bladder Control

In newborns, the bladder contracts to expel urine when the pressure reaches a certain point. By two to three months of age, they have some bladder control. In 1928, behavioral psychologist James Watson (Psychological Care of Infant and Child, W.W. Norton & Company, Inc., 1928) noted that if a small pot was consistently lifted to a newborn baby's bottom when it began urinating, soon it would begin pushing whenever it detected the familiar sensation of the bowl touching its bottom.

Young Babies

Youngsters can achieve daytime continence by age one, according to a 1993 report in the journal Current Problems in Pediatrics, although physical capability is only a small part of what is required. Children would have to be worked with consistently from infancy to be continent at such a young age. They would also need to be exceptionally mature. The inability of children this young to delay urination for more than a moment or two translates into accidents, since it is often impossible for them to get to the potty fast enough. Furthermore, young toddlers readily lose control in response to laughing, coughing, sneezing, vigorous exercise, and emotional upset.

Older Babies

Because bladder size increases as children grow, toddlers urinate less often than babies. Once they figure out how to calm bladder contractions and tighten the bladder sphincter simultaneously, they can stave off urination for longer after the urge hits. It takes children a while to discover how full is “too full,” so they misjudge how long they can wait before heading to the bathroom.

FACT

Learning to use the potty for bowel movements and urination usually happens at the same time. Otherwise, children are likely to learn to have bowel movements in the potty first.

Toddlers can cause themselves to urinate once they figure out how to tense one set of muscles while relaxing another. Telling them to “try” to use the potty won't help, because they won't know how to go about “trying.” All parents can do is point out when their child is urinating in an effort to increase his awareness of what is happening.

Parents can estimate bladder functioning by watching for certain signs.

  • Your child's diapers remain dry for one to two hours at a stretch during the day. More frequent urination makes training more difficult. If your child leaks urine, it may be caused by a physical abnormality, but more often its cause is a bladder infection. See your doctor immediately.

  • Your child urinates large quantities at one time. This signals that the sphincter is able to contain urine properly. If the stream is not strong and steady when your child urinates a lot, notify your doctor.

  • Your child can stop the flow of urine midstream. Not all toddlers can, but having mastered this tricky maneuver means they can tense and relax the bladder sphincter at will. That can reduce the number of accidents — assuming they can remember how to stop when the urge to urinate is strong. Most children panic.

  • Your child awakens in response to a full bladder. This awakening means the sensations of bladder fullness are strong enough to rouse the sleeping brain. Children who cannot wake up have problems with bedwetting.

  • Your child awakens dry after naps and/or in the morning. This symptom suggests that bladder size is normal and that urine production decreased during sleep, as it should. If hormone levels are insufficient to suppress urine production, children must make many trips to the bathroom during the night or wet the bed.

  • It is obvious when your child is about to urinate or defecate. It's not always obvious, but if it is, parents can try to help youngsters get to the potty on time.

Although children can make a lot of progress with bladder control during the first year or two of life if they are consistently worked with, an occasional daytime accident is to be expected until age three. Bedwetting can remain a problem if the sensation of a full bladder isn't strong enough to rouse a sleeping brain. Even at age five, approximately 15 to 20 percent of youngsters continue to wet the bed.

  1. Home
  2. Potty Training
  3. Readiness Skills
  4. Bladder Control
Visit other About.com sites: