Understanding Bladder Development And Function

One of the first milestones on the path to dryness for you and for your child is gaining Knowledge. You need to know why most children do not wet and why some children do wet, and most important what might be the cause of your own child's wetting problem. Understanding the normal development of the bladder is a key element to a successful potty training experience. Only after you have gained real insight into your child's unique condition can you successfully choose a treatment plan.



Newborn

Newborn babies have no bladder control, they reflexively release urine from the bladder approximately every two hours, or about 12 to 6 times a day. As a newborn bladder fills with urine, it stretches until it reaches full capacity (about 2 ounces). Then receptors in the muscle that lines the bladder wall (called the bladder detrusor muscle) cause it to contract by reflex, expelling the urine. At this stage of development, babies are unaware of urinating; the brain plays a very minor role, if any, in initiating and stopping the release of urine. In newborns, urinating is a simple muscle reflex.



Infancy

By about the end of infancy, because nervous system connection between the bladder and the brain work better, children begin to sense bladder fullness while awake. As soon as children come to recognize this sensation they can start developing their ability to inhibit the release of urine. They do so by contracting the muscle situated at the neck of the bladder (called the bladder sphincter muscle).



Toddlerhood

By the time children reach toddlerhood, that is between two and four years old, they can be expected to have control of their bladder during the day. By now, they likely have the muscle strength and coordination to master urinary control. They also are motivated by parental expectation and rewards, and by the satisfaction of emulating their toilet trained peers. Usually by four years of age, children can stop a bladder contraction when they want to as well initiate urination when they want to. This ability is called volitional bladder control.



Youths

Children older than five years, that is, youths, typically maintain volitional bladder control by day. We say that such a child has achieved daytime urinary continence. The child has learn that when he does not want to urinate, he must inhibit a contraction of the bladder detrusor muscle and actively contract the bladder sphincter muscle. In addition, the child considers how much he has drunk, where nearby bathroom are, and so on. When its convenient and socially acceptable, he will permit his bladder to empty by contracting the bladder detrusor while relaxing the bladder sphincter. Some time, a little grunt helps push out the urine and get the urination started.



Overview

Urinary control normally comes first during the day while a child is awake, then during naps. And finally at night. Children usually achieve bowel continence, that is, the willful control and release of stool, before they have achieved urinary continence. Bowel control ordinarily develops first at night, then during the day.

The reason why children achieve nighttime dryness on their own are unknown. So, setting an age at which children should be dry is arbitrary. Most authorities assume that the child will outgrow the wetting and give the conventional advice: "Don't worry about wetting until after she's five years old. Others say, "Wait until she's seven." Still other say "Wait until nine". Potty training can be address at almost any age after infancy, with the right training tailor for that specific age group.