PT Corner: Understanding Pediatric Pelvic Health

What do Pediatric Physical Therapists do with children?

Pediatric Physical Therapists are healthcare professionals who work with children ages birth through 21 years old to improve strength, balance, coordination, flexibility, endurance, motor planning, body awareness, and pelvic health rehabilitation. Yes, pediatric pelvic health! This includes the bowel (poop) and bladder (pee) systems. Many children struggle with this, and parents do not know where to find answers. This is where Pediatric Achievements can help!

What is pediatric pelvic health?

Pediatric pelvic health and rehabilitation consists of treating conditions and diagnoses such as urinary incontinence, enuresis (bed-wetting), urgency, difficulties with voiding (going poop and pee), bowel dysfunction, constipation, encopresis (leakage), and dysuria (painful urination). Treatment consists of education, exercise interventions, biofeedback, stretches, manual feedback, and breathing techniques.

What are normal bowel and bladder habits?  


When is my child ready to be toilet trained?

Bladder control usually occurs around 4 years of age. Things to look for to see if your child is ready:

  1. Cognitive awareness of the need to go to the bathroom and an understanding of where an appropriate place is to go to the bathroom
  2. Shows interest in using the toilet
  3. Independently able to get to the toilet, undress, dress, and flush the toilet
  4. Stays dry for 2 hours at a time and feels uncomfortable if wet
  5. Willing to interrupt activities to use the toilet

How can you help improve bowel and bladder habits in your child?

  • Use different language. Try to avoid saying “Did you have an accident?” and instead say something like, “Did your bladder leak?”
  • Encourage proper positioning for your child while pooping, which includes the following:
    • Feet are supported
    • forearms are resting on thighs
    • hips are at least at 90 degrees
    • back is straight with some leaning forward
  • Make sure your child is getting enough fiber in their diet! Recommended pediatric fiber requirements are below:
    • Ages 1-3 = 19 grams
    • Ages 4-8 = 25 grams
    • Ages 9+ = 30 grams
    • In general: 14 grams of fiber per 1,000 calories
  • How can you get fiber in your child?

  • Increase you child’s consumption of fruits and vegetables. When they become constipated, avoid foods that “bind” such as applesauce, bananas, peanut butter, and toast.
  • Make sure your child is getting enough fluids.
    Recommended fluid intake requirements are below:
9+ years7-81656-189356-64
  • Avoid irritants for your child’s bladder.
    These include:
    • Acidic foods such as anything tomato-based, coffee, tea, citrus fruits & juices, and spicy foods
    • Caffeinated and carbonated beverages
    • Milk
    • Chocolate
    • Foods with red or blue dye in them

When should I seek help for my child?

  • If your child is over the age of 5 and has 8 or more voids per day.
  • If your child is over the age of 5 and has 3 or less voids per day.
  • If your child goes more than one week between bowel movements. This is considered chronic constipation.
  • If your child’s bowel or bladder issues start to interfere with social engagement, school, daily life, and self-esteem.
  • If your child has bowel or bladder leakage during coughing, laughing, or exercising.

Talking about bowel and bladder habits can be very private and personal both for your child and you!  However, you are not alone and neither is your child!  We at Pediatric Achievements are here to help, so let our qualified and experienced therapists perform a full evaluation and recommended treatment program so your child can be healthy and successful with their bowel and bladder needs!

If you have any questions, please do not hesitate to reach out to us: 703-491-1044

Sandalcidi, Dawn. 2021. “Pediatric Incontinence and Pelvic Floor Dysfunction.” Online Continuing Education through Herman & Wallace. Lecture presented online via teachable, September 18.