Written by Laura Justin, physiotherapist in Australia
When we think about pelvic health, we often think of pregnancy and post-natal pelvic floor care. But pelvic health is important for all people, at all life stages - even children!
In early life, children’s pelvic floor dysfunction can present with incontinence, bed-wetting, constipation or as a result of trauma. In adolescence, pain or dysfunction can occur in athletes, due to menstruation, or changes in sexual function. Even for children without concerns, it’s never too early to start healthy pelvic health conversations and habits.
Early Childhood
In early childhood, healthy pelvic floor function can be maintained by ensuring healthy bowel and bladder habits such as:
A healthy diet with enough fibre helps to prevent constipation. Foods that are high in fibre include wholegrain breads and cereals, fruit and vegetables.
Sitting on the toilet regularly, for example, encouraging your child to sit on the toilet for five minutes about 20-30 minutes after eating breakfast, lunch and dinner. Regular toileting can help your child learn to be aware of and respond to their body’s urge to poo.
Use a footstool or child seat on the toilet to help your child achieve a comfortable sitting position on the toilet and avoid tensing or straining.
Although toilet training can be a frustrating and stressful time for children and parents, reducing shame, pressure and anxiety around toileting will help your child relax and develop healthy toileting behaviour. Help your child to understand their body parts with images, books and talk about it openly with them. Remember our bodies and their functions are not embarrassing or shameful, and showing our children this is essential for pelvic and overall health as they develop.
Adolescence
Puberty and adolescence is a time of great physical and emotional change, and a large amount of development occurs in the pelvis. Helping your child understand and talk about these changes can help develop a healthy body image and healthy behaviours.
Some important aspects of pelvic health in teenagers are:
Period pain: persistent pelvic pain can have a negative effect on the well-being of teens and young women. Studies show that up to one in five girls aged 16-18 had period pain severe enough to miss school, so it is important for young women with bad period pain to learn about their pain and seek help if they need it. Severe pelvic pain and endometriosis can be linked to painful or overactive pelvic floor muscles.
Sexual pain: adolescence is often a time where young people become sexually active, young women are the most likely to experience dyspareunia or painful sex. Discussing sexual health with your children is important, particularly helping them to understand that sex should never be painful, and that there is help out there if this is something they are experiencing.
Body image: Changes to body shape and increased perceived social pressure can, unfortunately, lead to poor body image in young people. Some studies show that young people “suck in” or brace their abdominals, creating increased tension in the abdomen and pelvic floor. This can lead to long term stress and overactivity of the pelvic floor. Promoting healthy relationships with our bodies is an important aspect of both psychological and physical health for young people.
Continence: urinary incontinence is not only something that occurs in menopause and post-partum, it also occurs in up to 10% of teenagers. Both stress and urge incontinence can occur in young people and is common with pelvic floor overactivity particularly in young athletes (such as gymnasts and runners). Reducing the stigma around continence with your child can allow them to discuss their symptoms, and you can support them in seeking intervention from a Pelvic Health Physiotherapist who specialises in working with children.
Overall the best thing you can do is reduce stigma, shame and create an open dialogue with your children. Children should understand that their pelvic floor and reproductive organs are just like other body parts, and it is okay to talk about.
Understand that your child may feel more comfortable talking to another professional, a friend or someone they can confide in about their pelvic health.
Try to encourage your children to ask questions and know that their bodies can do amazing things, and are not at all shameful.