What are good bladder habits?

To answer this question, an example from someone who actually came in for help with this exact problem will be used. Caris (not her real name) has given permission for her story to be used).

Caris started aerobics again when her baby was four months old. She felt that she needed to go to the toilet the whole time that she was in the class. This happened even when she went to the toilet just before the class. She did not experience any leakage of urine, although many women do, but needed to go to the toilet again after the class had finished. Caris also noticed that she was going to the toilet much more often after having her baby, even up to eleven or twelve times. She also went two or three times during the night. Once her baby slept through, she found that she didn't!

Caris spoke to her friends about this problem, but they all thought that it was normal after having a baby. As her Physiotherapist explained to her, it is not normal, but it is common. The same is to be said for leakage of urine during exercise. These are problems that can be helped.

After making a physiotherapy appointment, Caris learned that she had 'trained her bladder to go too often'. This can happen when you go to the toilet often, 'just in case' you need to go, like before going out, although you may already have been recently. When you wake up to feed your baby, if you go to the toilet when you don't need to, you are training your bladder to go more often than it needs to. You may then find that like Caris, your baby may sleep through and you won't. This is also mentioned in As Your Shape Changes, in the section called "Your bladder and your baby".

Caris did a bladder chart, where she measured the amount of urine that she passed when she went to the toilet. She often passed 175 - 200 mls of urine or less. (This does involve weening into an old measuring container, but it can be an interesting exercise).

Once she became aware of good bladder habits (see 'What are good bladder habits' below), after a few weeks she was passing 300 - 400 mls of urine, and was now only going to the toilet about seven times a day, and only one time at night. She had even had a few nights of not waking up at all to go to the toilet!

By being aware that these habits weren't normal, and finding out that it was OK to hold on a bit longer, Caris was able to get her bladder habits back to normal fairly easily. If she had continued with her old habits though, when she had another baby the problem could have become much worse. This problem can also become worse as women get older, so sorting it out as soon as possible after the birth is important.

The other thing Caris needed to do was to continue to work on her pelvic floor muscle exercises. Her baby was four months old already, but her muscles were still getting stronger and were not yet back to normal. This also contributed to the feeling of needing to go during exercise. Caris decided to continue with working diligently on her pelvic floor muscle exercises and continue with lower impact exercise like walking on the treadmill and bike riding until her pelvic floor muscles really felt strong. Then she would go back to aerobics classes.

If you experience a problem with visiting the toilet often or leakage of urine after the birth of your baby, try the following tips. If they do not work within four to six weeks, seek further advice.

What are good bladder habits?

Do you know how much your bladder holds?

Normally our bladder holds 300 - 500 mls of urine before we need to go to the toilet. This means that we should go to the toilet every three to four hours during the day, and no more than once per night.

Now when you are pregnant it is a different matter. Hormonal changes together with your baby pressing on your bladder (as your baby grows, there is less room for your bladder) means that you usually go to the toilet more frequently. This is common during pregnancy but should not continue long term after the birth.

If your bladder capacity is reduced AFTER having your baby, or you find yourself going to the toilet more often than you used to, then you can try to retrain your bladder.

Write down each time you go to the toilet. Having it in writing can help you to really see how often you do go.
Measure the amount of urine you pass over two or three days, including at night.
Re-train your bladder habits.
If you capacity is less than 300 to 400 mls regularly, or you are going much more often than three to four hourly, then you may need to re-train your bladder habits.
Hold on when you can. Try to hold on a little longer when you are able to, before you go to the toilet.
Seek further advice.
If you find it very hard to hold on, or find that you leak on the way to the toilet, you need more individual advice. Make an appointment with a Continence and Women’s Heatlh Physiotherapist, Continence Nurse Advisor or speak to your doctor to find out about health professionals near you who can help. In Australia, the Continence Foundation of Australia has a free call Helpline service, where you can speak to a Continence Nurse Advisor, who can give you advice, and also give you the details of your closest Continence Health Professional. The National Continence Helpline number is freecall 1800 33 00 66. To visit the Continence Foundation of Australia website click www.continence.org.au

For more information watch the video 'For 5 proven bladder control training tips', by Pelvic Floor Physiotherapist, and author of 'Inside Out - the essential women's guide to pelvic support'.