Learn about Urinary Tract Infections in Children with Neurogenic Bladder & Bowel

Q: When should I let my child with Spina Bifida catheterize?

A: Transitioning catheter care is a gradual process and depends on the child's learning profile, hand-eye coordination, fine motor skills, and body habitus. Delays in cognitive or motor skills should be considered when teaching the child to cath, but should not prevent trying. Usually there are phases to learning how to cath. First is learning how to set up for the procedure. Your child can help get the materials together for cathing. Next, your child can help set up the materials for cathing. To get a feel for when your child can help with the actual cleaning, lubricating, insertion, and removal, he or she can practice with a Cheerio. Sometimes, an occupational therapist can assess fine motor skills and design a program for improving the motor skills needed for cathing and/or suggest positional or other adaptations to facilitate access to the urethral area. Parents and children can use a hand-over-hand technique to begin learning the sequence of motor movements needed in catheterizing. Eventually, the parent can allow the child to cath under supervision. Some children are able to do this by the time they start school, but many are catheterized by the school nurse. Requesting catheterization training as part of the Individualized Education Program is another way to provide opportunities to learn the proper procedure. Some children, particularly girls, may have difficulty with cathing if there are mobility limitations (i.e. spina rods that inhibit bending) or body size issues. In these situations, or whenever catheterization of the urethra is difficult, the family can consider procedures such as the Mitrofanoff. For more information, review SBA’s health information sheets on toilet training and urologic care and management as well as Health Guide for Parents of Children Living with Spina Bifida