When do I let my child with Spina Bifida catheterize?

For those who use it, catheterization is an important part of bladder and kidney care. Transitioning care to your son or daughter is also important in the path to maximal autonomy. However, there is no standard timeline that every family must follow.

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, making sure to remain clean or sterile (depending on which technique you use).

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. The urology nurse can also provide guidance.

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 which 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, which allows for easier visualization of the catherization channel.

More information is available on this Web site in the Fact Sheet section and in:

Children With Spina Bifida: A Parent's Guide (The Special Needs Collection) Edited by Marlene Lutkenhoff

Health Guide for Parents of Children Living with Spina Bifida Edited by the SBA Editorial Review Board 

Both books are available in the Marketplace section of this website.

For more information on the genetics and factors associated with Spina Bifida, please visit the Spina Bifida Association fact sheet.

Interested in submitting a question for Question of the Month? Email us at sbaa@sbaa.org.

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