April 2025
What Is Spina Bifida and How It Affects Going to the Bathroom
Children with Spina Bifida often have trouble using the bathroom. This is because the nerves at the bottom of their spine may be damaged. These nerves help control the bladder (where pee is stored) and the bowel (where poop is stored). If the nerves don’t work well, a child may not feel when they need to go or may not be able to hold it.
Each child is different. Some children may not have accidents, but still need help because their body doesn’t empty pee or poop the same as other people. Toilet training may take longer and need special tools or steps, but it is possible.
Some children may need help going poop but not pee—or the other way around. Many will need help with both.
Starting Early
Bladder and bowel care begins when a child is born. Doctors check how the bladder is working to protect the kidneys. They may use medicine to help the bladder relax. Some babies start using a thin tube called a catheter to drain pee. This is called clean intermittent catheterization (CIC). Starting CIC early can help the bladder stay healthy and may make toilet training easier later.
Doctors also check how the child is pooping. If poop gets stuck (constipation), it can cause problems like infections or sore skin. Babies and toddlers might take medicine by mouth or use a suppository (a special kind of medicine that goes in your bottom) to help them poop. Keeping poop moving can help with toilet training later.
Learning to Use the Toilet
Most kids start toilet training around age 2 or 3. Children with Spina Bifida may take longer and may need extra help. They might use CIC to pee or take medicine or enemas to help with poop.
A good way to start toilet training is timed sitting. This means helping the child sit on the toilet at set times, like after meals or every few hours. This helps them learn the routine—how to undress, flush, and wash hands. Blowing bubbles, laughing, or making pushing sounds can also help.
Parents should give praise when the child tries, not just when they succeed. If timed sitting doesn’t work, doctors might suggest other treatments, like medicine or surgery. Enema programs can help clear the bowel and prevent accidents.
Children want to learn to use the toilet. If it’s not working, they may just need more help. You can find more information here: SBA’s Lifespan Bowel Management Protocol
Becoming Independent
As children get older, they can learn to do more by themselves. This might include using a catheter or managing their own enema program. This may take more time, especially if the child uses a wheelchair. Therapists can help find ways to make it easier.
At school, kids with Spina Bifida might need special plans to get the help and time they need to use the bathroom. They might also use special tools or equipment to help them at home and at school.
This information does not constitute medical advice. As specific cases may vary from the general information presented here, the Spina Bifida Association advises readers to consult a qualified medical or other professional on an individual basis.
By Jean Brown, MS, APRN, RNC
Reviewed April 2025 by Colleen Payne, MRC, CRC and Eileen Sherburne, PhD, RN
