Christopher Cooper, a pediatric urologist at the University of Iowa who co-wrote the 2012 and 2003 studies, began researching the issue after noticing a high frequency of UTIs and higher rates of voiding dysfunction among his young patients. “It started to seem like, if for eight hours a day you [as a teacher] are the primary caregiver for these children, you’re missing a potential opportunity to pick up on some abnormal things going on,” he says. It’s hard for a kid to advance academically and develop socially and emotionally if she is constantly distracted by her bladder troubles. “Wetting your pants at school is one of the most stressful things a child can face or even imagine,” Cooper says.
One mother in the Seattle area, Maija Brissey, says she will never forget the day her son, who struggles with urinary accidents because of a rare medical condition, came to her at the age of 6 and asked her if he had a disease. Apparently, his classmates had convinced him that he did because he kept peeing his pants. Over the years, Brissey says her son started disengaging from classes and from his neighborhood friend group, retreating to his room right after school rather than playing with his buddies. “We’ve got to do a better job of making using the bathroom more comfortable for kids,” says Brissey, a nurse.
When they’re in elementary school, kids’ bladder systems—and the psychological responses to these physiological sensations—are at a crucial point of development. According to Cooper, children are “very good at ignoring [their bladder] signals” after being regularly denied the opportunity to go when they feel the urge. And the side effects—from incontinence to recurring urinary accidents—can put stress on the bladder, which is a muscle, and thus make it stronger and overactive. Cooper cited the high rates of bladder cancer among truck drivers, who often hold their urine on long drives.
Read: The long lines for women’s bathrooms could be eliminated. Why haven’t they been?
Suzanne Schlosberg, a health and parenting writer based in Bend, Oregon, started advocating for policy reforms and greater awareness after experiencing similar issues with her child. A few years ago, Schlosberg teamed up with Steve Hodges, a pediatric-urology professor at North Carolina’s Wake Forest University, to create an online resource for parents, therapists, teachers, and others seeking to help children who suffer from toileting problems. One of the inevitable challenges of this issue is that many people don’t want to talk about bathroom issues. As universal and mundane as they are, they can be embarrassing to discuss—not only for kids, but also for the adults who care for them. These days, Hodges says he often finds himself writing letters to schools demanding bathroom freedom on behalf of his patients.