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Cathing for Kids I - How to Self-Catheterize

As a parent, teaching your child to self-catheterize is an important step in their journey to independence. If your child has Spina Bifida, a spinal cord injury, or any other condition that affects their urination and they need to catheterize, they may eventually get to a point where they can start catheterizing on their own.

To help prevent them from getting a urinary tract infection or other complications, it's important to educate yourself so you're prepared to help them when the time comes. Here are some tips and tricks we’ve come up with to ease your transition.

1. Catheterization is normal

Children typically start wanting to learn how to self-catheterize between the ages of three and five. This is around the time they'll begin attending preschool and kindergarten. When they see the freedom of their peers, they'll likely want the same. While your child may have different needs, letting them know that everyone goes to the bathroom is a good way to start in terms of normalizing catheterization.

2. Catheters are a tool

Reassuring your child that their catheter is a tool is a good way to make them feel better about self-cathing. Your child should know that their catheter is there to help them go to the bathroom safely, so they can continue to enjoy other, more fun activities. 

3. Educate your child on catheterization 

Your child will likely have a lot of questions, and educating yourself about the process will make your child's transition easier. Meeting with a healthcare professional is a good place to start. From the beginning, you'll want to stress the importance of cleanliness and hygiene in order to prevent infection. Using flashcards and other fun learning tools to teach your child the basics of self-catheterization will help them not to get overwhelmed when it comes to learning about how to take care of their bladders.

4. Establish a routine

Establishing a routine is one of the best ways to normalize self-catheterization for your child. The more your child performs their own self-catheterization, the better they'll get at it, until it becomes another part of their self-care routine, like brushing their teeth in the morning.

A normal bladder needs to be emptied four to six times a day, but this depends on how much water your child is drinking and how active they are. You can speak to your healthcare professional to see what schedule works best for your child's lifestyle. 

5. Emphasize hydration

At first, your child may be nervous about catheterizing on their own. Make sure they continue to drink enough water and liquids, and aren't doing things to avoid self-catheterizing. If your child has a phone or a watch, you can set alarms here to help remind them to empty their bladder throughout the day. Doing this will help when it comes to lowering their risk of infection.

6. Make a self-cathing kit

One of the ways you can make establishing a routine more manageable for your child is by ensuring they always have easy access to their catheter and self-catheterization supplies. The supplies your child needs will differ depending on the type of catheter they are using. Taking a backpack or plastic bag and making it into an all-in-one kit, filled with supplies like lubricants, sterile gloves, antiseptic wipes, wash cloths, etc. will make their self-catheterization process a lot less scary. 

7. Plan for emergencies

If you're worried about the cleanliness of the self-catheterization process, you can choose to store your child's catheters in two bags: one for dirty catheters and one for clean catheters. This is also helpful in case your child doesn't have access to a discreet place to dispose of their dirty catheters. 

If your child is in a place without access to a toilet, make sure they have a container to store their urine. It's also a good idea to look into closed system catheters (which have a drainage bag attached to the catheter) and other types of catheters with insertion supplies, as both of these are great options when it comes to keeping your child's self-catheterization experience clean and stress-free. 

How to self-catheterize

Your child should always wash their hands with soap and warm water before they begin the catheterization process. If they don't have access to a sink, you can also provide them with hand sanitizer or some other type of antibacterial cleanser. 

Clean intermittent catheterization (CIC) differs depending on gender. It's important to educate yourself on these differences before you start catheterizing your child, and before your child starts trying self-catheterization..

Catheterization for your daughter

1. Have your daughter wash her hands or use an antibacterial cleanser to clean them. 

2. Once her hands are clean, your daughter should sit on the toilet or her wheelchair, depending on her ability and the accessibility of the bathrooms and separate her legs wide to access her urethra. When she is first learning to self-catheterize, you can use a mirror to show her where her urethra is. Over time, she will learn to identify it by touch.

3. From here, your daughter should clean her genitals with a washcloth or disposable towelette, separating the labia and wiping from front to back to avoid spreading germs. 

4. After cleaning the area, it's time to insert the new catheter. If your daughter is using a non-lubricated catheter, she'll need to use something like k-y jelly, or some other water-soluble, lubricating material and apply it to the end of the catheter.

5. Have your daughter place the other end of the catheter into the toilet or some other container to drain.

6. Before your daughter inserts the tip of the catheter into her urethra, have her take a deep breath or two to relax. This will help with easier insertion.

7. Your daughter can now gently insert the lubricated catheter tip into her urethra, about two to three inches in. Hold the catheter there until the urine flow stops. To make sure the bladder is fully drained, your daughter should move the catheter slightly, gently pressing on her abdomen and leaning forward. Failing to get all of the urine out of the bladder can contribute to bladder or kidney infections.

8. Once the bladder is completely emptied, your daughter should slowly remove the catheter from her urethra. Make sure she pulls downward when doing so and pinches the end of the catheter to prevent the backflow of urine.

9. After the catheter is removed, it can be thrown in the trash or stored in a plastic bag until it can be properly disposed of. Make sure your daughter washes her hands again after disposing of or storing her catheter.

Catheterization for your son

Catheterization is a bit different for boys, though the process as a whole is very similar. 

1. Always start by having your son wash his hands, or clean with an antibacterial cleanser. 

2. Depending on your son's ability, you can have him sit on the toilet or stand over it. 

3. From here, have him clean the tip of his penis with a washcloth or a disposable towelette, starting at the center and working outwards in a circular motion. If your son is not circumcised, he will have to gently pull back the foreskin of his penis so that the urethral opening is visible for cleaning. 

4. After cleaning the area, it's time to insert the new catheter. If your son is using a non-lubricated catheter, he'll need to use something like k-y jelly, or some other water-soluble, lubricating material and apply it to the tip of the catheter.

5. Have your son place the other end of the catheter into the toilet or some other container to drain.

6. Before your son inserts the tip of the catheter into his urethra, have him take a deep breath or two to relax. This will help with easier insertion. 

7. Your son needs to hold his penis away from his body while inserting the catheter tip in. The catheter should be four to six inches deep. Your son may need to lower the penis as he inserts his catheter, as it sometimes gets more difficult to insert the closer it gets to the bladder. Unlike with girls, do not stop inserting the catheter once the flow of urine starts. Instead, push it another inch deeper so that the catheter is in the bladder. 

8. Your son should continue to hold the catheter in place until the urine stops. Have him gently press on his abdomen and lean forward to make sure his bladder is completely empty. Failing to get all of the urine out of the bladder can contribute to bladder and kidney infections. 

9. Once the bladder is completely emptied, your son should remove the catheter from his urethra. Make sure he pinches the end of the catheter while doing so to prevent the urine from dripping over him and making a mess. 

10. After the catheter is removed, it can be thrown in the trash or stored in a plastic bag until it can be properly disposed of. Make sure your son washes his hands again after disposing of or storing his catheter.

Checking in with a healthcare professional 

If possible, you should also speak or meet with a healthcare professional before your child starts intermittent self-catheterization. Your child's doctor will walk you through the steps of catheterization, and if you meet in person they'll be able to check your child's vision and motor skills to make sure they're ready to start catheterizing on their own. If these all check out, your healthcare provider will then ask your child to go through the self-catheterization process on their own in the presence of a doctor or nurse. Once they prove they can do this without help, your child is ready to start catheterizing on their own. 

How to find the right catheter for your child

A clean urinary catheter is essential for keeping your child from spreading germs and getting infections such as a UTI. Intermittent catheters are single-use and should be disposed of every time after your child empties their bladder. Most times, a straight catheter should work, but in some cases, an intermittent catheter with a coudé tip will be necessary for your child. 

If you're looking for a catheter for your child, Better Health carries a selection of disposable catheters that are reimbursable through insurance. To find the right catheter for you and your child, take our product quiz, or request free samples through our website.

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