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Incontinence - Cause, Myths Vs Reality


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Urinary Incontinence:

To understand what causes this needs some medical knowledge of the urinary excretory process. The two kidneys constantly filter the blood and deposit urine into the bladder every five to fifteen minutes. The bladder, being similar to a balloon, has a muscle on its neck called the internal sphincter which is open, and closes from the sense of urine in the bladder. As more urine is placed into the bladder, it fills yet hasn't expanded. When the bladder is full and not expanded, it signals the brain to close the external sphincter muscle and open the internal sphincter muscle. The brain interprets this as a need to urinate and has about thirty to sixty minutes to handle this. Meanwhile, more urine is being placed into the bladder and the bladder starts to stretch since the external sphincter is closed allowing pressure to build in the bladder. This sends a signal to the brain as a sense of urgency.

If one happens to reach a bathroom in time, you can consciously tell your detruser muscle to contract. This is the muscle that causes the bladder to close and will open the external sphincter muscle allowing urine to exit your body. If you however, happen not to get to a bathroom in time, the detruser muscle will contract automatically and you will wet whatever you are wearing.

Incontinence will occur when one or more of the processes listed does not work. Usually, the nerve impulses get disturbed before they go to the brain so the internal or external sphincter muscle does not close. Either failing also stops the bladder from expanding so the corresponding symptoms also occur - small bladder with frequent voiding / small bladder with constant weeping urine.

Bowel Incontinence

The human bowel is the final part of the lower intestine, and consists of two items - the rectum, and the anal canal. Out of these two, the only one under conscious control is the anal canal or the anal sphincter. Most of the time, this muscle is closed. Its action is similar to that on the length of a straw - each part of the neck does not create a seal, but the combination of the length of this does seal. The rectum is constantly being filled by the peristatic action of the digestive tract. If your diet happens to contain to much water, the weak anal sphincter will cause stool to weep. On the other hand, if your diet contains too little water, the peristatic action will cause your rectum to block and impact. This will cause reverse pressure.

The anal canal / sphincter can not withhold liquid.

Usually, when the rectum gets engorged, a signal is sent to the brain to void. If this signal is correctly intercepted, the reverse will relax the anal sphincter and the rectum will contract and empty. This is due to a physical drop in the pelvic floor muscles. This then causes the anal canal to mimic the peristatic action of the colon while the rectum walls contract.

In an incontinent person, the rectum does not store stools. This can be due to hypersensitivity of the rectum walls OR failure of the anal sphincter to create a seal. Another cause of incontinence - also the same for some infants, is an inability to understand the impulse of an expanding rectum. This causes the rectum to contract in sympathy with the colon, therefore the person concerned will void without any notification. Also since an infants diet is mainly liquid, its stools contain a high amount of liquid and are extremly easy to pass a weak sphincter.

peristatic action = muscular action of a tube which causes each segment of the tube to contract in turn thus propelling the contents of the tube. Within the human digestive system from the throat to the anus, movement is created by involuntary peristatic action.

The Myths Dispelled

1: Reducing water consumption will reduce your need to urinate.

FALSE: Reducing water consumption means that your urine will increase in concentration and toxicity so the bladder will contract when any urine is entered. Resultant is that you will wet more often. It also has the secondary effect of forcing your body to absorb more water from your stools and can cause constipation.

2: Laziness is the cause of secondary nocturnal enuresis / bed wetting

FALSE: 1.One cause of bed wetting is usually a change in the position of the external sphincter. This occurs either at the start or end of puberty depending exactly on the person concerned. 2.The human sub-conscious mind which is responsible for continence will not place itself or its body in a situation to make it uncomfortable and sacrifice valuable needed regeneration and resting time.

3. Night Diapers / Harassment / Stress / Corrective Action will help in eliminating secondary nocturnal enuresis / bed wetting.

FALSE: The pseudo infantile act that the child/adult is performing by wetting during times of rest - as perceived by the child/adult - is usually distressing to the child/adult. Adding to this stress will only increase the problem. Yes- protection is advisable, but only with the consent of the child/adult. Instilling self-confidence allows the associated stress to disapate and the body to relearn control.

4. Medication such as DDAVP will help in eliminating secondary nocturnal enuresis / bed wetting.

FALSE: DDAVP and similar work and interfering with the body's natural production of vasopressin. Vasopressin is the chemical within the body that controls water balance. Any medication that adds more of or suppresses something that is naturally created causes the body to conserve its energy and thus eliminate its own production. As a result, a child prescribed vasopressin will temporarily gain nighttime control, but will become dependent on the drug to revert back to the lack of control he/she had before taking the drug. Side effects of altering the body's water balance is constipation/diarrhea, kidney infections, aggressiveness, low self esteem, low concentration levels.

Secondary nocturnal enuresis / bed wetting is NOT caused by a body chemical imbalance and does NOT require medical intervention (in most cases). It IS caused by normal growth OR perceived stress, which will self heal without medical intervention. What I suggest is discrete nighttime protection with the child's consent.

5. Kegel exercises will eliminate / reduce urinary incontinence.

FALSE: Kegel only exercises the muscles of the pelvic floor and not the three urinary muscles concerned (detruser and two sphincter muscles). This type of exercise will tone up the anal sphincter if it is not already atrophied and one already has some control of that muscle. However, since the anal sphincter was never designed to hold liquid, a simple change in diet is usually more effective. Some of the side effects of anal sphincter strengthening is a build up of gas pressure within the bowels which causes stool to be excreted with the gas when the pressure reaches high enough to expel. Thus, kegel can create bowel incontinence to bowel continent people. Also, the reverse pressure can cause complications across the digestive tract. Thus, kegel should only be used under strict medical supervision when the complete history is known.

6. Holding urine within your bladder will eliminate / reduce incontinence / eliminate nocturnal enuresis / help train bladder control

FALSE: All holding urine at strain in the bladder is doing is putting back pressure on the kidneys and can cause the external sphincter to cramp. Back pressure on the kidneys can damage them, and cause potentially fatal chemicals to enter the bloodstream. A cramped external sphincter will either lock closed or open. If it is locked closed, a catheter will have to be introduced to empty the bladder which has the potential of introducing germs into the urinary tract. If the external sphincter is locked open, urinary incontinence will occur for at least the next 12 hours until the muscle relaxes.

WARNING - I strongly suggest that those urinary continent people who wish to try this that they don't as it WILL cause damage to your kidneys = fatal agonizing death.

7. Long term incontinence is curable.

FALSE: Failure of somewhere along the excretory process allows the muscles to stay open. Since the body is an expert at energy conservation, if signal interruption or muscle damage the two sphincters will stay open. Since they are no longer moving, they do not utilize the blood supply. This causes deposits along the blood vessels concerned eventually reducing and eliminating blood flow to the two sphincters. The two muscles will die. Also, the subconscious will ignore the nerve signal of urine entering the bladder. The detruser might still function to a certain extent but since the sphincters are both open, one will void urine using gravity. as a result, the detruser will only function as a direct stimulation to fear or contraction of the pelvic floor muscles.

8. Biofeedback devices work

FALSE: Biofeedback devices, more correctly known as nerve impulse units have little or no effect on the excretory system except to cause the detruser to contract thus emptying the bladder. Invasive surgical techniques have been found successful by implanting artificial external sphincters. However, with these devices, it is extremely important not to allow the bladder to overfill thus avoiding back pressure on the kidneys.

9. Electro-stimulation (introducing electric pulses to stimulate) of nerves / muscles can cure incontinence.

FALSE: Yes, it is possible to partly recover function to certain muscles, the sphincters included, but if the original cause of incontinence is not repaired, it does not matter what muscle you have subconscious control of, without the full nervous system working, you will not gain continence. The best result possible is still needing to wear protection and being aware of your need to void but really unable to do anything to prevent it happening. Also, as explained earlier, in a matter of days/weeks, you will be back to being fully unaware of the act.

10. Internal or External Laser Sphincter Surgery (Sphinceroplasty surgery) can cause / cure incontinence

FALSE: This is to cut the sphincter so it can open further. The scar tissue that will form does not alter the functionality of the sphincter. Complications from surgery can cause incontinence if nervous damage occurs, but this is rare. Urinary tract infections are more common with this type of surgery.

11. Diaper usage cause urinary tract infections.

FALSE: Urinary tract infections, and or infections within the urinary system are caused by bacterial introduction into the urinary system. Urine itself to the person is sterile, and as a result, it constantly cleans and sterilizes the urinary system. Bacterium are introduced by poor hygiene standards - IE introduction feces into the tract by poor cleaning / wiping the incorrect direction OR introduction of third party implement into the urinary system - usually a catheter etc without observing proper cleaning processes. (See also No5 in relation to back pressure on the kidneys)

12. Diaper usage / incontinence can cause kidney stones.

FALSE: Kidney stones are created by a build up of calcium deposits within the kidneys. The main cause of this is a lack of enough water within the diet. Calcium is one of the elements in urine, and is normally in weak enough concentrations to be totally dissolved in the urine. However, low water content urine means high concentration of elements which can crystallize and form stones within the kidney/bladder. Since the kidney/bladder is only designed to handle liquids, solid or semi-solid substance is similar to sand to the urinary system. This will cause damage to all organs concerned and also pain. Since the kidneys function are central to the functionality of the body, damage to those organs can be fatal.

13. Newborn babies ARE incontinent.

FALSE: The average newborn child has a fully functioning excretory system. What they do not have is the mental ability to understand what or how to react to their bladder or bowel needs. As a result, they fuss just before voiding. Most babies are placed in diapers and encouraged either by praise after the event OR ignorance before the event to void in diapers. Correspondingly, a newborn associates, due to no other knowledge, that they are supposed to use diapers for their eliminations. This is one of the earliest things that they learn, and why, in most cases, reversing this training is so difficult.

14. Bowel continence is achievable

FALSE : This will surprise most. The anal sphincter can't hold back liquid, so if you are on a liquid only diet, you will be bowel incontinent. As a result, those people, who pride themselves as being 'not an infant since they do not mess their diapers' is only due to diet, nothing else.

15. Gall Bladder Removal (cholecystectomy) causes bowel incontinence

FALSE: There is no direct correlation to a cholecystectomy (gall bladder removal surgery) and fecal incontinence UNLESS there were associated complications. Most cholecystectomy surgeries are currently preformed laparoscopicly (via keyhole surgery) and as such, complications are rare. Normal temporary side effects of laparoscopic surgery can include indigestion etc or in extreme cases, an over active or over sensitive bladder or bowels. This oversensitivity is caused by residual saline solution within the bladder / bowels rather than bowel / bladder damage.

However, there is about 1% of operations that cause other problems which may involve the surgeon to access the gall bladder via an alternative route. Some incontinence may be caused by such, but this is normally a temporary effect which clears up over a few weeks.

What you may be referring to as fecal incontinence could be diarrhea, which about 15% of patients suffer from until their digestive system adjusts to a new diet.

16. Surgical Intervention can cause incontinence - bowel and/or bladder

TRUE and FALSE: For surgery to effect continence, the surgeon needs to cut the spinal cord above the sacral vertebrae. This has also the side effect of eliminating any sexual control. However, surgery can sever the nerve group that controls the detruser. As a result, this part of your eliminations would revert to automated behavior - ie you would wet when your bladder started to fill. As you would be diaper dependent 24/7, your anal sphincter would follow suit. However, trying to find a surgeon willing to do this would be near on impossible.

17. Tasers / Electronic Devices / Acupuncture can effect continence

TRUE: It is possible to use an electronic device (hair removal device / muscle stimulation device etc) to overload the impulses that your bladder nerves are constantly sending to your brain. However, since this will affect all nerve impulse from your bladder and surrounding tissue, you also may loose sexual function and/or feeling.

Summary:

For correct safe operation of the human body and the urinary system, do not reduce your water intake. The industry norm is a minimum of eight glasses a day or 2.9 liters a day, but I suggest that you use the calculator or similar on the link below to calculate your own body needs.

http://www.csgnetwork.com/humanh2owater.html

http://www.bloodindex.org/Human_Water_Requ..._Calculator.php

Side note

Please don't be discouraged by the information here. Cases described above are the extreme. I put this together to try and answer the questions that keep being asked on this board. For your own safety and peace of mind, anything discussed here or any other questions should be addressed to a competent medical practitioner who is familiar with your history. Anything else is not being true or fair to yourself.

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  • 3 weeks later...

13. Newborn babies ARE incontinent.

FALSE: The average newborn child has a fully functioning excretory system. What they do not have is the mental ability to understand what or how to react to their bladder or bowel needs. As a result, they fuss just before voiding. Most babies are placed in diapers and encouraged either by praise after the event OR ignorance before the event to void in diapers. Correspondingly, a newborn associates, due to no other knowledge, that they are supposed to use diapers for their eliminations. This is one of the earliest things that they learn, and why, in most cases, reversing this training is so difficult.

So that means I can potty train my infant right after I have one?

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Yes, many years ago, as in in freud's time, parents would hold their infants over the pot or toilet or whatever they had until the infant urinated and had a bowel movement, then would 'reward' them.

Its not that infants do not have the muscle control etc.. its that they do not have the cognitive ability to recognize "hey i have to go to the bathroom" and they do not have the motor control to get themselves to the bathroom.

SO why you can train an infant to go to the bathroom over a toilet, and condition them to only go at certain times of the day, for them to be considered "potty trained" they would need both the cognitive and neurological development to use the toilet on their own.

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  • 1 month later...
Guest LOSTinDiapers

So that means I can potty train my infant right after I have one?

Do a Google search for Elimination Communication. That is what sarah_ab described with holding the infant over the toilet and timing bladder and bowel movements. I know a few sets of parents who have done this and I think it is BS. While, yes, the parent is able to know when the baby needs to toilet, it eats up every waking moment of your day because everyone knows how often newborns eliminate. You can spot these parents when they say that their child was potty trained at 6 months old.

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  • 2 months later...

TRUE: It is possible to use an electronic device (hair removal device / muscle stimulation device etc) to overload the impulses that your bladder nerves are constantly sending to your brain. However, since this will affect all nerve impulse from your bladder and surrounding tissue, you also may loose sexual function and/or feeling.

If I was taser my groin area with a high powered tazer gun would this completely fry the impulses between my sphincters and brain resulting in permanent incontinence? What do you think would be the outcome if one managed to get the probes into ones anal muscle cavity and fired? Would this make you bowel incontinent? And what do you mean about lose of sexual function? Would I lose the a ability to have a erection/stop feeling horny? Thanks...

Edit... Just making sure the next time I tazer myself I'm aware of the consequences to pervent any incontinence issues.

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  • 2 months later...

If I was taser my groin area with a high powered tazer gun would this completely fry the impulses between my sphincters and brain resulting in permanent incontinence? What do you think would be the outcome if one managed to get the probes into ones anal muscle cavity and fired? Would this make you bowel incontinent? And what do you mean about lose of sexual function? Would I lose the a ability to have a erection/stop feeling horny? Thanks...

Edit... Just making sure the next time I tazer myself I'm aware of the consequences to pervent any incontinence issues.

NO IT WOULDNT

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A superb article from BabyKeiff; what a pity I am too stupid to understand it!

I am interested in the process of evolution as it applies to this subject. Continence is a necessary attribute for den-living animals; and humans are the only den-living primate. Monkeys don't need it; they live in trees and so their waste products tend to be a problem only to animals who live below, and pet monkeys are notoriously difficult to toilet train. Monkeys are also notorious for defecating into their hands and throwing the faeces at an aggressor, so they must have some control.

The contentious Aquatic Ape Hypothesis (http://en.wikipedia.org/wiki/Aquatic_ape_hypothesis - worth a read!) maintains that we spent some time as a semi-aquatic ape in between leaving the trees and hunting the plains - if indeed we ever did the latter. There's no use for continence on for a semi aquatic animals, so it must have been a fairly late development in evolutionary terms, and this would be supported by the relative lateness of toilet-training in humans; we have mastered walking and talking, and many other skills before we master our sphincters.

As a matter of interest, does anyone know if seals are capable of continence when they are on their nursery beaches?

As all DLs and ABs have realised, continence is a deeply-embedded conditioned reflex reaction and almost impossible to reverse. Tough, we'll just have to live with it!

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1: Reducing water consumption will reduce your need to urinate

Not a good idea

I found this out the hard way i have sarcoidosis/neurosarcoidosis and by reducing water consumption i inadvertently incressed the allready high calcium levels caused by the sarcoidosis.

High blood calcium levels lead to thirst and excessive urine production. After a long time, high blood calcium levels may lead to kidney stones or calcium deposits in the kidney.

kidney stones HURT and passing stones every few months is NOT fun.

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  • 2 weeks later...

This may sound somewhat dumb on my part, but I thought all the nerves for the bowel and bladder were well protected from injury. But after my latest injury of L3,4,5,6, with nerve damage in both legs, combined with prior upper back injury and 10 permanent nerve blocks that my incon issues are a come and go or like on & off at times. When my back is real bad I do worse with it, but has slowly gotten worse over the past year.

It also acts on my digestive tract and with reflux. Cutting back on fluids makes both of these worse as well as creating more bladder urges and constipation that again makes my bladder more irritated.

One Doc says its the chronic high pain levels at times overloads the signals for control. Another Doc says its pressure on the nerves in my lower back noting that the steroid injections helped in the begining for bowel control and alergy meds helped some for the bladder control for a while. Third one thinks its the muscle spasms that I get all thru my body that indicate something out of control with my nervous system. And best was the forth he thought that since I was bedwetter later than the norm when I was younger and the lack of sleep for days at a time since the injuries and Somehow that was part of it. Most everything I can deal with but the incon issuses perplex me as well as complicate life.

Now I only take pain meds when It gets so bad that I cant sleep or cant fuction due to the pain and loss of range of motion. I am always at a high pain level and can have injuries, burns, cuts with no or little concern. They say that my feet and legs go numb/useless from something called positional pressure on the spine/nerves. Its about the same for my hands and arms, I can be doing something and loose the ability to use or grip.

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  • 3 months later...

If I was taser my groin area with a high powered tazer gun would this completely fry the impulses between my sphincters and brain resulting in permanent incontinence? What do you think would be the outcome if one managed to get the probes into ones anal muscle cavity and fired? Would this make you bowel incontinent? And what do you mean about lose of sexual function? Would I lose the a ability to have a erection/stop feeling horny? Thanks...

Edit... Just making sure the next time I tazer myself I'm aware of the consequences to pervent any incontinence issues.

Hah you might shit yourself from the chock and the pain, but you will probably soon after wake up and find that you will need to do it another time to have it happen again if that was what you were aiming for. But please go ahead, and have a camera ready, I would love to see a guy roast his nuts and/or anus with a tazer.

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  • 1 month later...
Guest lilme

Hah you might shit yourself from the chock and the pain, but you will probably soon after wake up and find that you will need to do it another time to have it happen again if that was what you were aiming for. But please go ahead, and have a camera ready, I would love to see a guy roast his nuts and/or anus with a tazer.

I'd watch that :roflmao:

~lilme

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  • 3 weeks later...

I like this thread, thanks for clearing that up for those who have not dealt with it. ;)

What I have they call "urge incontinence" ... funny that one hospital didn't believe me because they think it's all curable, but I don't go there when I can avoid it anyway, their doctors are idiots to. My regular docs kept pushing me to "find a cure" and ... well ... I didn't because I don't like taking meds more than I have to, so I just lived with it. Went in for surgery recently and had the chance to talk to a few nurses and doctors about it, they told me that likely mine isn't curable, probably some major nerve damage due to some things I had done in the past (I won't bore you with those details) so there is really nothing to do. This particular hospital that I did get the recent surgery at is one that I go to with most of my problems, so they have my full medical records. But yeah, for those who are not incontinent, it's wise to simply not try to become it, there is literally no turning back, ever, and even having a "cute" side to me, it's not as much fun as it may seem. Wise words from an advice columnist I once read "usually it's best to keep a fantasy a fantasy."

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  • 2 months later...

newborns are incontinent. Yes they have all the parts they need to be continent but they do not work the way they do in adults. Adults brains control when to empty the bladder but a newborn does not have the brain development needed to perform this function. As a result bladder control is handled by the sacral cord. A brief quote here and a link.

http://emedicine.medscape.com/article/453539-overview

In infants, the higher center of voiding control (the brain) is not mature enough to command the bladder, which is why control of urination in infants and young children comes from signals sent from the sacral cord. When urine fills the infant bladder, an excitatory signal is sent to the sacral cord. When this signal is received by the sacral cord, the spinal reflex center automatically triggers the detrusor to contract. The result is involuntary detrusor contractions with coordinated voiding.

A continuous cycle of bladder filling and emptying occurs, which is why infants and young children are dependent on diapers until they are toilet trained. As the child's brain matures and develops, it gradually dominates the control of the bladder and the urinary sphincters to inhibit involuntary voiding until complete control is attained. Voluntary continence usually is attained by age 3-4 years. By this time, control of the voiding process has been relinquished by the sacral reflex center of the sacral cord to the higher center in the brain.

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newborns are incontinent. Yes they have all the parts they need to be continent but they do not work the way they do in adults. Adults brains control when to empty the bladder but a newborn does not have the brain development needed to perform this function. As a result bladder control is handled by the sacral cord. A brief quote here and a link.

...

That is slightly incorrect. It is true that the bladder will empty by reflex action, but that reflex action occurs cause the child brain ignores the signals, and doesn't send the interrupt. The true definition of an incontinent person is one who has a failing in one of the methodologies needed to control continence. By definition, an infant is NOT incontinent, but is simply uneducated - or more correctly, taught to use diapers.

As I already stated, a infant LEARNS, by feedback - 1. The signal that it needs to urinate / vacate its bowel. 2. The feeling of evacuating itself. 3.The feeling of a wet/messy diaper - what the signals are, and tries to inform its parent etc of its needs by fussing etc. Most parents etc chose to diaper their child, and praise the child for wetting/messing its diaper. As a result, due to the teaching methodology invoked by its parents, a child learns to ignore the signal to urinate/vacate its bowels, and will use the diaper as intended. This action does not state that the child is incontinent, but it does state that the child has learned to behave in a way that suits its parents.

FYI, Marcuss, the Sacral Spinal cord, as stated, is the termination of the spine. It does NOT have the capability to make decisions. All nerve systems link to the associated muscles. It is the basis of how and why the reflex system works, which is vital for our self preservation. IE If you touch something that is hot, the sensation of 'hot' will loop back to the muscle controlling your arm, contract, thus moving your arm out of danger. This will happen before the sensation of 'hot' reaches the brain.

"The spinal cord functions as a long communication pathway between the brain stem and the sacral spinal cord. When the sacral cord receives the sensory information from the bladder (or any other connected nerve), this signal travels up the spinal cord to the pons and then ultimately to the brain. The brain interprets this signal and sends a reply via the pons that travels down the spinal cord to the sacral cord... "

Also, in very young children, the sphincter muscles do not correctly close. This causes the child to void constantly as soon as it enters the bladder / bowels. The sphincter muscles develop within a week or two from birth which allows them to close completely.

Thirdly, in children, as soon as food enters their mouth, this triggers the lower intestine to push its contents out in order to make room in its stomach. With weak/relaxed anal sphincter, or with a child ignoring the signal of filling bowels, the child will soil its diaper. As the child is toilet trained, it learns to reverse the movement of food in its lower intestine. This allows for the child to gain a higher nutrient level from its digested foods and eliminates the need to void as it eats.

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Actually, Babykieff, there is a slight difference in the brain at that time, the part that does regulate such things isn't even developed at that age. ;) So newborns are technically incontinent because the control is directed to a reflexive nerve until a certain age. I don't remember any more of the details myself, it's just not that interesting to me, but some non-AB/DL forum I use to work on I had to fact check this for another debate (something about evolution and such). Marcuss did a pretty good job of paraphrasing it anyway so I'll leave it at that.

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  • 6 months later...

<!--quoteo--><div class='quotetop'>QUOTE </div><div class='quotemain'><!--quotec-->13. Newborn babies ARE incontinent.

FALSE: The average newborn child has a fully functioning excretory system. What they do not have is the mental ability to understand what or how to react to their bladder or bowel needs. As a result, they fuss just before voiding. Most babies are placed in diapers and encouraged either by praise after the event OR ignorance before the event to void in diapers. Correspondingly, a newborn associates, due to no other knowledge, that they are supposed to use diapers for their eliminations. This is one of the earliest things that they learn, and why, in most cases, reversing this training is so difficult.<!--QuoteEnd--></div><!--QuoteEEnd-->

So that means I can potty train my infant right after I have one?

Diaper Star - I love your signature!! Love that movie!!

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  • 3 weeks later...

Actually, Babykieff, there is a slight difference in the brain at that time, the part that does regulate such things isn't even developed at that age. ;) So newborns are technically incontinent because the control is directed to a reflexive nerve until a certain age. I don't remember any more of the details myself, it's just not that interesting to me, but some non-AB/DL forum I use to work on I had to fact check this for another debate (something about evolution and such). Marcuss did a pretty good job of paraphrasing it anyway so I'll leave it at that.

Marcuss DID a good job of paraphrasing, you are correct BUT, he forgot the part that infants / newborns IGNORE the signals because of .... -

1 - they do not have the physical ability to go and relieve themselves

2- they do not have the reasoning to deduce that after voiding they will become uncomfortable

3 - they DO have the knowledge that they need assistance - and will fuss for attention prior to voiding.

If a newborn is taught to use a diaper either by praise after the fact OR by ignorance of the child's fussing, the child will accept, due to no other knowledge, that it is natural and normal to ignore the feelings, void in a diaper, and WILL pass bladder and bowel control to their autonomic bypass system. Their mind will still be informed prior and post effect.

Newborns are, by definition CONTINENT, since ALL of the mechanism works but lazy ignorant parental teaching has told them to ignore the signals. INCONTINENCE, by definition, is a FAILURE in one or more of the mechanism responsible for voiding.

Please, if you wish, check out the natural voiding methodology and infant potty training, which has been adopted in many cultures worldwide. It is only the so called 'developed world' that chose to diaper their children from birth - which is, in my opinion, a form of convenience for the parent at the cost of the child, as is bottle (formula) feeding the child rather than breast feeding.

In some cultures, the stink of a messy diaper is never experienced, since the child is breast fed from birth to 4-5 years of age, and diapers are not used at all. Even if diapers were used, breast milk does not contain the high levels of ammonia that causes baby diapers to reek.

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