Kidney health in children: Avoid these common misconceptions
By Dr Saumil Gaur
Kidneys are pivotal organs for the holistic development of children. But there are several myths among parents and grandparents regarding kidneys and their health, sometimes leading to non-scientific practices that are counterproductive to children’s health. This article looks at some of the commonly held beliefs and provides a rational basis for parents to make optimal and scientific decisions regarding their child’s health.
Can children really have kidney problems?
Yes. This comes as a surprise for many parents, but the reality is that kidney diseases are very common among children in various forms and among all the age groups from fetal age to childhood extending right up to teenage and adolescent life.
Will using public toilets cause urinary infections in children?
This is the most common myth among parents, however, urinary infections are not communicable diseases. It is a false notion that sitting on a common toilet seat can cause bacteria to “crawl” into or “stick” to the buttocks or genitalia and enter the urinary system and cause infection. This belief among parents has led to an inculcation of the wrong habit of controlling urination for long hours among young children in the quest for a visibly clean toilet. Holding in the urine can itself lead to recurrent urinary infections. Hence children should be encouraged to use any available toilet when in need.
Will using diapers cause urinary infections in small children?
This is another common misconception. Research has confirmed that diapers do not cause urinary infections in children if used judiciously. Using diapers keeps children dry and comfortable during the night or day.
Must all children drink 2-3 litres of water every day?
There is a belief that children should drink large amounts of water to prevent kidney diseases and urinary infections. As a result, many parents force their children to drink excess amounts of water against the will of the child. The amount of water needed to be consumed depends on the climate, the person’s body size, and physical activity.
Water is also consumed in the form of milk, juice, sambar, and other beverages. Hence while calculating the amount of water needed for any person, it is important to account for all the fluids consumed on a particular day. A small baby weighing about 10 kg will not be able to drink more than 300-400 ml of water everyday, which will be over and above the milk, juice, dal, etc. adding up to a total of around one litre per day. Similarly, a teenager weighing about 50 kg who is playing outside on a hot warm day will drink more than 3 litres owing to the larger body size, the weather, and excess physical activity.
So it is recommended that parents should avoid forcing children to drink excess amounts of water and let them drink appropriately as per the thirst mechanisms.
Bedwetting is a psychological disorder and it is the child’s mistake that they avoid getting up to use the toilet.
There are a lot of misconceptions regarding bedwetting, such as the child is lazy or psychologically disturbed. Bedwetting happens in children because of disturbances in the urinary bladder mechanism in its ability to hold the urine for the entire night or because of disturbances in the ADH mechanism which leads to over-production of urine at night. Any psychological basis for bedwetting has not been proved as no mental disturbance can cause a child to bed-wet 30 out of 30 days in a month. Academic pressure and nightmares at night have been wrongly linked to bedwetting in children.
Bedwetting in children can be ignored for years because there is no cure available and there is no need for treatment.
There is an unfortunate belief among people that bedwetting is quite prevalent. Owing to this, many children are deprived of the right treatment. Any child who is more than 6 years of age needs medical treatment for bedwetting. It can be treated in a hospital that runs a bedwetting clinic under the care of a specialist – a paediatric nephrologist. The treatment consists of specific therapies and medications. If treatment for bedwetting is delayed in children more than 6 years of age, it can lead to frustration, low self-esteem, depression, and avoidant personality.
Will abnormalities in kidneys detected before birth resolve with age?
There is a lack of awareness about the abnormalities detected in the kidneys before birth and how to deal with them. It is a common belief that if a newborn baby/infant is passing a good amount of urine, then the previously detected abnormality in the kidneys does not exist anymore and will not cause any harm in the future. However, such children should always be kept under the surveillance of a paediatric nephrologist who will look at the current status of the kidney disease and continue monitoring the progression or regression of this disease using certain scans, blood tests or urine tests. Such abnormalities in the kidneys should not be downplayed nor should it be assumed that they resolve by themselves until proven via tests.
Is swelling of eyelids in children not connected to kidneys?
Swelling of the upper eyelids could be due to a kidney disease known as nephrotic syndrome. People believe that swelling of the eyelid occurs because of allergy, oversleeping, excessive crying or infection. However, many times it is because of nephrotic syndrome in which protein leaks into the urine which can lead to swelling of the upper eyelids and gradually to swelling in the entire body. This condition can be detected by checking for protein in the urine.
Who is the right doctor for children with regard to kidneys?
It is especially important for parents to identify a doctor belonging to the right domain for treating their child. Kidney diseases in children come under the domain of paediatric nephrologists, who are specialised paediatricians who have acquired further training and skills in dealing with kidney diseases in children.
Dr Saumil Gaur, MBBS, MD (Pediatrics), FPN (Fellowship Pediatric Nephrology)
Consultant-Paediatrician and Paediatric Nephrologist
This article was published in association with Rainbow Children’s Hospital.