Improving Drinking and Micturition Habits in Preschool Children: An Educational Project

Abstract

<b><i>Introduction:</i></b> Children worldwide often do not drink enough. However, sufficient fluids are essential for physical and cognitive health. A regular and adequate supply of fluids also supports bladder maturation in the context of acquiring urinary continence. We investigated whether training preschool children and their caretakers improves drinking and micturition habits. <b><i>Methods:</i></b> This field study in a pre-post design was conducted in 6 kindergartens in the district of Garmisch-Partenkirchen from October 2018 to February 2019. An intervention group (IG) received a 3-day training on drinking and micturition habits and was compared to a control group (CG) without any training. Caretakers (IG + CG) were instructed about drinking and voiding management, too. Behavioral changes were identified by questionnaires. To analyze the long-term effect, group interviews were performed with the IG 3 months after training. The training was evaluated on different levels. <b><i>Results:</i></b> After training, the estimated total daily fluid intake in the IG (1,160 mL) significantly exceeded that of CG (830 mL) (<i>p</i> = 0.015). In the IG, fluid intake until 12:00 a.m. increased (<i>p</i> = 0.001), children took more time for voiding (<i>p</i> = 0.029), and urgency decreased (<i>p</i> = 0.008). Children (IG + CG) used leg support to enable pelvic floor relaxation more often both at home (<i>p</i> = 0.026) and in kindergarten (<i>p</i> = 0.047). Nocturnal enuresis was reduced by approximately 46% in the IG (<i>p</i> = 0.485). Group interviews in the IG showed a considerable learning effect. <b><i>Conclusion:</i></b> The present study could demonstrate an increased intake of fluids and significant changes in micturition behavior in the IG. So far, this is the first educational project in Germany addressing drinking and voiding management. Our results suggest that a training of preschool children and their caretakers is feasible and effective. Further nationwide research will be needed to confirm our results and assess the need for prevention in these areas.