Dr Bernadette Carr answers your questions on pelvic floor muscles after pregnancy

Dr Bernadette Carr says there are a number of ways to strengthen the pelvic floor muscles and stop leaks from happening.

Q. I had my second baby a few months ago and I have noticed in the few weeks that I wet myself whenever I sneeze or cough. Is there any way I can strengthen the muscles or should I consider surgery?

A. Weakness of the pelvic floor muscles is nearly universal after childbirth because of stretching of the pelvic floor muscles and if it is severe, it can cause a type of urinary incontinence called stress incontinence. 

This happens when sudden extra pressure on the abdomen and the bladder causes a small leak of urine, when you cough, exercise, sneeze or laugh, because of the weakened pelvic floor muscles.

Urinary incontinence of any kind is a very distressing condition and can be quite embarrassing at times, however the good news is that stress incontinence can usually be treated very effectively through exercises, with medication, and then surgery being a last resort.

You need to make an appointment to see your GP so that he / she can take a full history and perform a physical examination. 

Keeping a diary of how often and when the problem happens will be helpful for your GP.

There are a number of ways to strengthen the pelvic floor muscles and stop the leaks from happening. 

It is important that you exercise the correct muscles. Exercising the pelvic floor muscles is the same as trying to hold on when you need to pass water or stop wind escaping from your back passage by squeezing the muscle just above the entrance of the back passage. 

It takes practice and perseverance, the same as trying to strengthen any other muscles, and it can be very helpful to have someone to advise you how to design your exercise programme. 

Your GP may be able to put you in touch with a nurse or physiotherapist who specialises in this area.

In some cases, it is necessary to see a specialist if the cause of the problem is not clear, or if you are not making good progress. 

Your GP will be able to reassure you and to advise you on the most appropriate treatment programme.

Q. We are heading off to France for our first family holiday abroad with children aged five and seven. We have a ferry journey and then drive to where we are staying. 

I would like to bring some basic first aid kit items with me and wonder if you could advise me.

A. I am sure that the whole family is excited about the holiday. It is a good idea to have basic items with you.

I would suggest:

  • Adhesive plasters in various sizes.
  • Sterile wound dressings in various sizes.
  • Antiseptic wipes.
  • Examination gloves.
  • Sterile water.
  • Water-based burn dressings; small and large.
  • Rehydration sachets.
  • Antihistamine cream.
  • Insect repellent.
  • Pain relief tablets for both adults and children (such as paracetamol and ibuprofen).
  • Don’t forget to bring any prescription medication with you.

If any of the family suffers from travel sickness, there are over the counter remedies and your pharmacist will be able to advise you on the most appropriate.

It is important to include a sun block for everyone. Use a sunscreen with SPF50 and UVA protection — see what is the easiest way to apply the sunscreen to the children, for example, cream, lotion or spray. 

Water-resistant emulsion is advisable for swimming and water sports. Buy before you travel, do a patch test on each child and if their skin reacts, try a different brand. 

Apply the sunscreen to the areas that are not covered by their clothes and hat and apply to dry skin 20 to 30 minutes before you go outside and reapply every two hours. 

Remember to dry skin after you come out of the pool or the sea and reapply.

To avoid sunburn or getting overheated, plan any day trips and visits to pool or beach either early in the morning or late afternoon and try to plan activities so that they are in the shade between 11am and 3pm.


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