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When Your Child Needs Clean Intermittent Catheterization (CIC)

Children with urinary tract problems may require clean intermittent catheterization (CIC). This is the temporary placement of a tube (catheter) to help drain the bladder. A parent or another adult does CIC until the child learns how to do it. Children as young as 5 years old can perform their own CICs.

Boy placing plastic bags with catheters inside into backpack. One bag is labeled clean, other is labeled dirty.

How Is CIC Done?

CIC is done by passing a catheter into the urethra (tube that carries urine from the bladder out of the body). Once the tube reaches the bladder, urine begins to drain. CIC allows the bladder to empty completely. Once the bladder is empty, the catheter is removed.

Why Is CIC Needed?

CIC helps your child empty his or her bladder. CIC done regularly also helps prevent the following:

  • Urinary tract infections

  • Kidney or bladder damage

  • Wetting accidents (incontinence)

Feeling Nervous Is Normal

At first, inserting the catheter into your child’s urethra may seem scary for both you and your child. But you will have help from your child’s health care team. They will teach you how to perform CIC. And as your child becomes more independent, he or she can begin to help with CICs. Start by letting your child wash his or her hands and gather the catheter and other supplies. When your child feels ready, the health care provider can teach him or her how to do CIC.

How Often Is CIC Done?

Do CIC as often as instructed. Do not wake your child during sleeping hours to do CIC unless you are instructed to do so. For your child, perform CIC every 3-4 hours.

Your Child’s Catheter

Catheters are made of soft, flexible plastic. They come in many shapes and sizes. Some are disposable and are used once and thrown away. Others may be used multiple times if cleaned properly. Your child’s health care provider will choose the best catheter for your child. If your child uses reusable catheters, ask how often they should be replaced. Follow the health care provider’s instructions carefully.

Using a Catheter

Follow these steps when performing a CIC:

Step 1: Get ready

  • Gather your supplies. You’ll need the following:

    • A catheter

    • Lubricant or sterile water

    • Disposable wipes or a washcloth

    • A container to put the used catheter in

  • Wash your hands. Use soap and warm water.

Step 2: Lubricate the Catheter If Needed

Lubrication may not be necessary for girls.

Step 3: Insert the Catheter

For boys:

  • Clean the tip of the penis with a disposable wipe or washcloth.

  • Hold the penis on both sides, away from the body.

  • Gently insert the tube until urine begins to drain. Then continue inserting the catheter a bit more.

  • Hold the tube in place until the bladder is completely empty.

For girls:

  • Find the urethral opening. It is located below the clitoris and above the vagina.

  • Once the urethral opening is found, clean the area with a disposable wipe or washcloth.

  • Gently insert the tube until urine begins to drain. Then continue inserting the catheter a bit more.

  • Hold the tube in place until the bladder is completely empty.

Step 4: Withdraw the Catheter

  • Remove the catheter slowly.

Step 5: After the CIC

  • If your child used a disposable catheter, throw it away.

  • If your child used a reusable catheter, rinse it and dry it off. Then put it into a container, such as a plastic resealable bag.

  • Wash your hands with soap and warm water.

Tips for Successful CICs

  • Place two resealable plastic bags in your child’s backpack. Label one “Clean” and the other “Dirty” so your child can store reusable catheters accordingly.

  • Children capable of doing so should learn to do CIC beginning in kindergarten. Then your child won’t have to rely on the nurse for help with CICs.

  • Girls should avoid relying on mirrors to find the urethra if possible.

  • Keep in mind that your child may have some discomfort at first. This often lasts about 3 days for boys and 1-2 days for girls, but it depends on the child.

  • Stick closely to the catheterization schedule.

  • Make sure your child does not avoid liquids in an attempt to avoid catheterization. The schedule needs to be followed no matter how little fluid the child drinks.

Coping

The thought of having to regularly catheterize your child can be overwhelming. You may be feeling angry or sad about your child’s need for CIC. You may view it as a loss of freedom or normalcy for your child and your family. This is to be expected. But as you begin performing CICs, you will likely become more comfortable with it. And for your child, CICs will become a normal part of his or her daily activities. Also, keep in mind that you’re not alone. Your child’s health care provider will teach you how to perform CICs. When your child feels ready, he or she will be taught how to do his or her own CICs. In the meantime, it’s vital for your child’s treatment and emotional development that you be supportive and patient. Encourage your child’s success by seeing to it that he or she follows the voiding schedule.

Call the health care provider if your otherwise healthy child has any of the following:

  • In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher

  • In a child 3 to 36 months, a rectal temperature of 102°F (39.0°C) or higher

  • In a child of any age who has a temperature of 103°F (39.4°C) or higher

  • A fever that lasts more than 24-hours in a child under 2 years old, or for 3 days in a child 2 years older

  • Your child has had a seizure caused by the fever

  • Blood in the urine (a small trace of blood is normal)

  • Foul-smelling urine

  • Sand-like material (sediment) in the urine

  • Pain in the lower back or lower abdomen

  • Trouble inserting the catheter

  • Increased pain when inserting the catheter

 

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