My child wets himself/herself

Children may have a bladder control problem – also called urinary incontinence (UI)- if they leak urine by accident and are past the age of toilet-training. A child may not stay dry during the day, called daytime wetting; or through the night, called bedwetting (in medical terms, this is referred to as nocturnal enuresis).

Daytime wetting and bedwetting are frequent concerns for parents and their children. Of course, during their early development years, the release of urine at night-time is normal, which is why infants wear nappies. On average, a child will gain control of their bladder somewhere between the ages of 2 and 4 – each in their own time. By age 4, when most children stay dry during the day, daytime wetting can become a noticeable issue. By ages 5 or 6, children might have a bedwetting problem if the bed is wet once or twice a week over a few months. If this is the case, it may be that some form of treatment is necessary.

Don’t forget that bedwetting can be very difficult for a child. Not only is it embarrassing, but it can stop them from doing their favourite activities. They may also face bullying from other children, if the problem is made public at nursery school or primary school. It is important to get psychological help for the whole family, to ensure that the behaviour does not continue into adulthood.

Support_In_Continence_Infographics_Daytime Wetting Tips for Children
Daytime wetting tips for children.

If your child suffers from daytime wetting, here are some key tips to remember: 

  • Give them plenty to drink (6-8 cups of water spread out during the day), and increase the amount of water gradually, to help train the bladder and allow it to stretch naturally.
  • Avoid fizzy drinks or those with artificial colourings and flavours.
  • Help your child stay relaxed when they go to the toilet. Don’t forget that boys can also sit down to wee if that makes them more comfortable.
  • Think about using a device like a vibrating watch that can alert them when they need to go to the toilet.
  • Help your child exercise their bladder by letting it fill up and empty at regular intervals during the day - they need to learn to listen to their body signals and not go too often or not often enough!
Bedwetting tips for children.
If your child suffers from bedwetting, here are some key tips to remember:
  • Be co-operative and understanding when they wet the bed, and reward them when they don’t.
  • Ensure they go to the bathroom every night before going to sleep.
  • Avoid humiliating them in public about the issue - try to keep your tone friendly and soft when discussing what’s happened.
  • You don’t need to wake them in the night if they wet the bed - unless they realise themselves, it can wait until morning.
  • Don’t stop them from having sleepovers or socialising, but try to encourage them to wear incontinence pants and inform the parents in charge of the situation.

If you are worried about your child’s daytime wetting or bedwetting, then the first step is to speak to a healthcare professional, most likely a neurologist or urologist. Before the appointment, track your child’s bathroom habits for three days in a bladder diary.

Make a note of the following:

  • Quantity of liquid drunk
  • Times at which they have gone to the bathroom
  • Quantity of urine passed each time
  • Any daytime wetting or bedwetting incidents
child wets himself

Your healthcare professional can prescribe a short-term medication that could help. Before this, they may recommend some child behavioural change techniques, which take more time to implement, but are generally more effective in the long-term.

Child behavioural change techniques aim to encourage desired behaviours (e.g. self-control) whilst removing undesired behaviours (e.g. bedwetting). Incentives can be used to reward the child when they complete the desired behaviours, but punishments are never given if they perform undesired behaviours.

Throughout the process, a close eye is kept on the psychological and emotional state of the child, to ensure that they are feeling more independent and have more self-esteem, rather than feeling anxious, fearful or ashamed.

References

European Guidelines on Urinary Incontinence [Internet]. 2018 [cited 3 August 2020]. Available from:https://wfip.org/european-guidelines-on-urinary-incontinence/.

How to stop or manage daytime wetting [Internet]. 2018 [cited 3 August 2020]. Available from:https://www.eric.org.uk/how-to-stop-or-manage-daytime-wetting.

Nieuwhof-Leppink AJ, Schroeder RPJ, van de Putte EM, de Jong TPVM, Schappin R. Daytime urinary incontinence in children and adolescents. Lancet Child Adolesc Health. 2019 Jul;3(7):492-501.