Daytime wetting is not unusual, particularly in younger children. It is usually as a result of voiding dysfunction. Simply put this means that they get distracted e.g by play or school routines, hold on for too long and simply forget until it is too late. This can become habitual. Sometimes holding manoeuvres/behaviours can be seen in such children (jiggling, crossing legs). Children often say they don’t know they need to go to the toilet. They often appear to be unaware that they have wet themselves or feel the need to go to the toilet.
Voiding dysfunction can be due to problems with the bladder but it is frequently due to a child’s misperception of and their inappropriate behaviour around their toileting needs. This will generally improve with simple behavioural strategies and maturity.
Children who are constipated or have a urinary tract infection are more likely to have daytime wetting. Daytime wetting is also more likely to occur where your child is anxious or has experienced emotional upset.
Daytime wetting or incontinence can also occur when a child coughs or laughs, jumps or runs – this is called stress/giggle incontinence. This maybe a result of how the bladder and pelvic floor muscles function.
To help your child with continence during the daytime, ensure that they are drinking enough fluids. Try sending them to the toilet regularly throughout the day, when they need to go and when there is an opportunity to go both at home and at school (you don’t need to set a clock but remind them regularly).
This may help especially young children become more aware of their body signals and be less distracted with their toilet habits.
DO NOT ask them if they need the toilet as this may cause arguments/stress, just send them to try.
Rewards and reward charts may help to motivate your child.
Speak to school to ensure your child is able to access toilets freely and if need be has a change of clothing and a space to change. School will need to support your child with this. If you have difficulty your school nurse will be able to help you.
Encourage your child NOT to hold on unless absolutely necessary. In older children with stress incontinence, pelvic floor exercises may also help (see Eric.org.uk).
Make sure that your child understands that they need to try and empty their bladder fully each time they go to the toilet. Sometimes double voiding helps – instruct them to wee, count to 20 then try to wee again.
If you have any concerns that your child may be constipated or have a urinary tract infection see you GP for management.
If you are seen in clinic depending on your child’s history you and your child will be offered advice or management. In most cases this involves just changing behaviours, toileting routine, fluid intake and time – BE PATIENT.
Further advice for you and your child can also be obtained on the ERIC (Education and Resources for improving Childhood Continence) charity website. Eric.org.uk