Accidental daytime wetting (diurnal enuresis) is common in younger children and in children who are toilet training or who have just gone through the toilet training process. In rare cases is daytime accidental wetting is a sign of an underlying condition. It is also common to see children who wet the bed at night to have some form of daytime wetting.
Occasional daytime wetting in younger children is a normal part of development. However, if daytime wetting begins to interfere with your child's social skills, academic progress in school, or sense of well-being, a discussion and evaluation with your pediatrician or with a pediatric urologist may be recommended.
Causes of DaytIme Accidental Wetting
In very young children and a child who has just been potty trained, some daytime wetting or accidents are not unheard of.
- Young children often get so caught up in playtime or activities, they forget to go to the bathroom or ignore their body's signals. Often, these children are too distracted with what they are doing to pay attention to their need to urinate.
- Younger children often wait until the very last second to urinate, and, by this time, it is too late to get to a bathroom.
- Some children hold their urine because they are too busy doing something else to take a bathroom break, resulting in an accident.
- Stress or a change in life circumstances can be emotional for children of any age. Accidental wetting often stops once your child's stress is addressed.
In these instances, parents can do the following to help ensure a child uses the bathroom regularly to avoid accidents:
- Make sure your child goes to the bathroom as soon as they wake up in the morning.
- Gently remind your child to use the bathroom every few hours to ensure they are not "holding it in." Ask your child's teacher or daycare provider to do the same.
- Modeling good bathroom habits by announcing your visits to the bathroom may help in establishing a normal routine for your child.
- Using the Chesapeake Urology For Kids Bathroom Chart can be helpful.
In other cases, there may be an underlying cause of your child's daytime accidental wetting:
- Urinary accidents may be a sign of a urinary tract infection.
- Rarely, daytime wetting can be a sign of an undiagnosed structural abnormality of the urinary tract.
When to Call the Pediatric Urologist
After evaluation or discussion with your primary care physician, you may be referred to a pediatric urologist because of:
- Recurring pain during urination
- Troublesome, frequent urination
- Urge to urinate frequently but only urinating small amounts at a time
- Documented urinary tract infections
What to Expect at the Doctor's Visit
In most cases, accidental daytime wetting is a part of normal child development that your child will outgrow over time. If you take your child to a pediatric urologist for daytime accidental wetting or because you notice possible signs of infection, there are several exams and evaluations your doctor may perform to determine if there is an underlying cause of your child's wetting.
A pediatric urologist will typically ask you questions about the daytime wetting patterns, if your child wets the bed at night, and will also perform a physical exam.
Your doctor may order additional tests including:
- A urinanalysis and urine culture if a kidney or bladder infection is suspected
- An ultrasound or voiding cystourethrogram if a developmental issue of the urinary tract is suspected
- A urodynamic study, which looks at how the bladder empties, if a problem of the nervous system that is affecting your child's bladder is discovered
Treating Daytime Wetting
In most children, daytime wetting is part of normal development and learning to recognize their body's signals. In these cases, your child will usually outgrow daytime accidental wetting.
If your doctor finds that your child has a kidney or bladder infection, treatment with medication such as an antibiotic will often stop the daytime wetting once the infection is cleared.
Home treatment and behavioral therapy to encourage your child to stay dry during the day is often successful in young children. Some tactics to try include:
- Use a reward system - For every day your child is dry, they get a sticker on a chart. At the end of the day, or at the end of the week, you can reward your child for staying dry.
- Have your child go to the bathroom at regular intervals throughout the day and make sure they are well hydrated. The Chesapeake Urology For Kids bathroom chart is a great tool for parents.
- Teach your child to not hold in his or her urine.
- Be aware of signs that your child needs to urinate such as squirming or crossing legs and have them use the bathroom before it's too late.
The specialists at Chesapeake Urology For Kids provide parents with useful tools for tracking a child's urinary habits and to help encourage proper bathroom use: