Introduction
Daytime wetting is when your child cannot control their bladder and leaks urine while they are awake. It is also called urinary incontinence.
The bladder is the organ that holds liquid waste called urine, or wee.
Toilet-trained children should be able to control where and when they go to the toilet to empty their bladder.
Daytime wetting is different from wetting your pants by accident. It is normal for toilet-trained children to have accidents occasionally, but regular accidents could be a sign of daytime wetting and other health issues.
Daytime wetting can be very embarrassing for children, especially in school. It is usually a medical problem not caused by your child being naughty or lazy.
Signs and symptoms
With daytime wetting, your child may:
- struggle to get to the toilet in time
- not feel the sensation of needing to do a wee and go without realising
- have non-stop dribbling of urine
- leak urine at different times, with breaks in between
- not go to the toilet enough
- always be "busting" or have an urge to go to the toilet.
See your local doctor as soon as possible if your child:
- has non-stop dribbling of urine
- has been previously dry but has now started wetting
- have a urinary tract infection
- is completely emptying their bladder
- is having social or emotional issues caused by daytime wetting.
Diagnosis
Your child's doctor can diagnose daytime wetting based on signs and symptoms, a medical history, and a physical check.
The doctor can refer your child to a specialist if they think the daytime wetting is caused by an issue with their body, behaviour, or signals from their brain.
Your child may also be referred to a continence nurse specialist for treatment. A continence nurse advisor is a nurse who is specially trained in treating bladder and bowel issues.
Treatment
Treatment of daytime wetting will depend on what is causing it.
Treatment can include things like:
- managing other bladder and bowel issues like constipation or hard poos
- re-teaching your child toilet training skills, like sitting on the toilet properly and setting specific times to go during the day
- medication to relax the bladder
- relaxation exercises for the pelvic floor muscle – the muscle that helps your child to stop and start a wee.
You can also try things at home like:
- making sure your child isn't having too many drinks with sugar, caffeine, and bubbles, which can irritate their bladder
- using a rewards chart to help your child remember to use the toilet regularly
- helping your child to spread their water intake out evenly throughout the day
- treating and preventing constipation
- getting to know what is "normal" for your child's toilet habits.
Management
Types of daytime wetting
Different types of daytime wetting in children can include:
- leaking – when your child is in the habit of holding on and their bladder overfills to the point where they cannot get to the toilet in time
- overactive bladder – when the bladder has trouble holding on to an average amount of urine, and your child needs to urgently go to the toilet more than 8 times a day
- underactive bladder – when the bladder gets used to filling up too much from your child not going to the toilet enough, so it stops sending a warning signal to the brain that it is overflowing
- incomplete emptying of the bladder – when the bladder does not empty properly, and urine leaks out after your child has been to the toilet
- constipation – when poo becomes too big and hard in the bowel and presses on the bladder.
Other less common causes of daytime wetting include:
- emotional stress and trauma
- urinary tract infections
- giggle incontinence – losing control of the bladder when giggling or laughing
- stress incontinence – losing control of the bladder when doing physical movement that involves pressure, like jumping or running
- physical or neurological issues related to your child’s urinary system – like a neurogenic bladder or bowel.
Children with developmental delays, intellectual disability, or other developmental disorders can take longer than other children to toilet-train.
Supporting your child with daytime wetting
Parents and carers must remember that children do not usually wet their pants on purpose. Daytime wetting is not caused by naughtiness or laziness and can be very upsetting and embarrassing for children.
You can support your child while they are getting treatment for daytime wetting by:
- getting them actively involved in making things like a rewards chart or toilet reminders
- talking to them about the wetting and asking them how it makes them feel
- following their lead when out and about, and having an exit plan if an accident happens
- working with your child to plan for accidents, and an “emergency bag” with a spare change of clothes and things to help clean up
- explaining the bladder or bowel issue in simple terms and letting them ask lots of questions when you see the doctor or nurse.
A positive and calm approach from parents and carers can help your child build their confidence, reduce emotional stress, and get dry faster.
Resources and more information
