Daytime wetting factsheet
Introduction
Daytime wetting, or incontinence, is when your child cannot control their bladder and leaks urine while they are awake.
Children who are toilet trained should have some control over when and where they go to the toilet to empty their bladder. Most children are toilet trained by the age of five, while 40-60% of children between the ages of four and six will have wet their pants by accident at some stage.
Daytime wetting is different from wetting your pants by accident. It can be very embarrassing for children, especially in school. It is usually a medical problem that is 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 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.
The amount of urine your child leaks can range from a few dribbles in their underwear to complete loss of bladder control.
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
- has a urinary tract infection
- is completely emptying their bladder by accident
- is having social or emotional issues caused by daytime wetting.
Diagnosis
Your child’s doctor will make a diagnosis based on:
- your child's signs and symptoms
- medical history
- a physical exam.
Your child may be referred to a specialist if the daytime wetting is caused by an issue with their body, behaviour, or brain signals.
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 its cause. It can include:
- managing other bladder and bowel issues like constipation or hard poos.
- re-teaching your child's toilet training skills, such as 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 might also try things at home like:
- ensuring your child isn’t having too many drinks with sugar, caffeine, or bubbles, which can irritate their bladder
- using a rewards chart to help your child remember to use the toilet regularly
- helping your child spread their water intake 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 a normal amount of urine, and your child needs to urgently go to the toilet more than eight times a day.
- underactive bladder: when the bladder gets used to filling up too much from your child not going to the toilet enough, 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.
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.
- neurogenic bladder – when there are problems with the signals between the body, bladder, and brain.
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
Children do not usually wet their pants on purpose. Daytime wetting is not caused by naughtiness or laziness; it can be very upsetting and embarrassing.
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 how it makes them feel
- following their lead and having a plan to leave when you are out and 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.
Parents and carers who take a positive and calm approach can help their children build confidence, reduce emotional stress, and dry faster.
Resources and more information
