What is typical toileting behavior?
Urinary accidents are common during the nursery and preschool years, as most children are toilet trained by about 3 years of age. Young children may have accidents during the school day, especially when they are toilet training and younger than 5 years of age. They are still learning to understand the signals that their bodies are giving them and may wait too long to head to the bathroom.
When should I be concerned about a child’s difficulties with bladder control?
Even children that are successfully toilet trained have occasional “accidents” for some time after training. Accidents may also occur in response to stressful events at home or in school, but these should not persist for a long period of time.
Caregivers should be concerned if their child regularly (e.g., once a week) urinates in their clothing during the day or regularly wets their bed at night past 5 years of age, or if a child returns to having accidents after they have successfully been toilet trained, even if they are younger than age 5. The child’s urination may be involuntary or intentional.
What can I do to help a child with difficulties with bladder control?
Caregivers know their children best. If you are a caregiver, there are a few things you may attempt to help your child with enuresis.
- Talk to your child. Ask your child simple questions to try to understand what stressors might be related to enuresis episodes.
- Create a calendar to mark “dry and sunny” nights or “wet and rainy” nights, paired with rewards for consecutive dry nights.
- Use moisture alarms (when available) that make your child aware of when they begin to wet the bed. This works very well but it can take several weeks to actually prevent or stop bed wetting.
- Avoid having drinks during the night. Let your child have the last drink one hour before bedtime. Remind your child to use the toilet right before bed.
- Have scheduled toilet visits once or twice during the night to empty the bladder.
- Encourage your child to go to the bathroom more often during the day.
- Reward your child when they are able to not wet the bed at night.
- Be supportive and warm with your child when an enuresis episode occurs and avoid giving punishments or being critical. Let your child know that it was just an accident and accidents happen.
If you have already tried some or most of these suggestions and the problems your child is facing persist, negatively interfering with your child and family's daily lives, it may be the moment to seek out professional support. When a child is struggling with peeing in their clothing or bed, it is important to discuss what is happening with a doctor.
What kind of professional support can I seek out for help?
It is not unusual that some caregivers feel embarrassed, inadequate, guilty or angry if their child is struggling with enuresis. But, if you are concerned, support and guidance are available now. Communicate concerns during and between visits with your child's doctor. Pediatricians or family physicians can help to address initial concerns and refer to specialized professionals.
A doctor will diagnose enuresis only if the child is at least five years old, considering that it is common for younger children to have poor bladder control sometimes.
Other requirements for a diagnosis include:
- Peeing their clothes or bed on purpose or by accident.
- Symptoms that happen at least twice a week for at least three months, or that cause problems for the child in school or with friends.
A doctor will examine the child to rule out medical problems like a urinary tract infection or diabetes. Medical professionals may also prescribe medicines that can help reduce enuresis.
The public system provides services through the Child and Adolescent Mental Health Services (CAMHS) and Centers of Multidisciplinary Assessment, Counseling, and Support (KEDASY).
Where to find more information
Specific, detailed, and clinical information on Enuresis can be found at [clinical short guide at the program website].
If you want to know more about the closest available services for educational and public health systems for children and adolescent assistance across the country, go to our Services Mapping webpage here.
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