Daytime wetting

What is daytime wetting?

• Daytime wetting (or daytime incontinence) is the uncontrollable leakage of urine while the child is awake.
• It can be continuous (continuous dribbling of urine) or intermittent (leakage of urine at intervals while staying dry in between).
• The amount of leakage can vary from a few drops on the underwear to large puddles.
• 1/3 of children who wet during the day also have bedwetting. Daytime wetting can be very embarrassing for school aged children.

What are the symptoms?

Children with daytime wetting commonly experience a sudden need to pass urine (urgency), and may leak if they do not reach the toilet in time (urge incontinence). They may also need to pass urine often (frequency). Children may experience urine leakage after laughing (giggle incontinence) or after certain physical activities (stress incontinence or part of urge incontinence).

How common is it?

Most children are toilet trained by 5 years of age. However, almost 20% of 4 to 6 year olds wet their pants at some stage, and 3% wet twice or more in a week.

Why does it occur?

• Children commonly have daytime wetting because they have overactive bladders. Not drinking enough fluid and drinking caffeine-containing drinks such as chocolate or cola drinks can worsen overactive bladders and therefore also worsen daytime wetting.
• Children who hold on to their urine (void withholding) can have incomplete bladder emptying and also daytime wetting. Incomplete bladder emptying may lead to recurrent urinary tract infections.
• Constipation can also commonly cause daytime wetting which can resolve with treatment for the constipation.
• Girls can sometimes have leakage of urine a few minutes after voiding due to trapping of urine in the vagina from poor toilet posture (vaginal entrapment)
• Other less common causes of daytime wetting include emotional stress, urinary tract infections (particularly in children who were previously dry) and diseases to the structures of the urinary tract or nerves (particularly in children who have continuous dribbling of urine).
• Children with developmental delay or autism may take longer than their peers to gain normal bladder control.

What can you do to help?

Try these ideas:

• Make sure your child is drinking enough fluid.
• Avoiding caffeine containing drinks.
• Treat constipation (with increasing fluids, dietary fibre and the use of laxative).
• Remind your child to go to the toilet regularly (aim for 5-7 times a day), and not to hold on for too long if they feel the need to go to the toilet.

When should you get professional help?

• If your child has continuous dribbling of urine.
• If they have been previously dry but have now started wetting.
• If you suspect that your child may have a urinary tract infection.
• If the amount of wetting is severe or is causing problems for your child.

Other treatments which may be recommended by your doctor or continence advisor include teaching the child how to relax their pelvic floor muscles to ensure that they completely empty their bladder when they void, bladder training, and medication.

• Most children grow out of daytime wetting with time and patience.
• Your child cannot control his/her daytime wetting, so punishment will not be helpful.
• Seek professional help if you are concerned.