When bedwetting is more than just a phase

Many children experience bedwetting, which can cause them to feel embarrassed or upset. This is why it's important to reassure them calmly and avoid blaming them. Dr Srihari Singaravel, a consultant paediatric urologist, explains that urinary incontinence in children is more common than parents realize and can be daytime, nighttime, or both.

Most children start to stay dry during the day between the ages of two and three, while some don't achieve nighttime dryness until around age seven. Bedwetting isn't always due to sleeping deeply; some children may not recognize the bladder's signal while asleep or produce more urine at night due to hormonal patterns. It's also possible that children who regularly hold in urine for long periods may find it harder to control their bladder.

While bedwetting is usually not a structural issue, it can be functional. Parents should watch out for frequent urination needs, difficulty going more than an hour without using the toilet, and repeated accidents at home or school. Conditions like constipation and recurring urinary tract infections can also be relevant, as the bowel and bladder are close together and can impact each other.

If a child's bowel is consistently full, it can put pressure on the bladder and worsen urgency or frequent urination. Simple habits like using the bathroom every two to three hours, staying hydrated earlier in the day, and maintaining regular bowel movements can help children develop healthier bladder and bowel routines. For some children, medical support may be necessary, especially if symptoms persist or interfere with their daily life, including sleepovers, school trips, confidence, or routine activities.

Treatment options depend on whether the issue occurs during the day, at night, or both. Nighttime bedwetting might be addressed with medication to reduce urine production, while daytime symptoms could require treatment for constipation or an overactive bladder. A bladder diary, ultrasound, or uroflow studies might be used to assess the bladder's function.

It's equally important to consider the emotional aspects of bedwetting. Children may feel embarrassed or anxious, particularly in situations like sleepovers or school trips. Unlike adults, children don't wet the bed on purpose, so punishment can increase stress and shame. Instead, parents should maintain calm routines, praise effort rather than outcomes, and avoid criticizing after accidents.

Teachers and caregivers can also assist by ensuring easy access to toilets and handling incidents discreetly. Dr Srihari emphasizes that urinary incontinence is a medical and developmental issue, not a discipline problem. Children need understanding, patience, and the right care rather than judgment.