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Quick reference medical handouts used by Pediatric offices


Management of Daytime wetting (Diurnal enuresis)


Causes of Daytime wetting

  • Urinary tract infection

  • Juvenile diabetes

  • Incomplete emptying of the bladder (due either to rushed elimination or a medical issue)

  • Constipation

  • Highly focused attention to play or other activities

  • Fear of bathrooms

  • Emotional stress

  • Consumption of soft drinks and/or caffeine

Daytime accidental wetting (diurnal enuresis) is common in younger children. Children may become so involved in play that they forget to go to the bathroom. Also, they may hold on to urine too long. These children:
· Tend to empty their bladders only 2 or 3 times a day compared with the normal 5 to 7 times a day.
· Often do not empty their bladders when they first wake up.
·
Often do not empty their bladders completely when they use the bathroom

Home treatment may be all that is needed to improve daytime accidental wetting, especially if the wetting is not due to any medical condition or stress. Try the following:

  • Check with your child's physician to make sure there are no medical causes for the daytime wetting.

  • Encourage your child to go to the bathroom whenever the urge happens.

  • Reward your child for being dry. You may use hugs, stickers, or special treats as rewards. Reward them for sitting on the toilet regardless of the result as they will not be able to achieve dry pants initially.

  • Don't make your child wear a diaper. Wearing a diaper may make him or her feel babyish. Also, it may be hard for a child to get the diaper off when using the toilet. Wearing disposable underwear like Pull-Ups may be helpful, but it may also make the problem last longer because the child may have less motivation to learn bladder control.

  • After voiding urine have your child count to 20 and try to empty their bladders again. This reduces residual urine in the bladder

  • If the child is at school it is important to communicate with the child’s teacher about management during school hours

  • Encourage your child to use the toilet when you notice signs that he or she may need to go, such as squatting, squirming, crossing the legs, or standing very still.

  • Offer more liquids to drink. Drinking more liquids will increase the amount of urine in the bladder, causing your child to need to go to the bathroom more often. The recommendation for children is 6-8 glasses of water or water based cordial evenly spaced throughout the day (including 3-4 glasses while at school). DRINKING LESS DOES NOT HELP as the bladder fills more slowly making it harder for the child to recognize a full bladder,

  • Have your child go to the bathroom every 2 hours during the day. Set a timer that will remind your child (and you) that it is time to use the bathroom. As urgency improves, the interval between voids can be extended

  • Encourage your child to take extra time on the toilet so that he or she will be more likely to empty the bladder.

How Teachers Can Help with daytime wetting
  • Support children in your class to drink at regular intervals. Children should have at least 3-4 glasses of water per day while at school.
  • Get to know the child and their family. Discuss the particular needs of the child with the parents. Have them put spare clothes, wipes and a plastic bag in the child’s bag
  • Support a toilet routine/management plan for the child during the school day. This may involve a "special" signal from the child indicating that they need to go to the toilet
  • Look out for signs that the child may need to go to the toilet – holding postures, playing with pants etc.
  • Make sure that the toilet environment is safe.

posted 11-11-2011 on kidsgrowth.com

 

As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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