Bedwetting and Daytime Accidents in Young Children

Childhood bedwetting

My daughter will turn 5 years old this October.
However, she not only wets the bed at night but also has incidents of wetting her pants during class at kindergarten.
According to her teacher, most of these incidents occur while she is taking a nap.
Interestingly, she does not have any accidents while at home during the day.
What should I do? Should I continue to wait and see, or should I seek medical advice? I previously took her to a pediatric clinic for a urine test, but the doctor indicated that there were no abnormal findings in her physiological state and suggested that I take her to see a child psychologist.
Is there no other option besides this? Are there any additional strategies I can try? If I don’t wake her up at night, she wets the bed about 3-4 times a week.
However, if I do wake her up to use the bathroom, she does not have any bedwetting incidents.
During the day, she wets her pants about 1-2 times.
Thank you, Dr.
Lin.

Zhenzhen de ma, 30~39 year old female. Ask Date: 2005/09/02

Dr. Lin Huizhen reply Pediatrics

Dear Dr.
Lin Huizhen, Chief of Pediatrics at Tainan Hospital, Department of Health, Executive Yuan:
Many children aged 5-6 years still experience bedwetting, and there are various reasons for this.
You mentioned that they have been taken to a pediatric outpatient clinic for examination, but I am unsure which tests were conducted (besides the routine urinalysis, were there any other tests?).
If physiological abnormalities are ruled out, sometimes certain medications can be prescribed for a period to improve the condition, and it does not necessarily indicate a mental issue with the child.
Wishing you good health and all the best from the Pediatrics Department of Tainan Hospital!

Reply Date: 2005/09/02

More Info

Bedwetting, or nocturnal enuresis, is a common issue among young children, particularly those around the age of five. It can be distressing for both the child and the parents, especially when it occurs during the day as well. In your case, your daughter is experiencing bedwetting at night and occasional daytime accidents, particularly during nap time at preschool, but not at home. This situation can be complex and may require a multifaceted approach to address effectively.

Firstly, it’s important to understand that bedwetting is often a developmental issue rather than a medical one. Many children simply take longer to develop the bladder control necessary to stay dry through the night. The fact that your daughter does not wet herself during the day at home suggests that she has some level of bladder control, which is a positive sign. It’s also common for children to have different levels of control in different environments, which can be influenced by factors such as stress, anxiety, or simply the comfort of being at home versus being in a school setting.

Since your daughter has been evaluated by a pediatrician and found to have no physiological issues, it may be beneficial to consider behavioral strategies and environmental adjustments. Here are some suggestions:
1. Establish a Routine: Create a consistent bedtime routine that includes a trip to the bathroom right before bed. This can help reinforce the habit of emptying her bladder before sleeping.

2. Limit Fluid Intake Before Bed: Reducing the amount of fluids your daughter drinks in the evening can help minimize the likelihood of bedwetting. However, ensure she stays hydrated throughout the day.

3. Nighttime Waking: Since you mentioned that waking her up to use the bathroom at night prevents bedwetting, consider implementing this as a regular practice. You could set an alarm to wake her up once or twice during the night for a bathroom trip.

4. Positive Reinforcement: Encourage and praise your daughter for dry nights and successful bathroom trips during the day. Positive reinforcement can motivate her to continue practicing good habits.

5. Addressing Daytime Accidents: For the daytime accidents, especially during nap time at preschool, it may help to communicate with her teachers. They can remind her to use the bathroom before napping and ensure she feels comfortable doing so. Sometimes, children may hesitate to use unfamiliar bathrooms or may be too engrossed in play to recognize their need to go.

6. Consider Stressors: Evaluate if there are any stressors in her life that could be contributing to her accidents. Changes in routine, new environments, or emotional challenges can sometimes manifest as bedwetting or daytime accidents.

7. Consult a Child Psychologist: Since your pediatrician suggested seeing a child psychologist, this could be a valuable step. A psychologist can help identify any underlying emotional or psychological factors that may be contributing to her bedwetting and daytime accidents.

8. Patience and Understanding: Lastly, it’s crucial to approach this situation with patience and understanding. Bedwetting is often a phase that many children outgrow, and it’s essential to provide support rather than punishment or shame.

In summary, while bedwetting and daytime accidents can be concerning, they are often part of normal development. By establishing routines, encouraging positive habits, and addressing any emotional factors, you can help your daughter navigate this phase more comfortably. If the situation does not improve or worsens, seeking further evaluation from a specialist may be necessary. Remember, you are not alone in this, and many families face similar challenges.

Similar Q&A

Understanding Bedwetting in Children: When to Seek Medical Advice

Hello Doctor: I would like to ask about my younger son, who is almost 7 years old and in the first grade. He often wets the bed at night. Should I take him to see a doctor? Which specialty should I consult? He usually wakes up only after he has already wet the bed. I'm not s...

Dr. Lin Zhebin reply Family Medicine
Hello: Common causes of bedwetting in children, aside from psychological factors, may include nocturnal polyuria, overactive bladder, and abnormalities in the brain's awakening centers (where the brain does not sense urine). If your son experiences any of the following sympt...

Managing Bedwetting in Children: When to Seek Medical Help

My 10-year-old daughter has been experiencing frequent bedwetting at night, which has become more severe compared to previous years. How should we handle this? Does she need to see a doctor? If so, what type of specialist should we consult?

Dr. Pei Rensheng reply Pediatrics
Hello: Bedwetting, generally speaking, is considered a concern if girls are over four years old and boys are over five years old and still experience this issue. Doctors may consider treatment for children with bedwetting problems. The incidence of enuresis tends to decrease with...

Understanding Bedwetting in Children: Causes and Solutions

Hello, doctor. My child is now 5 years old. Last summer, he was able to sleep without wearing diapers and did not wet the bed. However, this year, he has been frequently wetting the bed at night, but not during the day. I now let him wear diapers at night, but when I do, he does ...

Dr. Tu Xiuhong reply Urology
Hello: Your child's condition is quite special. Please take your child to the hospital for further examination and treatment. Thank you!

Effective Strategies to Help Your Child Overcome Bedwetting Issues

Dear Dr. Hong, I would like to seek your advice regarding my daughter, who is in the second grade and turned eight this year. During the day, her urination is completely normal, but she has a persistent habit of bedwetting at night that we have been unable to improve. We try to ...

Dr. Hong Shaohui reply Pediatrics
It is recommended that you visit a pediatric outpatient clinic to discuss with a specialist and to check for any physical or psychological issues.