Daytime Wetting

I want to share some effective strategies for school aged children with daytime wetting or leaking.  Daytime wetting is a little more common in girls, and nighttime wetting is a little more common in boys, but both sexes can be affected. The children often describe that they don’t feel like they need to go to the bathroom until the last minute. Then it’s too late and urine begins to come out in their underwear. Parents describe the frustration of noticing that their child is fidgeting or reminding them to go to the bathroom, with their child responding “I don’t have to go”. Five minutes later, urine is leaking out or they are urgently trying to find a bathroom.

Making sure that the urine/urinary tract is normal is always prudent when noticing this behavior. You can consult with your pediatrician about this. Also, constipation and infrequent stools can contribute to daytime wetting problems. Address these factors first. If neither of these things is found to be contributory, you can move on to some behavioral techniques.

It seems that when these children’s bladders become overly full, they sent a very urgent message to the brain and begin contracting before the child has a chance to get to the bathroom. Parents describe this as “waiting until the last minute” or being so interested in play that they “ignore needing to go to the bathroom”. You and I receive messages from our bladder well in advance of actually needing to use the bathroom. We have time to finish what we’re doing and leisurely make our way to the toilet. Children with daytime wetting often don’t have this luxury.

We know that “timed voiding”, which is emptying the bladder on a schedule, rather than waiting for internal messages, is very effective in preventing overfull bladders from sending urgent messages. It’s almost impossible for a child, who has little comprehension of time, to remember to “Go to the bathroom every 2 hours”. A discreet, independent reminder can make all the difference.

Using a vibratory wristwatch is a great way of fostering the independent behavior of going to the bathroom on a regular schedule. Usually around every 2 hours is a good amount of time to begin with. For school age children, I prefer watches in which you can set specific times. That way, you can coordinate with the teacher the times that would be less disruptive but allow him/her to start p.e., recess or lunch with an empty bladder. Voiding at the end of the school day allows your child to begin the trip to home with an empty bladder, eliminating accidents on the bus or running to the bathroom when entering the house.

The Vibrowatch offers 12 independent times and vibrates about 20 seconds, making it difficult to ignore. The Medose and WobL watch each offer 6 independent alarms, and vibrate for 20 and 5 seconds, respectively. You can watch these videos to get a better idea of how these watches work. Most of my patients are amazed at how well their children do once they’re given a simple tool to help.

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