Bedwetting: Worse after Back to School?

Getting back into the groove of a new school year can be very exciting but may also come with some unanticipated events as well.  Some children who have become dry over the summer begin to have some accidents once school starts. 

Why does this happen? What can you do?

Different Schedule

Going back to school is physically and emotionally draining until a routine is established.  Any change, even good ones, can cause increased wetting.  Having a different sleep-wake cycle during the summer versus the school year can contribute.  Especially with older kids, who may have stayed up very late during the summer, it can take a couple of weeks to adjust. Being exhausted may cause children to just sleep through the need to wake up and urinate.

• Reassure your child that once the new routine is established, dry nights will most likely resume. 
• Do your best to have a regular bedtime, with double voiding before bed (urinating twice about 30 minutes apart).

In a 24 hour period of time, your child’s body needs a certain amount of fluid to stay healthy.  A relaxed summer schedule and outdoor camps that push fluids help kids get plenty to drink during a summer day.

However, drinking throughout the entire day is not always easy for kids during the school year.  Many children do not drink anything with breakfast and only 8 ounces at lunch.  Sips of water from the fountain are the only other opportunity to drink and many water fountains are currently closed.

• Encourage drinking of a large glass of water, juice or milk with breakfast, even if they don’t feel thirsty.
• Send a water bottle, educating your child on the importance of drinking it all during the day.  Most other kids will also have water bottles at school. Being able to keep it on their desk also helps with compliance of taking in adequate water.
• Pack an extra drink with lunch.

Change of Diet

Eating during the school year can also be different than the summer.  Lack of fruits and vegetables, with an increase in cheese, bread, milk can lead to less frequent stools.  Regular bowel movements are important in staying dry at night.

• Include high fiber foods in lunches and snacks.
• Read labels when buying foods and look for the most fiber.

Changes in Elimination

Fear of the school bathroom or overly strict teachers can prevent your child from urinating or having a bowel movement when they feel the urge to do so.  Trying to “hold it” until they get home can lead to embarrassing daytime accidents or constipation.

• Ask your child about the bathroom rules in their classroom.  It may take a gentle email to the teacher to allow unrestricted bathroom privilege in a child who is nervous about the rules.
• Ask your child about any other reason they might not be using the school bathroom.  Fear of bullying, cleanliness, lack of toilet paper, etc. are reasons that come up.  Come up with solutions for these concerns.
• Providing quiet toilet time at home before school and after school can help your child relax and produce a bowel movement in the comfort of their own home.  Your child may need a reminder and/or persuasion to sit at the prescribed times. Permission for electronic time or reading time can make it more enjoyable. 

Sleepovers

Invitations for sleepovers or school trips start with the new school year.  For children with nighttime accidents, having a backup plan is important. 

• Waterproof pants, sleeping bag liners, or medication may help.
• Limit the number of spontaneous sleepovers until the bedwetting has improved.

Bedwetting Alarms for Relapse

For a temporary relapse with the start of the school year, children who have become dry while using a bedwetting alarm can simply restart it for a few weeks.

• Restarting the alarm reminds the body what it should be doing in the nighttime.
• Once a regular school schedule is established for a few months, this is actually a good time to begin use of a bedwetting alarm in children who are still consistently wet at night.