You need to discuss this problem with your doctor. Most commonly bedwetting (nocturnal enuresis) is a simple and self-limiting condition which can respond to simple measures such as:

• Improving fluid intake during the early part of the day and at school while reducing the fluid intake in the afternoon and evening.
• Avoiding diuretic drinks such as coffee, tea, blackcurrent juice and fizzy drinks.
• Regular daytime toileting and bladder emptying
• Treatment of constipation
• Remove your child’s nappy or pull-ups to encourage awareness.

Children can have daytime wetting (incontinence) due to a variety of conditions such as:

• Overactive Bladder: an overactive bladder where the child feels the need to use the toilet very frequently (more than 6 times a day) and urgently and may have daytime wetting (urge incontinence) with or without night-time wetting (nocturnal enuresis).

• Infrequent voiding: where the child empties their bladder infrequently (less than 4 times a day), and they may not empty their bladder fully each time.

• Voiding dysfunction: where the child has wetting with withholding behavior and they may not empty their bladder sufficiently. They could also have bowel problems such as constipation

• Giggle incontinence: where your child only wets when they are giggling.

The management of your child’s wetting (incontinence) should always consist of the following simple measures:

• Improving fluid intake during the early part of the day and at school while reducing the fluid intake in the afternoon and evening.
• Avoiding diuretic drinks such as coffee, tea, blackcurrent juice and avoiding fizzy drinks.
• Regular daytime toileting and bladder emptying (bladder re-training).
• Treatment of constipation.

You can use positive feedback to achieve this (positive praise, star charts, reminders).

Please see the following links for examples of a star chart and a toilet training certificate, which you may use or design your own

Link to toilet training certificate: Toilet Training Certif0001.pdf

Link to Star Chart: Star chart0002.pdf

it is important to seek medical help if your child is wetting with any of the following features:

• Your child started to wet again after having been dry for a while (secondary incontinence)
• If your child has had a urine infection
• If your child has blood in the urine
• If your child has daytime wetting (incontinence) as well
• If your child has to use the toilet very urgently (urgency, urge incontinence) and many times a day (frequency)
• If your child has soiling (stool in the pants)
• If your child has excessive drinking and is passing a lot of urine by day and night

• your doctor will ask you many questions about your child’s wetting and urine habits as well as their general health, growth and development. It is also important to let your doctor know if there is any family history of kidney conditions or other illnesses such as high blood pressure (hypertension) or diabetes.
• Sometimes, you may not remember accurately how often your child empties their bladder and how severe the wetting is, or if they are passing small or large amounts of urine, so your doctor will ask you to keep a diary of your child’s urine habits and fluid intake ( how much they drink each time, how often they empty their bladder and how much urine they pass each time, and if they are wet before or after passing urine).
• Please follow this link to obtain such a diary to use before your see your doctor, as completing this will help with your child’s initial and follow-up consultations. Link to bladder diary: Bladder Diary0018.pdf

Your doctor will decide if your child’s wetting could benefit from any further medications or treatments. The types of treatments that are available for the various wetting problems are:

• Desmopressin (Desmotabs’ or Desmomelts’), which is used to treat night-time wetting (nocturnal enuresis) where your child’s urine production at night is large. Your doctor will advise you if this is suitable for your child and at what dose to give it.
• Anticholinergic medications:  These are medications that are used to treat detrusor overactivity (daytime wetting). Your doctor will advise you which is the most suitable for your child and at what dose to use it.
• Enuresis Alarm: Your child may also benefit from using a special alarm at night to treat their night-time wetting (nocturnal enuresis), and this is called the enuresis alarm. You can find out more about this alarm and how to get one from the ERIC website (address available in the links page of this website).