Key points to remember about daytime wetting
- daytime wetting is when your child leaks wee during the day
- some tamariki with daytime wetting also wet the bed
- daytime wetting is not your child’s fault - don’t punish them or get angry
- if your child regularly wets during the day after being toilet trained, see a health professional
- regular toilet visits and treating constipation can help
- improvement takes time - your child’s healthcare team can help you make a plan
See the KidsHealth page on bedwetting for more information on wetting the bed at night.
What causes daytime wetting?
There are several reasons why tamariki may wet themselves during the day. Your child’s health professional will help work out what might be causing their wetting.
An overactive bladder
Some tamariki have a bladder that empties before it’s full. Your child may suddenly need to wee urgently, go to the toilet often or leak wee before they get there.
Delaying toilet visits
Some tamariki put off going to the toilet, especially when they are busy playing. Their bladder may become too full and leak.
You may notice your child crossing their legs, squatting or wriggling to hold on.
Difficulty emptying the bladder
Some tamariki don’t fully relax the muscles around the bladder outlet when they wee. This is called dysfunctional voiding. Their wee may stop and start, and some wee may stay in the bladder.
Other tamariki don’t empty their bladder often enough or have difficulty getting all the wee out.
Constipation
A bowel full of poo can press on the bladder and make it harder to store or empty wee. Treating constipation is an important part of managing daytime wetting.
Constipation Treatment For Children
Other causes
Urinary tract infections (UTIs) can cause wetting.
Urinary Tract Infections In Children
Daytime wetting can also happen due to issues with the urinary system's structure or the nerves that control the bladder. These are uncommon.
What you can do to help your child's daytime wetting
Be patient and reassuring. Your child is not wetting on purpose.
Things that may help include:
- encouraging regular toilet visits
- offering water regularly throughout the day, including with meals and snacks
- giving your child time and privacy to relax on the toilet
- using a footstool if their feet do not reach the floor
- having spare clothes and place to change at school
- talking with their teacher about easy access to drinking water and toilets
- avoiding drinks containing caffeine, such as tea, coffee, cola and energy drinks
If your child needs protection for leaks, choose something comfortable and discreet together. Ask your child’s healthcare team for advice.
Praise your child for following their plan, such as taking toilet breaks. Reward your child for their efforts rather than for staying dry.
When to get medical help for your child
See a health professional if your child has daytime wetting.
Tell the health professional if your child:
- dribbles wee continuously or is always damp
- has a weak wee stream or strains to wee
- has repeated urinary tract infections
- has constipation or soiling
- has difficulty walking or weakness in their legs
See a health professional urgently if your child has pain when weeing, a fever or seems unwell. They may have a urinary tract infection (UTI).
Urinary Tract Infections In Children
Tests for children with daytime wetting
The health professional will ask about your child’s wetting, toilet habits and bowel movements. They may also examine your child.
A diary can help. Record:
- when your child wees and, if possible, how much
- when wetting happens
- what and how much your child drinks
- when your child poos and whether it’s hard or painful
Your child’s health professional will usually arrange a urine test to check for infection and other possible causes.
Some tamariki need an ultrasound scan of their kidneys and bladder. This may be recommended if your child has continuous leaking, repeated UTIs or wetting that does not improve with treatment.
Your child’s health professional will explain any other tests they recommend.
Your health professional may refer your child to a:
- continence service
- paediatrician (child health specialist)
- urologist (a doctor who specialises in the urinary system)
Managing daytime wetting
Treatment depends on the cause. Most tamariki start with a plan that includes:
- regular toilet visits
- enough drinks during the day
- treatment for any constipation
Improvement can take time. Your child’s healthcare team will review their progress and adjust the plan if needed.
If your child also wets the bed, the healthcare team will usually help them with daytime wetting first.
Regular toilet visits
Encourage your child to wee regularly rather than waiting until they are bursting. Their healthcare team may suggest going to the toilet every 2 to 3 hours.
Useful times may include:
- when they wake up
- before school
- during school breaks
- after school
- after dinner
- before bed
Your child should also go when they feel the need to wee.
Alarms may help. Work with your child and their teacher to make the routine manageable.
A star chart can help encourage your child to follow their toilet routine. Give stars for things they can control, such as taking toilet breaks or drinking water regularly, rather than for staying dry.
Relaxing on the toilet
Encourage your child to sit comfortably with their feet supported and knees apart. Give them time to wee without rushing or straining.
Double voiding
If your child has trouble completely emptying their bladder, their health professional may suggest double voiding. This means having a wee, waiting briefly by counting to 20 and then trying again. This helps reduce leftover wee in the bladder.
Help with bladder and pelvic floor coordination
Some tamariki need help learning to relax their pelvic floor muscles while weeing. A health professional with experience in children’s bladder problems can teach them exercises.
Treating constipation
Treating constipation can help the bladder work better. Your child may need changes to their toilet routine and laxative medicine. This can help to keep their poo soft and easy to pass.
Constipation Treatment For Children
Medicines
Some tamariki need medicine alongside their bladder and bowel routine.
Medicines such as Desmopressin and oxybutynin may help. Your child’s health professional will prescribe these if they are right for your child. They will check for side effects, including constipation or difficulty emptying the bladder.
Surgery
Most tamariki with daytime wetting do not need surgery. If your child has a structural problem in their urinary system, a specialist will explain the treatment options.
More information
This PDF guide has information, tips and resources to help tamariki and teenagers with bladder and bowel problems. It includes advice on toilet training, managing continence problems and supporting children with additional needs.
Continence NZ provides information, resources and support for children and families with bladder and bowel problems.
They also have bowel and bladder resources available in different languages, including te reo Māori, Tongan, Samoan, Hindi and Chinese (Mandarin).
A video explaining why daytime and bedtime wetting happens and what you can do to help.
Source: Primary Children's Hospital (USA)