5 tips to beat persistent wetting in children

Day and night wetting up to the age of five is not considered abnormal by the International Children’s Continence Society (ICCS), though the majority of children will be toilet-trained before. Prolonged bed wetting (nocturnal enuresis) alone is usually of no great concern, and tends to sort itself out.

On the other hand, persistent daytime wetting (sometimes in combination with bed wetting), especially if the child needs to go to the toilet frequently and urgently, should be evaluated by a paediatric urologist. The same goes for recurrent urine infections and constipation. The following are baseline tips to consider before proceeding with investigations or medical treatment.

Adequate fluid intake

Water is the best, but milk, fresh juice, and orange and lemon squash are also fine.

Avoid sugary blackcurrant and dark-coloured drinks, and fizzy or caffeinated drinks (including Red Bull and Lucozade) as these irritate the bladder muscle. Good fluid intake allows the bladder to develop a larger capacity, helping to prevent bed wetting. Restricting drinking in children is counter-productive.

The National Institute for Clinical Excellence (NICE) guidelines on fluid intake are:
 

• 4-8 years
  Female 1000-1400ml
  Male 1000-1400ml
• 9-13 years
  Female 1200-2100ml
  Male 1400-2300ml
• 14-18 years
  Female 1400-2500ml
  Male 2100-3200ml

Regular wees

Every three hours is ideal. This avoids the bladder becoming over-full and avoids stagnant urine in the bladder. It also “trains” the bladder muscle to work properly.
 

Be aware of the child’s stooling habits

Constipation prevents sufficient bladder emptying, causing infections and wetting. Children should stool every day or every other day with a soft stool.
 

Always check their toilet routine

Especially with young girls, as recurrent cystitis is very common in this age group. They should be seated comfortably with their feet on a step to help them balance and relax the pelvic muscles. One leg out should be taken out of their underwear, this allows the bladder to empty properly and avoids reflux of urine into the vagina. You should always wipe from front to back.
 

Cranberry juice, probiotic yoghurts and Vitamin C help to prevent cystitis

D-Mannose, a naturally occurring sugar, has been shown to be effective at preventing E-coli urinary tract infections. Three quarters of a teaspoon mixed with water or juice is a natural and effective way to prevent them.