About 20% of all children who wet the bed at night also wet themselves while they’re awake. We see those little circles of moisture on the child’s clothes. But when we suggest they need to go to the toilet, they tend to say they don’t have to. And when we look at them straining to hold it in (hopping from one foot to the other, or crossing their legs tightly) they still say they don’t have to go. Just a few seconds later, the circle appears on their clothes. Many parents explain this by saying the child was busy, and concentrating on other things, or was afraid of missing out on something. It sounds logical but if that really were the case we’d all be walking around with urine stains on our clothes. All of us, children and adults are busy and concentrating on all sorts of things and yet we know how to restrain ourselves and hold it in perfectly. Some parents get mad at their children and relate it to a deliberate behavior. However, the explanation for this behavior is not simple at all. We see in our clinics daytime wetting children referred by dermatologists suffering from severe persistent painful and irritating skin inflammation, who nevertheless continue daytime wetting.
Still, don’t despair, there is a solution.
Although the reason for day wetting is not yet fully understood, most cases can be resolved. When daytime-wetting accompanies nighttime-wetting the focus is on treating the night problem using the bedwetting alarm. In almost all cases, using the alarm at night solves the daytime problem as well. When the problem is of wetting only during the day ,this is the treatment intervention that works:
- Take the child to the toilet every 45 minutes, whenever that can be done. The emphasis is on taking. Not suggesting, not asking, simply physically taking the child by the hand and getting them to try to pee in the toilet. Even if they objects, deny they need to, promises to do it later, whatever is the case, don’t give up. They must visit the toilet and try. They do not have to actually urinate but they have to try. The trial does not have to last more than 2 minutes.
- During the treatment course , every time the child take their own initiative they cancel the need for the next imposed visit by parents – for example, if the child was taken at 17:00, with the next visit scheduled for 18:00, then they go on their own initiative at 17:20, this cancels the imposed visits scheduled for 18:00).
- When you observe a significant improvement in toilet visit initiations and in prolonged periods of dryness, they proceed to the next step. You reduce the frequency of imposed toilet visits to one in every 1.5 hours. When further improvement is observed you further reduce frequency of visits to one in 2 hours . Keep reducing frequency of imposed visits until complete independent dryness is achieved.
- In cases of daytime wetting, we recommend to see a doctor and an ultrasound test of the urinary tract.