Daytime accidental wetting is much less common than
bed-wetting. But about 1 out of 4 children who wet the
bed at night also wet during the day.1
Knowing the cause of the wetting will help you and your child's doctor
decide on the best treatment. Daytime accidental wetting is more likely than
bed-wetting to develop after a child has had
bladder control for at least 6 months to 1 year (secondary diurnal enuresis). This pattern of wetting
is often related to a medical condition, such as an infection or a defect in
the urinary tract, or emotional
stress. Treating the condition will usually
stop the wetting. But daytime wetting can be a matter of normal development,
with no medical cause.
If daytime wetting begins after a child has
had consistent bladder control, consider the possibility that stress, such as
the birth of a new sibling, is the cause. Accidental wetting often stops after
the stress is addressed and managed. Some children may benefit from seeing a
mental health professional.
Daytime wetting as a part of normal physical development
Daytime accidental wetting (diurnal enuresis) is common in younger
children. Children may become so involved in play that they forget to go to the
bathroom. Also, they may hold on to urine too long. These children:
Tend to empty their bladders only 2 or 3 times
a day compared with the normal 5 to 7 times a day.
Often do not
empty their bladders when they first wake up.
Often do not empty
their bladders completely when they use the bathroom.
Some children have accidental daytime wetting because they
try to hold their urine too long. To keep from wetting themselves, children may:
Squirm, cross their legs,
hold their thighs together, or use their hands to hold back the
Stand very still, looking as if they will wet themselves if
If a child has accidental wetting during the day, it can
affect his or her performance in school or friendships. The child may be afraid
of wetting at school or on outings. He or she may also be afraid of being
teased by friends. Treatment can help the child lead a more normal life and
have higher self-esteem.
When to call a doctor
Daytime accidental wetting may
be a normal part of a child's growth and development, or it may be caused by a
medical condition. Getting your child's problem evaluated by a doctor is
important if there is any chance that a medical condition is the cause.
Cloudy or pink urine or bloodstains on
Urinating more often than usual.
or complaining when urinating.
Urge to urinate frequently but
usually passing only small quantities of urine.
Your child is leaking (dribbling) when urinating
or has a weak urine stream. The child may have a birth defect in the urinary
Your child age 4 or older is having daytime accidental
wetting and is leaking stool. The child may have stool blocking the intestines,
caused by having constipation over a period of time.
Your child had bladder control but is wetting again.
Evaluating daytime accidental wetting
If you take
your child to the doctor for help with the child's accidental wetting, a
medical history and physical exam will be done to discover if the wetting is a
symptom of a medical condition. The doctor will ask you and your child
questions about the wetting, such as when and how often it happens. As part of
the physical exam, the doctor will examine the child's abdomen, rectum, spine,
and genital area and may watch the child urinate. Depending on the results of
the physical exam, the doctor may do other tests, such as:
urinalysis and urine
culture and sensitivity test, if a bladder or kidney
infection is suspected. For more information, see the topics Urine Test and Urine Culture.
urodynamic study, if a lack of nervous system control
of the bladder is suspected.
If a child has both daytime and nighttime
accidental wetting, the doctor may treat daytime wetting first, because children
normally gain daytime control over their bladders sooner than nighttime
control. Accidental daytime or nighttime wetting may increase after treatment
If daytime wetting is caused by a medical condition,
you can have treatment for the medical problem and the daytime wetting will
Treatment for daytime wetting that is not caused by another
medical condition may include:
Medicine. Oxybutynin (such as Ditropan or Oxytrol) may be
used to treat daytime wetting in children and adults. It
helps control the bladder muscle that releases urine.
Surgery. If the child has daytime wetting that is
caused by birth defects within the urinary system, surgery to correct the
defect may be needed. But sometimes the surgery does not make the accidental
Counseling. Sessions with a counselor may be
helpful for the child who has accidental wetting that is caused by emotional
stress. Counseling may involve psychotherapy or hypnosis (hypnotherapy). The
goal is to reduce or help manage the stress or to prevent stress.
treatment may be all that is needed to improve daytime accidental wetting,
especially if the wetting is not due to any medical condition or stress. Try
Encourage your child to go to the bathroom
whenever the urge happens.
Reward your child for being dry. You may
use hugs, stickers, or special treats as rewards.
your child wear a diaper. Wearing a diaper may make him or her feel babyish.
Also, it may be hard for a child to get the diaper off when using the toilet.
Wearing disposable underwear, such as Pull-Ups, may be helpful. But it may also make
the problem last longer, because the child may have less motivation to learn
If your child delays going to the bathroom and holds on to
urine until he or she loses control and wets, try the following:
Encourage your child to use the toilet when you
notice signs that he or she may need to go, such as squatting, squirming,
crossing the legs, or standing very still.
Offer more liquids to
drink. Drinking more liquids will increase the amount of urine in the bladder,
causing your child to need to go to the bathroom more often.
your child go to the bathroom every hour during the day.
your child to take extra time on the toilet so that he or she will be more
likely to empty the bladder.
How this information was developed to help you make better health decisions.