Having difficulties with bladder control is very common in young children. This is partly due to immature bladder function which will naturally improve with age, but control problems are more marked amongst children with physical and learning difficulties.

**If **your child’s cognitive skills are delayed in language and understanding, it is likely they will need a bit more time and patience to master toileting skills.

Some children are especially anxious about new routines or demands. They might need extra patience, planning and organisation. It will help if you use strategies you know will ease your child’s stress - for example, you could give them choices over aspects of the toileting routine. Ask them if they want to take a toy with them or take their pants off beforehand. You could also explain the process in advance, making it fun by including favourite toy animals or dolls in role-play.

**Body Awareness **– Some children have an over or underdeveloped sense of their body’s needs – such as the need to do a poo or a wee. If your child has reduced body awareness, they may not notice the discomfort of sitting in a wet nappy. Or, if they have heightened body awareness they may go to the toilet repetitively, even when they have little need to do so. You can model listening to your own body signals as well as incorporating body listening into stories and play to help the child build their skills.

Physical difficulties – If your child has continuing bladder difficulties they might have an underlying medical condition, such as an infection or abnormalities in their urinary system. Keep a record of the problems they are experiencing and when they occur, before consulting your doctor.

In New Zealand 15 percent of five-year-olds wet their beds regularly, as do five percent of 10-year-olds. It is generally not considered a concern until children are aged seven or older. For children with disabilities or who are neurodiverse, bedwetting can be more long-lasting and can get in the way of school camps and sleepovers. This can be upsetting for everyone.

Some tips that might help with bedwetting:

You’re probably already doing these, but it might help to tick them off and know you’ve covered the basics.

• Keep your child’s fluid intake up during the day – aim for six to seven water-based drinks, at regular intervals during the day.
• Encourage your child to go to the toilet before going to sleep.
• Protect the mattress with a waterproof cover.
• Don’t pick your child up and take them to the toilet while sleeping – it is important they learn to wake up to bladder demands.
• Bed alarms are available which are triggered by moisture in the bed, which helps develop children’s awareness of a full bladder and the need to go to the toilet. Talk to your GP or needs assessor/navigator about a referral to an incontinence nurse.
• Celebrate and praise your child for their toileting wins. Never get angry or punish your child for toileting accidents.

Regression and Relapses

Just when you think you’re over this stage in your child’s life - you find the bed wet again! Regressions and relapses happen. Take a deep breath and don’t panic. It might be a blip on the road to toileting success, or there may be something going on with your child that you need to know about. Remember, behaviour is communication, so find out what your child is trying to tell you.

Firstly, investigate if there are any health issues that are causing the problem – for example if your child has a urinary infection or is constipated this will lead to changes in their toileting behaviour. If all possible medical causes have been investigated and treated and the problem persists, look externally. Perhaps your child is stressed due to changes in the family environment – you’ve shifted house or had a relationship breakdown. The problem could be in their school environment – they don’t like their new teacher or have had a falling out with a friend.

Once you’ve identified the issue it will be easier to provide the calm and supportive environment your child needs.

Remember:

There is usually a reason for children to act in a particular way. It’s our job as parents to figure out what that reason is and do what we can to fix the problem with the help of others.

Try not to let feelings of embarrassment get in the way of talking to other parents and people who can help, about your child’s toileting issues. You’re not alone - toileting issues can be so frustrating and be really hard to manage.

Believe in your child’s ability to learn and celebrate their achievements.

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