Yossi’s mother was at her wit’s end. Yossi’s grey pants were wet again. It was the second time that week.
“Yossi, please go change your pants,” she sighed.
“But Mommy, why?” Yossi asked.
“Why Yossi? Because you are wet again. Didn’t you realize that you needed to go to the bathroom?”
“Maybe. I was just so caught up in my game that I forgot to go.”
“Alright, Yossi, just go wash up and change your pants,” his mother suggested. Why was six-year-old Yossi suddenly wetting his pants when he had been fully dry for three years?
During the Day
When children are potty trained and then fail to hold their bladder during the day, there can be several causes.
Stress or anxiety: When children learn to use the toilet between the ages of two and four, they are utilizing a complex system of neural connections and muscle control. If your child is distracted, bothered or frustrated, he might not be able to control those minute processes. Stresses on his emotional health can include a new school, a new sibling, different living arrangements or a problem with friends. The best way to understand whether your child is suffering from an anxious form of wetting himself is to talk to him about the issue. Is he aware of it? Is there something bothering him? Maybe he needs to verbalize the issues in order to work on the physical nature of the problem.
Physical: There are several physical problems that can lead to wetting during the day, among them urinary tract infections and diabetes. Urinary tract infections can lead to more frequent urination or sudden urges to urinate. Diabetes often requires more frequent urination because the body is trying to secrete the excess sugar in the blood. In addition, children with diabetes might experience excessive thirst which will lead to more frequent urination. A trip to the doctor can help rule out these medical causes.
Bladder-specific: Two issues with a child’s bladder can increase pants-wetting: an immature and/or overactive bladder. Because the process of urination requires complex neural and physical connections, if the bladder and the brain have not yet learned how to effectively communicate, this can result in frequent pants wetting. On the other hand, an overactive bladder induces spontaneous, strong contractions of the bladder muscles that can result in an urge to urinate, causing daytime accidents. Your child’s pediatrician or a children’s specialist can help you counsel your child’s brain to catch up to his body.
At Night
Unlike daytime wetting, bed-wetting or enuresis, is a more common occurrence than most people realize. According to the American Academy of Pediatrics, about twenty-five percent of 5 year olds, and ten percent of 6 year olds wet their beds. Bed-wetting is often attributed to a psychological or anxiety disorder, but new research is actually proving that this is not always the case. Below are some common causes of bed-wetting:
Genetics: If both parents wet their beds after the age of 6, there is a 75% chance that the child will wet his bed as well. If only one parent wet the bed, there is still a 44% chance of bed-wetting.
Developmental Lag: Just as some children are late talkers or walkers, there are children who are late in controlling their bladder while sleeping. Eventually, even with a lag, all children learn to walk or talk, so too, will they learn how to stay dry at night.
Deep sleep: Some children sleep so deeply, they cannot recognize when their bladder is full and therefore do not have enough time to get to the bathroom.
Small bladder: Physically, the child might have a small bladder that might overfill at night, causing nighttime urination.
While extremely frustrating to the parent, the American Academy of Family Physicians states that up until the age of six, bed-wetting is not abnormal. After the age of six, they suggest several methods in order to prevent it:
Limit fluids before bedtime.
Have your child go to the bathroom at the beginning of the nighttime routine and then again right before sleep.
Create a reward system for dry nights.
Ask your child to change the sheets after they get wet.
Have your child train his bladder by holding his urine for longer times during the day.