08/09/2026

LYFE TUESDAY | SEPT 8, 2026

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Beyond bedwetting

while nighttime dryness can take longer, sometimes up to seven years. A common belief is that children wet the bed because they sleep too deeply. However, for some children, the signal from the bladder does not reach the brain in time resulting in urinary incontinence. This means a child may not recognise the need to urinate during sleep. Others may produce more urine at night due to hormonal patterns or

U RINARY incontinence in children is a more common condition than parents realise. Most children who are incontinent suffer from daytime urinary incontinence (symptoms of urinary incontinence while awake during the day), nocturnal enuresis (bedwetting at night while asleep) or a combination of the two. While occasional incontinence is part of normal development, persistent urinary leakage beyond the age of five may begin to affect a child’s confidence, school participation and psychological well-being. This is a highly manageable condition with the right guidance. Globally, about 10% to 20% of children experience nighttime bedwetting, while 7% to 10% have daytime symptoms. So, it is not unusual and rarely an issue. o Understanding urinary incontinence in children without blame

develop habits of holding urine during the day, which can make things worse. These are functional issues rather than structural problems.

Addressing bowel habits, including better toilet posture, can significantly improves urinary symptoms.

their confidence, medical support is needed. Treatment depends on the pattern whether it happens during the day, at night, or both. For nighttime bedwetting, medication may be considered when the condition affects the child’s daily life such as school trips or sleepovers. The medicine mimics the natural antidiuretic hormone, helping reduce urine production at night. For daytime symptoms, treatment focuses on the underlying cause. This may include treating constipation or if needed, medication to relax the overactive bladder. When both are present, daytime symptoms are addressed first. However, treatment is not one-size-fits-all. Understand how the bladder is functioning before starting medication. Tools such as ultrasound, uroflow studies and bladder diaries may be used. A common approach to bedwetting involves three months of medication followed by a two-week break in between to assess progress. Many children improve within the first cycle, with most responding well within two to three cycles. Supporting children without shame Beyond treatment, emotional support is essential. Children with incontinence may feel embarrassed or anxious, especially in social settings. The first step is to remove blame. This is not something the child is doing intentionally. Parents can focus on effort, keep routines calm and avoid punishment that can increase stress. Teachers and caregivers can also help by allowing easy toilet access and maintaining a supportive, private environment. Urinary incontinence is a medical and developmental issue, not a discipline problem. With time, understanding and the right support, most children improve significantly. Children need understanding, patience and the right care instead of judgement. This article is contributed by Sunway Medical Centre, Sunway City consultant paediatric urologist, paediatric and robotic surgeon Dr Srihari Singaravel.

habits alone significantly improves urinary symptoms. Simple factors such as poor toileting posture can also play a role. Children whose feet do not touch the ground when sitting on the toilet may struggle to empty their bowels properly, which can indirectly affect bladder control. First steps parents can take at home The good news is many children improve with simple, consistent routines and habits rather than immediate medical treatment. Encourage or remind children to urinate regularly, about every two to three hours, avoiding prolonged “holding” and ensuring adequate hydration earlier in the day can help. Reducing excessive fluid intake in the evening and maintaining good bowel habits through a balanced diet with enough fibre and fluids are also important. These are small changes, but when done consistently, they can make a meaningful difference. When medical treatment is needed For some children, especially when symptoms persist or begin to affect

The bladder is healthy but not yet fully coordinated. Parents should take note and seek help if the

symptoms are frequent and associated with urgency or begin to affect the child’s daily life, such as not being able to go more than an hour without having to go to the toilet or more frequent “accidents” at school or at home. Other signs include constipation or recurring urinary tract infections which could also signal a far more serious issue. Overlooked link between bladder and bowel One of the most important and often overlooked contributors is constipation. The bladder and bowel sit closely together and function as part of the same system. If the bowel is full, it can press against the bladder, reduce its capacity and make it more overactive. This can lead to urgency, frequent urination and incomplete emptying. In many cases, addressing bowel

What is normal, potential red flags for parents to notice

Bl adder c on t r o l deve l ops gradually

as

children

grow.

Most

achieve

daytime control between the ages of two and three,

Constipation could also signal a far more serious issue related to urinary incontinence.

Some children have the issue of their bladder failing to reach the brain in time, leading to incontinence. – ALL HANDOUT PICS