Bedwetting: Daytime program for nighttime dryness

If your child has any daytime bladder or bowel “issues” then the daytime program for nighttime dryness should be considered.

1. 1. Children should use the bathroom the moment they wake up and at least every 1½-2 hours during the day until they go to bed. Children that go often also have episodes when they do not go frequently. These kids will hold it at times and will need to be told to use the potty. Avoid using statements like “wait till we get home” or “try to hold it longer.” Do not ask your child if they need to go potty or if they can go. Just simply say it is time to go potty.
2. Children should be told to relax and take their time in the restroom. They must not strain, push or be in a hurry. If they are straining or trying too hard tell them to stop and relax. Close the bathroom door and tell them to sit (even the boys) deep into the potty with their legs apart. Younger kids should place their feet on a step stool. Closing their eyes and taking deep breaths is very helpful. Do not send them with a book, game, or toy. This will only distract them from understanding the subtle sensations of normal emptying of their bladder and bowel. Pit stops are not allowed, and they should stay on the potty for 3 minutes.
3. Children with abnormal potty habits should avoid stimulants that cause them to be hyperactive and less likely to relax. This becomes especially important when a child has ADD, ADHD, or has a classic anal-retentive personality (type-A personality). They should also avoid drinks and foods that are potentially irritating to the bladder. There are many items one could list, but the biggest offenders are caffeine drinks, chocolates, and
   
   sugar/carbonated drinks.

4. A bowel program is essential. Painful, difficult and long bowel movements will discourage a child from using the potty. Remember, even if a child does not have obvious constipation, they may need to have frequent bowel movements to urinate better. There are no medications or procedures that will make a child urinate better. But if they have frequent bowel movements (goal=2 mushy poops a day), they will have to sit, take their time, and usually pee well when they poop.

   We can safely manipulate the bowel movements with diets and mild laxatives. Fiber, fruits, vegetables and increasing fluid intake can help with constipation. Laxatives are usually required to get the results that are needed. Common examples include Miralax (glycolax), Senokot, lactulose, mineral oil, and milk of magnesia. Consult your child’s doctor if you have any concerns or questions about laxative use.

Many times additional help is needed from devices and products that assure your child will follow the program and achieve success.

– Dr. D. Preston Smith

Dr. Smith is board certified and he has authored or co-authored many articles, papers, chapters, and books in Urology and Pediatric Urology. His research has been presented throughout the world. Dr. Smith’s dedication to helping children with urologic problems inspired him to establish PottyMD.