It's common for children to experience bladder issues as they grow, including an occasional urinary tract infection (UTI) or periods of daytime and nighttime wetting – especially as they potty train.
"Urinary tract infections and nocturnal enuresis – commonly known as nighttime bedwetting – are the most common bladder issues affecting children," says Janelle Traylor, APRN, FNP, a nurse practitioner with Children's Health℠ who specializes in caring for children with urological issues.
But if your child has frequent UTIs, or prolonged difficulties with daytime or nighttime urinary incontinence (often called accidents), it may be time to seek help from a urologist.
What causes urinary tract infections in kids?
Urinary tract infections are caused when bacteria trigger an infection in the bladder, kidneys or urethra. Developing a UTI may be a sign that your child is not effectively or completely emptying their bladder. However, some children are at increased risk of developing UTIs due to a blockage in their urinary tract or a condition that causes an abnormal, backward flow of urine from their bladder to their kidneys.
"Voiding dysfunction is the most common cause of UTIs in the patients we see over the age of 2," says Traylor. "Kids are often busy playing, and they don't like stopping what they're doing to go to the bathroom. But holding the urine in their bladder too long can allow bacteria to grow."
Your child's pediatrician can do a simple urine test to screen for a UTI if they experience any of the following UTI symptoms:
- Abdominal pain
- Daytime accidents or nighttime bedwetting
- Fever (this may be the only symptom evident in infants)
- Foul-smelling, cloudy or blood-tinged urine
- Frequent need to urinate, though little urine may be produced
- Loss of energy
- Nausea, vomiting or loss of appetite
- Pain or burning sensation when peeing
If your child suffers from frequent UTIs, talk to your child's pediatrician about seeing a urologist who can help screen for underlying physical conditions that could be contributing to the infections.
You can help your child prevent UTIs by encouraging them to pee when they need to go, rather than holding it in.
Instead of asking children if they need to go to the bathroom, make it part of their daily schedule. Encourage a bathroom trip every few hours.
"We encourage kids to take frequent potty breaks and to take their time when going," Traylor says. "They'll want to hurry to get back to what they were doing, but it's important to teach them not to rush, so they can completely empty their bladder."
When should I seek help for my child's nighttime bedwetting?
Children who are potty training will naturally have wetting accidents from time to time. And while mastering daytime dryness may come easily for some kids, it can often take several months for them to get the hang of staying dry overnight.
Traylor stresses that nighttime accidents are common in young children. But if your child is 6 years old or older and still having frequent daytime or nighttime pee accidents, it may be time to seek the help of a urologist.
"Before the age of 6, we consider nighttime accidents to be developmentally normal," Traylor says. "However, after the age of 6, that's when we get a little bit more concerned. Socially at that age, it becomes more important for kids to spend the night or have sleepovers at camp, and we want them to be able to do those things confidently without fear of accidents."
Treating nighttime bedwetting
If your child is dealing with nighttime accidents, remember that most children outgrow bedwetting on their own. There are few things you can do as a parent:
- Start with at-home behavioral interventions, including using a sticker chart to encourage and celebrate the nights they stayed dry.
- Address bedwetting in older kids by encouraging them to drink lots of fluids and go to the bathroom every two to three hours throughout the day. This will teach them to fully empty their bladders.
- For heavy sleepers, you can try a bedwetting alarm, which attaches to kids' underwear and wakes them up if they have an accident. This may help train them to wake up when they need to urinate.
If these at-home efforts don't help and bedwetting accidents are starting to affect your child socially and emotionally, seek the help of a specialist. Pediatric urologists can perform tests to examine bladder functionality, suggest interventions to help kids improve pelvic muscle control and even prescribe medications if needed.
Want to understand more about common potty problems in kids? At Children's Health, our experts treat the full range of urologic conditions, from simple problems such as bedwetting to the most complex conditions requiring advanced surgical intervention. Learn more about our Pediatric Urology services.
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