Teaching your child to use the toilet and transitioning out of diapers is a major milestone. Some children learn to control their bladder and bowel within a few weeks, while others have lingering problems for years. Most children are daytime toilet trained by age 5.

Incontinence is the involuntary (accidental) release of urine at least twice a month after a child has been toilet trained. A child may experience incontinence:

• During the day (daytime incontinence)
• At night, also known as bedwetting (nighttime incontinence)
• Both during the day and at night

Because all kids are different and some take longer than others to toilet train, children aren’t considered to have daytime incontinence until they’re 5 or older, or nighttime incontinence until they’re at least 7 years old.

Incontinence can be caused by:

• Anatomic abnormalities or birth defects, such as spinal cord problems like spina bifida
• Diabetes, Urinary Tract Infection (UTI), and other medical conditions
• Constipation
• Diet, including caffeine and acidic juices
• Emotional stress
• Incorrect urinating posture
• Sexual abuse
• Urinating infrequently

Bedwetting can be caused by:

• Bladder contraction before it’s full
• Developmental delay
• Drinking too much before going to bed
• Family history of bedwetting
• Problems waking up from sleep (being a deep sleeper)
• Uncompleted toilet training

University of Miami Health System pediatric developmental-behavioral specialists work with children and families to help resolve daytime incontinence, bedwetting, and toilet-training problems. We develop a personalized treatment plan to help your child gain bladder control.

Tests

Physical exam
Your child’s doctor conducts a physical exam and gathers a complete health history to help determine what’s causing daytime incontinence, bedwetting, or another toilet training issue.

Urine test
Urine tests check for infection and kidney problems, which can cause incontinence.

Blood tests
Your child may also have a blood test to look for health conditions that can cause incontinence.

Treatments

Urgency containment exercises
Your child learns and practices exercises to strengthen the muscles that control the flow of urine (sphincters). Our pediatric specialists use kid-friendly approaches to make it a positive learning experience.

Behavior modification
Your care team will recommend strategies your child can use to overcome incontinence problems, such as:

• If your child is thought to have an overactive bladder, try gradually increasing the time between visits to the toilet
• Schedule regular time for your child to visit the toilet
• Restrict fluid intake for several hours before bedtime

Bedwetting alarm
A bedwetting alarm (device that triggers an alarm when it detects moisture) and a consistent routine can help children learn to control their bladder at night. Punishing children for wetting the bed is ineffective and can lower their self-esteem.

Medicines

In some instances, doctors prescribe medicines to reduce the number of bedwetting episodes. Usually, the medicine only offers a temporary solution and bedwetting usually resumes once the child stops taking it. Your child’s doctor may prescribe medicine in addition to other approaches as part of the treatment plan.

Why Choose UHealth?

World-class health care for children. Children and their families come from all over the world to receive top-quality care from our compassionate team of pediatric specialists. Your child receives personalized attention from doctors who are sought out for their expertise.

Research leads to better treatments for your child. In addition to seeing patients, our doctors are involved in leading-edge research at one of the nation’s top medical schools, Miller School of Medicine. Through this research, we have access to innovative treatments and procedures more quickly than other facilities. Our team uses the latest technologies and research findings to provide your child with superior, personalized care.

HealthySteps program helps children meet milestones. All our general pediatrics offices use the HealthySteps program to ensure that children are developing appropriately for their age — physically, emotionally, and psychologically. When there are issues or concerns, we work closely with patients and their families to connect them with support resources.