Excessive Peeing Habit Can Be Trained
Question: We moved from Toronto to Prince Edward Island several months ago. Our daughter is 6-years-old. She is a very healthy and active girl. However, in the past two years, she has a problem of wetting her pants in the daytime. This can happen when she is at home and when we go out with her, but never in school or in bed. We notice that she drinks a lot of water and juice. She enjoys playing with her friends, and sometimes we see her dancing around looking like she needs to use the washroom. But when we suggested that to her, she would always deny it, and then within minutes she would wet her pants and say that she can’t help it. When we go out for a drive, she often refuse to use the washroom before we leave, but within a short time she can’t wait to pee. Our doctor in Toronto said that she is just lazy, and told us to discipline her. However, we have tried all kinds of punishment, and so far nothing has helped. We are worried that she may have an illness that we are not aware of. Can you tell us what we should do?
You certainly have a very interesting problem. Anytime when a young child drinks a lot and pees frequently, we have to make sure that she doesn’t have diabetes mellitus, more commonly known as sugar diabetes. However, because she has been doing this for two years and has no other sign of diabetes, it is unlikely to be the case. Your doctor can do some blood and urine tests to make sure it is not the problem.
The next thing that one should consider is bladder or kidney infection. Children who have urinary tract infection often have other symptoms, including pain when they pee, and the urine can have a strong odour and looks cloudy. In addition, there may be fever also. Some children can be born with an abnormal urinary tract that gets infected more easily. If these infections are not recognized early, kidney damage can occur, which can lead to kidney failure later on in life.
It is not difficult to check whether your daughter has a bladder or kidney infection. The urine can be tested by dipstick as well as culture to look for bacteria. Most infections are easily treated with antibiotics. If there is confirmed urinary tract infection, more tests would be necessary to make sure that she has a normal urinary tract.
However, there is another simple explanation for many children who wet their pants in the daytime: they are drinking too much fluid and they don’t pee often enough. Many children like to drink water from a glass or water bottle, or go to the tap directly as a way of exercising their newfound independence. Others just love the taste of juice or milk. The bottom line is that they take in more fluid than their body’s need.
Most of the time it is not a problem at all. Very few children will drink excessively to the point of harming themselves. They just need to go to the washroom to pee more often. However, there are some children who would rather play instead of taking the time to go to the washroom, even though they know that their bladder is quite full. They would even dance around and deny the need to pee, as you have described, and the next moment she has already peed in her pants.
This type of behaviour cannot be controlled by punishment alone. Instead, one has to understand the reason why it is happening, and then plan out your strategies to deal with it. The first thing that you should do is to observe how much fluid that she is actually drinking in a day, and then see whether you can help her to reduce it. You can discourage her from taking drinks from the tap, and give her smaller glasses or half-filled water bottles instead.
You can also watch and see how frequent she actually pees, whether in the washroom or in her pants. Then try to anticipate and get her to pee before her bladder is too full. Of course you have to discuss with her that her wetting of the pants is not acceptable and that you are going to help her to change. Positive reinforcement and rewards work a lot better for this problem than punishment.
Once in a while, a child can be born with a small bladder. As a result, these children will need to pee more often because the bladder cannot hold as much urine as other children. In this case, the child will wet the pants or use the bathroom very often all the time. Your doctor can arrange for some tests to see whether this is truly the case. This problem can be helped by training the bladder. If the child says that he needs to pee, ask him to wait for 5 minutes, and later for 10 minutes, and gradually lengthening the time to stretch the bladder so that it can hold a larger quantity of urine. If the problem is serious, medication is sometimes necessary to help these children.
I hope you can see that many children with your daughter’s problem do not have a serious medical condition. Some simple observation and intervention may be all that you need to do. Punishing a child often doesn’t help, rewarding for a successfully dry day or week would be much more effective.