Treatments for children's incontinence

It’s always worth checking for infection

If your child seems healthy apart from the bed-wetting, it’s very unlikely that there’s a serious cause. If you have any reason to believe there is an underlying infection, your doctor may suggest a urine test. They’ll send a sample to the laboratory to check for infection, and will also do a simple ‘dipstick’ test to ensure no other health issues are prevalent.

Bed-wetting alarms (enuresis alarms)

These alarms can be an effective treatment. Designed to ring or buzz the moment bed wetting starts, they wake the child, which gets them into the habit of waking up when urine needs to be passed.

Alarms can either be purchased or in some cases supplied by your health service (in which case you should get the practice nurse to show you how to use it properly). A bit of patience and commitment is required but you should find it pays off. There are two main types of alarm.

• ‘Pad and bell alarms’ have a plastic mat that you place in the middle of the bed, where wetness usually occurs. The mat has an electrical circuit within it that is connected by a flex to a bell or buzzer alarm. You place the alarm out of reach so that, when it sounds, your child has to get out of bed to switch it off and can then go to the toilet.

• ‘Mini-alarms’ are neater. They clip onto the child’s nightwear, near the collar. A thin flex connects the alarm to the sensor, which you attach to their underwear. Wetness activates the alarm which can be switched off temporarily, but the child must change into dry clothes to prevent it going off again.

Using a bed-wetting alarm

• For at least the first 10 nights, you will probably have to wake your child when you hear the bed wetting alarm, so that he or she can switch it off and go to the lavatory. You will also need to help your child change the sheets and reset the alarm. A ‘baby alarm’ system will help you to hear when it goes off.

• After about 10 days, many children will have learned to wake up promptly to ‘beat the buzzer’, so there will be a smaller wet patch. This is progress.

• If your child does not wake with the alarm, make it louder by placing the sound box in a tin.

• Be patient. Some children become dry after about 2 months of using the alarm, but many need 4 months.

• If your child becomes completely dry using the alarm, carry on with it for a further month.

In truth, quite frequently the child is the only person in the house not woken by these alarms. The overall success rate is about 68% and you may prefer something that works for the whole family. If after about 6 weeks, there’s no progress at all (such as a smaller wet patch, or the alarm going off later in the night), it’s best to stop using it and try again a few months later.

Medicines for children's incontinence

Medicines can provide short-term relief for your child's bladder weakness but they don’t train the body to be in control, so they can’t really cure the problem. As soon as the child stops taking them, bed-wetting often reoccurs. Most people prefer to use protection products to manage a child’s incontinence, but medicines can be useful for situations where you need to be sure, like school trips where your child needs to share accommodation. A doctor’s prescription is required.

• Desmopressin helped the kidneys make less urine and was taken as tablets or a nose spray. On average, it gave 2 dry nights a week, with about one-third of children completely dry. However, it has recently been withdrawn due to side effects

• Imipramine is a drug that helps the bladder hold more urine. On average, taking Imipramine, if available in your country, gives 1-2 dry nights a week. It used to be popular, but is not used much nowadays. It has some side-effects which your doctor can explain to you. It’s not as effective as Desmopressin.

• Oxybutynin calms overactive bladder muscle. It may be helpful if your child has daytime wetting as well as bed-wetting, and has to rush to get to the toilet (urgency). However, there are side-effects (dry mouth, constipation, blurred vision) and to date it has not been researched as thoroughly as Desmopressin.

If your child’s incontinence is due to a medical condition or disability and you require more information, please visit the looking after loved ones section.