There are 2 main causes for daytime wetting.
1. Limited or inappropriate fluid intake
2. Inability to hold on due to concentrated urine, due to limited or inappropriate fluid intake.
What can you do!!
1. Without making any changes to his (his/her) usual fluid intake over the next week make a diary of what he is drinking, how much he is drinking and when he is drinking it.
Normal drinking times should be
Breakfast, morning tea, lunch, afternoon tea, dinner and supper .
These times can be altered to suit, but 6 evenly spaced drinks/ day are very important. This is to ensure that the urine in the bladder is dilute enough not to cause irritation to the bladder, which leads to spasm with the urge to pee and then uncontrolled leakage.
The best thing to drink is water, followed closely by milk or dilute juice. If you are giving him raro etc then this must be well diluted. Make up to approx. 1 ½ litres / sachet. Avoid fizzy drinks esp. coca-cola or Pepsi or other drinks that may contain caffeine.
2. Set 6 times per day when he must have a drink. Use a star chart.
If as I suspect he is not a good drinker then start slowly, i.e. 50 - 100 mls each drink slowly increasing the amount in his glass over the next 4 - 6 weeks until he can drink a full glass at each sitting.
If you expect him to drink too much too soon, then he may feel bloated with the increase in fluid, and become resistant to drinking at all.
As you increase his fluid input over the next few weeks things may appear to get worse before they get better. Don't give up at this stage, it is very much to be expected. He may wet more during the day; he may begin to wet his bed at night more frequently.
You are aiming to get your son to drink approx. 1500 - 1800 mls / day.
Use star chats with good cheap rewards for drinking 6 / day for 1 day. When he can do that increase to 2 days and so on until he consistently drinks for at least 2 weeks in a row. Increasing the volume he drinks as he tolerates.
It is important that you take the responsibility for reminding him to drink. This may be necessary for the next 4 - 5 yrs until he is mature enough to take responsibility for himself.
3. When he is drinking better volumes, i.e. 1litre / day then you can start on bladder training.
This is a process of stretching the volume the bladder can comfortably hold at any one time.
Mostly your son should be able to hold on for 2 ½ - 3 hrs when adequately hydrated. Peeing volumes of up to 150 - 200 mls each time.
Bladder training means getting the urge to pass urine, but then being able to ignore it so that the feeling goes away. The urge to pee may occur again anything from 10 mins to 1 hr later depending on how much you have had to drink in the previous hour. If you have good bladder habits this process may occur 3 -4 times before you take yourself of to the toilet.
Before you start the process of bladder training you need to do a dairy of how often he pees, and if possible measure a couple i.e. get him to pee into an old jug to access his volume. This gives you something to look back on and compare how well he is doing in a few weeks time.
4. Check that he is not constipated. If constipation is a problem this also puts pressure on the bladder and can increase the irritation that may be experienced with the urge to pee.
Normal bowel habits are different for everyone, but the general rule is that the motion should be soft and easy to pass. Any thing from 2-3 / day to 2-3 / week.
Ask your son if he has to strain to have a motion, if so look at his diet to ensure he is eating good balanced diet. Increasing his fluid will also help prevent constipation.
5. Any behavioural change like the one I have just outlined for you can be very difficult to maintain for any length of time without support.
For ongoing support with managing this problem, which may take from 3 - 8mths
Please contact your local continence advisor. This number can be assessed through the NZCA web page or via 0800 650 659.