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"Back to school is a physically and emotionally stressful time for many children, compounded by the sudden change in sleep patterns and schedules that generally wreak havoc on eating and other routines established over the summer," Dr Ming-Hsien Wang, a paediatric urologist at Johns Hopkins Children's Center in Baltimore, said.
Children who experience bed-wetting flare-ups when they go back to school should maintain a regular urination schedule through the day, Wang advised.
In such cases, she writes a note to teachers explaining the child's condition and recommending bathroom breaks about every two hours.
Since the brain controls the bladder, establishing a regular bathroom routine during the day helps improve brain-bladder communication in general, Wang explained.
Physical and emotional stressors are well-known contributors to bed-wetting and daytime incontinence in children. The vast majority of bed-wetting cases are caused by lifestyle issues, such as lack of regular bathroom breaks, inadequate hydration and poor diet.
"Changes in lifestyle take care of 80% of these problems," Wang said. Among other things, she recommends providing emotional support, letting the child know the condition is fixable, providing plenty of water to ease urination, stopping fluids about three hours before bedtime, and having children empty their bladder before going to bed.
However, she added, biological and anatomical causes must be ruled out before focusing on lifestyle changes. (September 2010)
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