I HAVE a five-year-old son who just started going to school last September.
Everything seemed to be going fine until around the end of last month when he started to wet himself continuously at home.
As far as I know, he doesn't wet himself much at school, so far. He is going to the toilet, but only doing a small amount each time.
He seems to have lost bladder control. I have to change him several times during the day and he doesn't wet himself at night then.
I don't know what the best way to approach this is, as my doctor has checked my son's urine sample and said that everything was fine and that it is probably a psychological issue.
I don't think that my son likes using the toilet at school. He is quite a timid child and probably wouldn't ask the teacher to go.
Would you have any suggestions?
ENURESIS in the proper name for wetting yourself. There are two kinds of enuresis, primary enuresis and secondary enuresis.
Primary enuresis describes when a child has always wet themselves. So, as they go through the toilet-training process, they never really achieve bladder control and so will wet themselves on and off during the day.
Resolving a primary enuresis (assuming there are no complicating medical factors) requires a retraining of the child. So, we need to reinforce all of their successful uses of the toilet to wee and try to ignore or minimise any accidents.
Secondary enuresis occurs when a child has successfully toilet-trained and then reverts to a period of wetting, some months or years later. Typically, secondary enuresis (assuming there are no complicating medical factors) occurs because of some emotional upset that disrupts the child's equilibrium.
Most often it is stress or anxiety that gets displayed in the wetting accidents. This is rarely a conscious action by the child. More often they are trying to stay dry, but end up wetting themselves anyway.
From what you have described, I think your son may have secondary enuresis. You noted that the wetting accidents only started since he went to school and you have also ruled out any medical problems.
So, the key task is to try to work out what it is about school, or about his routine since starting school, that may be stressing him. If you can identify and resolve the source of any stress, then the wetting accidents are very likely to stop.
One possible source of stress that you have already identified is that he may be worried about having to use the toilet in school. If he is holding on to his urine during the day, then this is likely to disrupt his urination habits in the evening too.
However, since the issue with the toilet might also be a source of stress for him, do explore with him what it is about the school toilet that he doesn't like.
It may be any one of several things. He might be afraid to ask permission to use the toilet. He may not like a perceived lack of privacy, or may not feel comfortable locking the door. He may not like the toilet bowl, or the urinals, or the smell in the bathroom.
Since he is only five, you might be best off suggesting as many of these possible reasons (or any more you can think of) for him, to see if he picks any of them out as an issue for him. If any problem does emerge, hopefully it will be easily resolvable.
Do go in to talk to his teacher. Ask him/her about the toilet routines and the physical environment, in case that helps to identify a possible problem and the solution for your son.
But, also talk to him/her about the other aspects of the class that he may be finding a big transition.
So explore with her about how he is settling into the academic aspect of school. Check also about how he is finding the social aspect of school.
It is quite likely that one of these two areas could be pressurising for him?
Remember too that it is a big deal to start in school and it may be just taking him time to get used to it. His routine at home may have changed a lot too since starting 'big' school. I'm not sure if you have changed your work/home routine since he is spending longer hours in school?
It may even be that he is just more tired, given all that is going on now.
Whatever it may be that is stressing him, it is well worth discovering what it is. I do think that if you can sort out any emotional stress that he might be feeling at this time, that his secondary enuresis will resolve itself.