Dr Catherine
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8-15 years

After taking her out of night time nappies she wet the bed fairly frequently - probably 4 nights out of 7 and then over the next few years this reduced to maybe 3 or 4 nights a month with weeks of no wetting at all and some periods of wetting a couple of nights in a row. She has never been great at drinking lots of water during the day but I encourage her to do so. I have noticed that on a couple of occasions recently she was 'busting' to go to the toilet all of a sudden during the day - could this be a sign of a UTI? She hasn't been going to the toilet more frequently than normal or complained of burning or stinging when urinating though.

Secondary bedwetting is much more common among children who take longer to achieve nighttime continence in the first instance. As I am sure you are aware, secondary bedwetting has two major underlying causes: physical and psychological. Physical or medical causes typically include urinary tract infections, constipation, juvenile diabetes or even tapeworms. So your first response is to have these ruled out. It is not uncommon to see a spike in bedwetting during the colder months or during school holidays – firstly, because children tend to sleep more soundly in winter and secondly, holidays often means greater activity, excitement and overtiredness. The majority of secondary bedwetting results from emotional problems. The three most common psychological stressors for children include the birth of a sibling, hospitalisation and starting school, although other situations such as peer relationship difficulties, bullying, or parental divorce or separation can also cause anxiety in children. Stress can also result from positive experiences, which can be the case when children are excitedly anticipating an upcoming event. If stress is the cause, once the stressful situation has been resolved, children’s bedwetting usually stops. In the meantime reassure your daughter that none of this is her fault, promoting self-confidence and positive self-esteem is particularly important at this time. With respect to school camp, if your daughter were prone to returning to bedwetting at times of change then I would look into using medication to help her while on camp. Speak with you GP about this and give it a trial before she attends camp, as the medication does not work for all children. All the best! Regards, Dr Cathrine