Bed-wetting and urinary infection in children

Being alert to urinary symptoms can ensure that if there is a problem, your child will get the treatment he needs. Most urinary problems are easily fixed if identified early.

Bedwetting

Even after your pre-schooler learns to use the toilet and stays dry all day (usually between ages two and four), she may still wet the bed at night now and then. This is normal until the ages of six or seven. After this age, bedwetting is still normal, but it can be upsetting to your child and keep her from enjoying social activities such as sleepovers.

You don't want to punish or criticise your child for wetting the bed. It is not intentional and not under his control.

When is it an infection?

The following signs can indicate an infection:

• If your child suddenly needs to urinate more frequently (every five minutes, say) but produces only a small amount of urine each time.

• If the change to frequent urination is accompanied by pain, fever or foul smell.

• If your child experiences abdominal pain or unexplained fever

Consult your paediatrician, who will check for infection with a urinalysis.

Girls get more infections

This is because the opening of the urethra, the tube leading from the bladder to the outside, is short and close to the anus. Bacteria can easily enter the bladder. There are some precautions you can take to minimise the risk of a urinary infection:

• Wipe your daughter from front to back, and teach her to do it this way.

• Keep personal wipes or nappy wipes on hand in the loo for use after bowel movements.

• Avoid bubble bath, which can enter and irritate the bladder and prepare the way for an infection.

• Make sure that girls drink water or other liquids frequently. Girls should have to urinate every two to four hours during the day, and their urine should be very pale (almost clear) if they are drinking enough fluid.

When to worry

Alert your paediatrician if your child who seldom or never wets at night begins to do it often. This could be a sign of urinary infection, or it could signal diabetes, kidney disease or constipation. Similarly, when a child who has been dry during the day begins to have daytime wetting, there is almost always a physical reason. Any change requires some detective work and maybe a check-up.

How it flows

Watch your child's urine stream, especially if you have a boy. A nice, strong flow that arcs well away from the body is normal in boys. A weak, dribbling stream, or the constant release of small amounts of urine that leave underwear or nappies perpetually damp, can signal an abnormality of the urinary tract. If a child has to strain to urinate or has a hard time starting, let your healthcare provider know; there may be a problem with the urinary tract.

Colour and odour

If your child's urine is pink or cola-coloured or is very dark or smells unusual, bring it to your healthcare provider's attention straight away. Kidney or liver problems may be the cause, and this needs immediate investigation. Early treatment may avoid kidney damage.

While most urinary problems are easily fixed, it is important to be able to recognise problems so they can quickly be addressed.