printable pdf Gaining full control over one’s bladder and bowel movements takes time; it is a long process of learning and development. It is not only a learning process, for which children need to learn to correctly recognise when they need to go to the toilet and act appropriately, but their bodies must also develop.
Even if a child is mostly able to go to the toilet when needed, accidents are very common and are generally nothing to worry about. It is important to remember that most of the time accidents (even if they occur regularly) do not occur deliberately, and are generally not a sign of the child 'acting out' to annoy you. Quite often there are physical reasons for repeated accidents, so if the child has repeated accidents far beyond the age of where they should be able to control their bladder/bowels, it is often necessary to seek medical advice.
Because children often start to attend a nursery school around the age of four, it can cause problems if they have not yet acquired proper bladder and bowel control by this time. Understanding and supportive nursery workers can play a key role in determining if this becomes a problem. If a child has not managed to get control of their bladder and/or bowels by the age of five, starting school can be a particular test for the child, as well as for carers and teachers.
Also, by the age of four or five, children generally are starting to become aware of the social stigma attached to wetting or soiling themselves. They become very conscious of the response of other children and the possible repulsion of adults who have to deal with the hygiene issues. This can lead to anxiety in the child as well as their carers, which can make the problem worse.
Therefore it is important to realise that, while an occasional accident is completely normal and nothing to worry about, if wetting and/or soiling occurs persistently it is important to examine the reasons behind these accidents.
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Children generally learn to stay dry between the ages of two and five, although many children take a bit longer. Under the age of two most children wet themselves. It is also generally the case that children take longer to become dry at night, when they can already stay dry during the day.
Bed-wetting is therefore quite common, affecting about 15% of 5 year-olds, 7% of 8 year olds, 5% of 10 year olds and 2% of 15 year olds. Normally bed-wetting is nothing to worry about. The main things for you to do are to ensure that the child is clean and comfortable, and not embarrassed about it.
Bed-wetting can be caused by many things. For example, it tends to run in families; about 70% of children who wet the bed after the age of five have a family history of bed-wetting as well. Children who wet the bed are also often very deep sleepers, and are therefore unaware of their full bladder or their wet bed when they are sleeping.
Foods that contain caffeine, such as chocolate, or drinks such as tea and cola can exacerbate bed-wetting, especially if the child has these foods or drinks before going to bed. Sometimes bed-wetting is caused by urinary tract infections or constipation, so it is important to make sure that there is no physical problem or illness that is causing the bed-wetting.
If a child has been fully dry by day and by night for six months and then starts bed-wetting repeatedly for no physical reason, this may be a sign of emotional distress. However, this is not always the case.
It is important to realise that most children wet the bed for no serious reason, even if they are mostly dry. However, if the child wets the bed frequently after the age of 5 or 6, it is important to examine the reasons behind this. For further information, see section on bed-wetting.
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Children generally learn to control their bowels by the age of four, but some children take longer than this.
Problems with bowel control can be due to a number of reasons, such as general development delay, physical disability, physical conditions (such as constipation) as well as emotional issues.
If a child has an accident in their pants this is called 'soiling'. For children over the age of 4 such accidents should be rare. However, if the child still occasionally passes large amounts into their pants, or passes small amounts on a regular basis, it is important to examine the reasons behind this. For further information, see section on soiling.