Going back to school can be exciting - and stressful, especially for kids ages 5 to 7 who are at risk of having wetting accidents.

About 15 percent of children in the early grades have daytime accidents. But a University of Iowa pediatric urologist suggests ways to prevent accidents and help kids learn bladder control.

“First, parents and teachers should recognize that not all children in kindergarten, first grade or even second grade have complete control of their bladders,” said Christopher Cooper, M.D., associate professor of urology in the UI Roy J. and Lucille A. Carver College of Medicine.

“Children can have unstable bladder contractions that hit them suddenly, where they need to go to the bathroom immediately or they will have an accident,” added Cooper, who treats children at Children’s Hospital of Iowa at UI Hospitals and Clinics.

To prevent accidents and decrease stress on the bladder, Cooper recommends that children go to the bathroom relatively frequently or what may seem to be relatively frequently but is really within a normal range. He offers these tips:

- During the school day, teachers in kindergarten, first and second grade should encourage each child go to the bathroom every two to three hours. Free access to the bathroom should also be granted for children that need to go at other times.
- Parents can encourage their child to remember to go at least twice, if not three times, a day - at morning, lunch and afternoon.
- It’s especially important for parents and teachers to encourage children to go to the bathroom about an hour after lunch. For reasons that are not clear, many wetting accidents occur from 2 to 5 p.m.

Parents and teachers can provide additional support to minimize the stress or embarrassment of a wetting accident:

- Ask if your school keeps spare clothing on hand. If your child routinely has problems, provide the teacher or nurse with a set of your child’s own clothes to keep in a discreet location.
- Reassure the child that his or her bladder has “played a trick on them,” and if they start going to the bathroom more often, they will get more control.
- Never punish a child for a wetting accident. No child wants to be wet.

Wetting accidents often occur because young children have not yet learned to pick up the early warning signs telling them to go to the bathroom. Cooper noted that it can be a “big revelation” to many children to learn they can actually control their bladders and that many teachers are “pros” at dealing with children’s wetting accidents and helping children get changed and avoiding embarrassment.

“Kids at this age are often blissfully unaware of their surroundings so they may not even notice that someone right next to them has had an accident,” Cooper added.

Some parents seek medications to control young children’s wetting accidents. A preliminary review of clinic practices at the UI suggests that teaching children to void on a regular basis can be as effective as using medication.

“Medications can temporarily offer help but are no replacement for developing bladder control. If good toileting habits are not set up, the medication effects wear off, and the wetting problem returns even if the child still takes the medication,” Cooper said.

Defecating control problems in children age 5 and older are rare but do happen. If a child is routinely having both bowl and bladder accidents, he or she should be evaluated by an appropriate medical professional, Cooper said.

As with all medical care, it is best to consult your personal physician before making any changes to your or a family member’s health care routine.

University of Iowa (Health Sciences)