It is not unusual for chldren who have been diagnosed with a small bladder capacity to experience nocturnal enuresis. This form of incontinence often rectifies itself once the bladder grows. There are two schools of thought when it comes to increasing children’s bladder capacity. One approach draws on bladder training. The aim of bladder training is to slowly increase the amount of urine the bladder can hold up to the range expected for her age. This involves encouraging your daughter to hold her urine for increasingly longer intervals during the day. For example, she might start by visiting the toilet every 30 minutes, and increase this time by 15 minutes every few weeks, progressing up to urinating every two or three hours during the day. A way of measuring whether or not she is able to hold increasing amount of urine is to record once a week the amount of urine passed at a particular time during the day and night. You need to be careful that this approach does not lead to daytime accidents. The second approach involves fluid management where we stretch out the fluids your daughter drinks over a 24-hour period. The ultimate goal here is to prevent her bladder over-filling at night when she is asleep. Encourage your daughter to drink approximately every 2 hours, tapering off in the evening. She should avoid drinks high in caffeine as this stimulates the kidneys to produce larger amounts of urine placing additional pressure on her bladder. You could combine either of these approaches with a conditioning alarm, which is designed to wake your daughter and help her to identify when her bladder is full and needs emptying. Any form of treatment or management should be under the guidance of a medical professional so I urge you to discuss these approaches with you doctor.

Regards,
Dr Cathrine

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