This is certainly a challenging situation. With respect to treatment, it is best that you follow the guidelines and recommendation of your Pediatrician. He or she will have a much better idea how best to manage the situation medically. You could certainly discuss with your Pediatrician the possibility of pairing natural remedies with Ditrapan or Tofrinal to help reduce the behavioural side effects. A change in diet can also be helpful. The one thing we do need to think about however is the potential impact this is having on her self-esteem. You need to make sure she doesn’t just see herself as just someone who wets. Help her to identify all those things in her life she is good at by praising all her successes (even small ones!). The more support and encouragement she receives the better she will feel about herself. With respect to managing her daytime wetting, you could certainly try putting her in DryNites. Encourage her to change these each time she wets, this will ensure there is no odour build-up and less chance of discovery. You could ensure her friends do not see them by wearing tight shorts over the top (the ones that are made for dancers or gymnasts provide a nice snug fit). Explain to her the importance of drinking regularly throughout the day and how this will help build bladder capacity. Given the many competing demands of school, I understand how difficult it must be for her to remember to go to the toilet as well. Support from her teacher is paramount to success at this age; perhaps you could ask her teacher to remind her to go to the toilet at regular intervals throughout the day as this may go some way toward reducing her daytime wetting.

Regards,
Dr Cathrine

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