Wet Pants? Give Kids a Break

Until Third Grade, Children Need Easy Access to Bathroom

From the WebMD Archives

Aug. 12, 2003 -- At school, some young children don't get the bathroom breaks they need -- and end up wetting their pants. It's a lesson for teachers: Letting young kids take a break when nature calls could prevent bladder disorders, a new study shows.

"Daytime wetting causes children and their parents distress, and often indicates an underlying condition with the potential to affect adversely renal and bladder development," writes researcher Christopher S. Cooper, with the department of urology at the University of Iowa.

His report appears in this month's issue of The Journal of Urology.

In fact, upwards of 15% of children wet their pants at school, Cooper writes. About 40% of young patients seen in pediatric urologists' offices suffer from dysfunctional voiding, he adds.

Based on surveys completed by 467 Iowa elementary school teachers, Cooper found that:

  • The majority of teachers -- 80% -- offered set times for the children to go to the bathroom during the day
  • 61% asked all children to go to the bathroom at this time, while 39% asked only those who volunteered.
  • 69% of kindergarten teachers allowed the child to go to the bathroom at anytime, compared with 40% of first-grade teachers, 35% of second-grade teachers, 25% of third-grade teachers, and 25% of fourth-grade teachers.
  • A third of children requesting a break were told to wait.

Other findings:

  • 86% of the teachers considered voiding every hour to be abnormal.
  • 41% believed that boys went to the bathroom for reasons other than to relieve themselves; 38% thought the same of girls.

When children are given limited access to the bathroom -- or discouraged from responding to the natural urge -- they may grow up with urinary problems, writes Cooper. This can happen when very young children have not completely developed the muscles that control urination.

As children gain better bladder and bowel control, it's reasonable for teachers to set limitations on bathroom use, he adds. However this should not apply to kindergarten and first grade. This is the critical period when children gain mastery over bladder control. In fact, the incidence of accidental pants wetting didn't decrease until after second grade, he writes.

Restricted bathroom access should begin in third grade, when fewer cases of wet pants occur, Cooper says. Also, bathroom conditions in school should be better maintained, since they tend to get worse as the day wears on, he writes.

SOURCE: The Journal of Urology, September 2003.