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Enuresis (Paediatric)


“Bedwetting is a widespread and distressing condition that can have a deep impact on a child or young person's behavior, emotional wellbeing and social life. It is also very stressful for the parents or carers. The prevalence of bedwetting decreases with age. Bedwetting less than 2 nights a week has a prevalence of 21% at about 4 and a half years and 8% at 9 and a half years. More frequent bedwetting is less common and has a prevalence of 8% at 4 and a half years and 1.5% at 9 and a half years.” (NICE 2010)

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Coventry Guidance  
Coventry Paediatric Enuresis Clinic Referral Criteria

GPs should refer children to the School Nursing Team for initial Tier 1 advice having excluded and treated UTI or constipation.

The Paediatric Continence Service accepts referrals from the School Nursing Team for Children aged 5 to 18 registered with a Coventry GP practice with:

  • Daytime wetting associated with an overactive bladder
  • Nocturnal enuresis

Referrals will ONLY be accepted from registered nurses working in the SCHOOL NURSING TEAM after the child and parent have been offered formal tier one advice and follow up using a School Nursing Team referral form (copy attached)

About TIER 1 advice

NICE guidance and The Paediatric continence forum recommended that TIER 1 ADVICE should include:

  • Advice and support to help promote ‘healthy’ bladders and bowels, to reduce the risk of problems such as constipation and urinary tract infections, developing or once developed being missed with referral to GP for treatment
  • Demystification of bedwetting and daytime wetting Explaining that it is not deliberate, nor is it the child’s fault and that the child should not be told off or punished and an explanation of the reasons why it may be happening
  • Encourage day time water-based drinks (see fluid advice).
  • Avoid caffeinated, fizzy and energy drinks and provide Information about how much fluid children should be drinking
  • Avoid high salt and high protein foods late in the day (these increase urine production)
  • Encourage regular daytime toileting (about two hourly)
  • Avoid all food and drink in the last hour before sleep
  • To try and pass urine before settling for sleep each night.
  • Restrict screen use up to one hour use before bed
  • Consider a trial of at least two consecutive nights without products (e.g. pyjama pants, nappies) and provide information about bedding protection.
  • Advise parents not to lift/wake the child when they go to bed (The only times when lifting may be acceptable is in the short term when it is particularly important that the bed stays dry e.g. when on holiday)
  • Consider access to the toilet at night. If this is difficult try to find ways to make it easier e.g. torch by the bed or potty in the room
  • Consider whether the child is able to get out of bed, or has anxieties or fears that may result in difficulties getting up e.g. fear of the dark
  • Advise parents/carers to only use rewards for things that are in the child’s control. Remember that a child cannot control what happens when they are asleep. Therefore, encouragement and positive comments should be made for dry nights, but rewards (if used) should focus on things that are in the child’s control, such as drinking recommended levels and toileting during the day, for toileting before sleep, helping to strip their own bed etc. Do not give rewards for dry nights, but do notice and praise any efforts made by the child
  • Monitor progress by keeping a diary of wet and dry nights, of waking after wetting, of waking to use the toilet
Moat House School Nurses
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Hollyfast Little Heath St Elizabeths Stanton Bridge
Joseph Cash Parkgate St John Fisher St Laurences
Keresley Grange Pearl Hyde St Patricks Three Spires
Moseley Ravensdale Whittle Academy
Radford Richard Lee
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Barrs Hill Caludon Castle Cardinal Wiseman Eden
Coundon Court Grace Stoke Park Foxford
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Whoberley Hall Southfields St Andrews Sowe Valley
Woodfield Prm Stoke Heath St John Vianney Stretton C of E
Stoke Prm St Johns C of E Willenhall
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Rugby & South Warwickshire Guidance  
About the Compass service

A school nursing service for the delivery of the Healthy Child Programme 5-19, led by school nurses for the promotion, prevention and protection of children and young people’s health and wellbeing.

Our service is available to all Warwickshire school aged children and young people from 5-19 years old (up to 25 years old for people with special educational needs).

The service follows Warwickshire Safeguarding Children’s Board policies and procedures and forms part of multi-agency services for children, young people and families where there are child protection or safeguarding concerns.

Our caring and friendly school health and wellbeing team are available at a time that suits you and at a place where you feel comfortable.

How the service can help

We provide health and advice on a range of health topics, which we can share with you:

  • Individually, face to face or by phone
  • In group workshops
  • Via our confidential parent / carer text messaging service

Contact us if you need support as a child / young person with:

  • Healthy eating
  • Dental health
  • Friendships
  • Bullying
  • Anxieties about changing schools

Contact us if you need support as a parent / carer with:

  • Parenting
  • Behaviour
  • Fussy eating
  • Sleep
  • Continence
  • Referral onto additional services

Support for young people on topics such as:

    • Emotional wellbeing including stress and anxiety
    • Relationships
How to access the service

If you feel that you, or someone you know, would benefit from our support or would like some more information about the service, you can get in touch anytime via:

  • Our confidential downloadable referral form
  • ChatHealth confidential text messaging for young people aged 11-19 years on 07507 331 525
  • Parentline confidential text messaging for parents / carers on 07520 619 376
  • Your local school nursing team
We checked this service was likely to be safe, effective, caring, responsive and well-led during registration.
Community Paediatric Service

For children with enuresis issues who have had all the help they can from the School Nurses as well as Doctors, but still have bed wetting issues can be referred to the Community Paediatric service delivered by South Warwickshire Foundation Trust. 

About Community Paediatrics

We see children and families with a range of long term conditions for assessment, investigation, management and support.

In particular, we provide medical care to children and young people with complex health conditions, developmental problems, disabilities, life limiting conditions and social vulnerability.

We carry out statutory assessments for children to support Education and Health Care Plans, for those looked after by the Local Authority, and for those with suspected abuse or neglect.

We also provide advice and support to families requiring palliative care and following the death of a child.

We accept referrals from GPs, health visitors, school nurses, allied health professionals and other hospital and community doctors. We will see children and young people up to their sixteenth birthday and we will continue to see young people with complex needs up to their nineteenth birthday.

Children must be registered with a Warwickshire GP or in a Special School.

Location / how to find us:

The paediatricians in South Warwickshire are based at Warwick Hospital and Crown Way Clinic in Leamington.

Clinics are held at Warwick Hospital, Round Oak School, Welcombe Hills School, Ridgeway School, Crown Way Clinic and Stratford Health Centre.

The paediatricians in North Warwickshire are based at Riversley Park Children’s Centre in Nuneaton. Clinics are held in Bedworth Health Centre, Riversley Park Centre, Atherstone, Exhall Grange School, Oakwood School and Woodlands School.

The paediatricians in Rugby are based at the Orchard Centre. Clinics are held in the Orchard Centre and Brooke School.



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