Wetting the Bed

Bedwetting, also known as nocturnal enuresis, is a common childhood problem. Some estimate that there are approximately 5 million children who wet the bed in the United States alone!

Once children become aware of their bladder filling, they learn to consciously control and coordinate their bladder. This generally occurs by 4 years of age. Nighttime bladder control usually takes longer and is not expected to happen until between 5 and 7 years of age.

However, approximately 20% of 5-year-olds, 10% of 7-year-olds, and 5% of 10-year-olds may still wet the bed. Bedwetting is not a serious medical condition but it can be frustrating and challenging for parents — and embarrassing, especially for older children.

Causes of bedwetting

• Your child is a deep sleeper and does not awaken to the signal of a full bladder.
• Your child has not yet learned how to hold and empty urine well. (Communication between the brain and bladder may take time to develop.)
• Your child’s body makes too much urine at night.
• Your child is constipated. Full bowels can put pressure on the bladder and lead to problems with holding and emptying urine well.
• Your child has a minor illness, is overly tired, or is responding to changes or stresses going on at home.
• There is a family history of bedwetting. Most children who wet the bed have at least one parent who had the same problem as a child.
• Your child’s bladder is small or not developed enough to hold urine for a full night.

Physical or emotional problems rarely cause bedwetting. Most children with bedwetting do not have an underlying medical problem. Some medical problems that may contribute to bedwetting include diabetes, urinary tract infections, fecal soiling (encopresis), constipation, kidney disease, seizures, and sleep problems.

Signs of a medical problem

If your child has been completely toilet trained for 6 months or longer and suddenly begins wetting the bed, talk with your child’s doctor. It may be a sign of a medical problem. However, most medical problems that cause bedwetting to recur suddenly have other signs, including:

• Changes in how much and how often your child urinates during the day
• Pain, burning, or straining while urinating
• A very small or narrow stream of urine or dribbling that is constant or happens just after urination
• Cloudy or pink urine or bloodstains on underpants
• Daytime and nighttime wetting
• Sudden change in personality or mood
• Poor bowel control
• Urinating after stress (coughing, running, or lifting)
• Certain gait disturbances (problems with walking that may mean an underlying neurologic problem)

What you can do

1. Do not blame your child

Remember that it is not your child’s fault and make sure they know that. Let them know that most children outgrow bedwetting. Offer support, not punishment, for wet nights.

2. Be sensitive to your child’s feelings

If you don’t make a big issue out of bedwetting, chances are your child won’t either. Also remind your child that other children wet the bed. Set a no-teasing rule in your family. Do not let family members, especially siblings, tease your child. Let them know that it’s not your child’s fault.

3. Protect the bed

A plastic cover under the sheets protects the mattress from getting wet and smelling like urine.

4. Take steps before bedtime

Have your child use the toilet and avoid drinking large amounts of fluid just before bedtime.

5. Be aware

Take note of your child’s daily urine and bowel habits.

6. Other tools

There are also other treatments available such as a medication called DDAVP and bedwetting alarms. You can discuss these alternatives with your child’s pediatrician.

Most importantly, do not blame your child and stay positive. In most cases, bedwetting decreases as the child’s body matures. Nearly all children outgrow bedwetting by their teens.