Bedwetting can be frustrating for children and parents. The key is to know when it’s not a problem and a natural part of being a child, and when to talk to your doctor. In this article we’ll look at what’s normal and the possible causes of bedwetting, and at the treatments available for persistent bedwetting.
When should my child stop wetting the bed?
Bedwetting is a little more common in boys than girls and it’s estimated that:
- 1 in 6 five year olds wet the bed 2 or more times a week
- 1 in 10 seven year olds wet the bed 2 or more times a week
- 1 in 14 ten year olds wet the bed 2 or more times a week
- 1 in one hundred 18 year olds wet the bed 2 or more times a week
Bedwetting in the under fives is often thought not to be a problem unless the child is very upset by it. Equally, occasional accidents in older children shouldn’t be cause for concern.
What should I do when my child wets the bed?
Experts agree that:
- Reassuring your little one that it’s not his fault
- Making sure he knows that it will get better
- And that he’s not alone with this problem
is the best way to deal with bedwetting. Becoming angry will probably make the problem worse.
When he’s wet the bed, be calm and loving as you strip and re-make the bed and help him to change his pyjamas. Settle him back to bed and let him fall asleep again.
When he’s old enough to help you change the bed then get him involved as children respond well to being given responsibility – even if it’s quicker for you to do the task alone.
What causes bedwetting?
Primary bedwetting (doctors call this primary nocturnal enuresis) is when the child has always wet the bed or his nappy. Secondary bedwetting (secondary nocturnal enuresis) happens when the child has been dry for a long spell (at least 6 months) and the problem suddenly recurs.
- Stress can often cause bedwetting to start again after your little one has been dry for a long time. Changing schools or starting school, moving home, bullying or unhappiness at home are some of the reasons.
- The child may be making more urine that the bladder can deal with.
- The bladder may be ‘irritable’ and only holds small amounts of urine – you may notice that your child wants to go to the bathroom frequently during the day too.
- Your child may sleep very deeply and not wake when the bladder indicates that it’s full.
- Occasionally bedwetting can be part of a health problem.
If you’re concerned then talk to your doctor, but the health problems that can cause bedwetting are:
- Constipation – the bowel doesn’t empty properly and presses on the bladder.
- Type 1 diabetes which can cause a lot of urine to be produced. He may be tired/lethargic and very thirsty too so talk to your doctor sooner rather than later if you recognise these symptoms.
- Urinary infections cause frequent visits to the bathroom and stinging when he pees. He may also feel unwell, have a fever and the urine will probably smell unusual/bad. Urinary infections are more common in girls than boys.
- Children with ADHD (Attention Deficit Hyperactivity Disorder) are more at risk of bedwetting.
- Very often there is no clear reason why bedwetting starts – so don’t worry too much if you can’t find a cause.
What can I do to prevent or treat bedwetting?
Self-help measures for bedwetting are easiest to start with.
- Avoid too many drinks in the evening before bedtime (2-3 hours before) and avoid tea, coffee, cola etc which have caffeine in them. Caffeine can increase the amount of urine the kidneys produce.
- Make sure he goes to the bathroom just before bed.
- Nappies/diapers designed for older children may give them a little confidence when they sleep and be a good temporary measure if the bedwetting is caused by stress or infection.
- Get him to discuss any fears he may have or upsets that he’s going through – it may be something as simple as being afraid of the dark or not wanting to go to the bathroom at night because there’s a spider in there! A night light and bathroom inspection should help.
- If you think he may be constipated then talk to your doctor about treatment. Ensure he’s drinking plenty during the day and having plenty of fruit and vegetables in his diet to prevent constipation.
- Avoid lifting him or waking him to take him to the bathroom during the night. This can prolong the problem and doesn’t help him achieve his own bladder control.
- Ask him to help you change the sheets and his pyjamas when bedwetting occurs.
- Use a reward system to help him stay motivated to overcome the problem. A simple chart to which he can add stars or coloured stickers to the days where he achieves the goal will help him see his improvement. Because most children don’t have control over their bedwetting, the goal should be ‘going to the bathroom before bed’, ‘getting up to tell mum and dad that the bed is wet’ and/or helping to change the sheets etc’. Adding the goal of a completely dry night can be added as you see an improvement. Make it into a game and make sticking the sticker to the chart something special with lots of praise.
If these approaches don’t work:
Bedwetting alarms wake the child as soon as he starts to wet so that he can get up and go to the bathroom. Over time the child becomes conditioned to waking before he wets.
They work by placing sensors in the pyjamas or underwear and they’re linked to an alarm – a bell or a vibration. Alternatively a pad in the bed can be used and is linked to an alarm.
They’re effective in up to 80% of children, especially those aged 7 and over, but take 3-5 months’ use to get complete and consistent dry nights.
- He may be frightened when the alarm first goes off so you might want to sleep in the same room for the first couple of nights.
- If your little one sweats a lot at night they can give false alarms.
- Watch for the batteries running low
- Make sure he doesn’t switch the alarm off and go back to sleep!
In severe cases your doctor may prescribe a drug called desmopressin which reduces the amount of urine that is made.
Parenting is about persistence, consistency and patience with love! All this applies to dealing with bedwetting as it does to anything else.