When your child is running a high fever or displaying an unknown rash, you probably don't hesitate to ask your pediatrician for advice. But what if your child starts wetting the bed at night when she has been dry for some time? Or should you be concerned if your child has been potty trained for a year, but can't seem to make it through the night without having an accident? Do these situations warrant a call to the doctor?
Many parents may wonder when bedwetting warrants a discussion with their pediatrician. That time may be different for every family depending on their circumstances, but Dr. Michael Ritchey, a pediatric urologist in Houston, Texas, says he usually does not treat bedwetting (enuresis) until a child is 7 years old, so until then parents may want to try different strategies.
"Before consulting their doctor about enuresis, many parents try restricting fluids before bedtime or awakening the child several hours after they are asleep," says Dr. Ritchey. "We usually do not start treating children until the age of 7 since there is a high rate of spontaneous resolution at that age. However, if a child perceives bedwetting as a problem and asks their parents for help, then it should be brought up with their pediatrician."
Joan Dyer*, a mother of three, says her oldest son had been dry throughout the night for several months. "So when he had a few accidents, I wasn't too concerned," she says. "Now, four months and several soggy sheets later, the accidents have become a nightly event. "We have tried cutting back on drinks in the evenings and waking him up to use the bathroom, but the problem is not getting any better," she says. "We've decided to talk to his pediatrician about it at his 5-year exam."
Some children experience secondary enuresis, which means they start to lose control of their bladder at night after they have consistently been dry. According to the National Kidney Foundation, secondary enuresis can be caused by the same things that affect children who have always experienced bedwetting, such as producing too much urine at night or a family history of enuresis.
"If your child is experiencing ‘simple' bedwetting, it is considered a relatively benign condition, and most children will outgrow it," says Dr. Barry Kogan, a spokesperson for the National Kidney Foundation's Pediatric Nephrology/Urology Committee. There are signs, though, that could suggest your child is experiencing more than normal bedwetting and may need medical attention. According to Dr. Kogan, these include:
- Daytime wetting in addition to bedwetting;
- Severe constipation;
- Bowel accidents;
- Urinary tract infections.
According to the American Academy of Pediatrics, only 1 percent of bedwetting cases are related to medical problems, but ruling these problems out may help you and your child feel better about the situation.
In addition, if your child's bedwetting is becoming a problem for your child (or you), a trip to the pediatrician may help put everyone's mind at ease.
If you decide a doctor's visit is in order, providing the following information to the pediatrician may assist with the evaluation:
- Family history of bedwetting;
- Frequency of bedwetting;
- Any pattern of bedwetting, such as occurring only after drinking caffeine or when tired;
- Daytime wetting in addition to nighttime accidents;
- Anything unusual about the way your child urinates (such as straining or pain) or the way the urine appears (cloudy or pink);
- Bedwetting that develops after six months or more of consistent dryness;
- Medication your child is taking.
For a complete "Voiding History" questionnaire to help you prepare for the doctor's appointment, visit the National Kidney Foundation's Bedwetting Web page.
Kay Davidson*, a mother of one, decided to speak with her son's doctor about his bedwetting at his 5-year exam. "Our pediatrician wanted to wait and see if our son would outgrow the problem before starting any treatments," she says. And her doctor was right, as they eventually discovered that a prescription allergy medication was the culprit. In addition to wetting the bed, her son had also begun to fall behind in school, and when he stopped taking the medicine, his schoolwork began to improve and his sheets started staying dry. Now that he is 7, he is completely dry at night," says Davidson.
If you feel that medication may be contributing to your child's nighttime accidents or if your child is experiencing behavior problems in addition to bedwetting, be sure to discuss these situations with your pediatrician.
If a trip to the doctor rules out all medical problems and your doctor recommends the wait-and-see approach, what can you do to help your child until that dry day?
Dr. Ritchey suggests letting your child wear an absorbent undergarment, such as GoodNites® Underpants, when sleeping. "Wearing [such a product] … will not delay the time it will take for your child to outgrow bedwetting," he says.
Patience and empathy may be the best medicine during this difficult stage. "Parents can take the emphasis off of bedwetting, and place it on all the other good things the child does," says Dr. Kogan. "It is important that both the child and family realize that there are lots of good and successful things the child is accomplishing."
