Bedwetting Causes, Information, and AdviceKristen Hass, CPNP and Ben Spitalnick, MD
Last Updated: 02/10/21
Read Time: 4 minutes
Is your older child or teenager still wetting the bed? If so, should you be concerned? Read on for insight on what causes bedwetting, when should you see your child’s doctor and a few potential bedwetting solutions.
Bedwetting, also known as nocturnal enuresis, is when a child age 5 or older isn’t able to control their bladder and urinates (pees) at night while sleeping. Bedwetting isn’t just stressful, frustrating and overwhelming for you: Your child can experience these emotions too.
More than 5 million children in the U.S. experience bedwetting, and it’s slightly more common in boys. 20% of kids still wet the bed at age 5, 10% at age 7, and 5% at age 10. Nighttime bedwetting can even last through puberty, and up to 1-3% of older teenagers wet the bed.
How does a child control their urination when they sleep?
Kidneys make urine and pass it down tubes into the bladder. A muscle gate (sphincter muscle) holds the urine in the bladder. When the bladder is full, it sends a message to the brain, and the brain tells the gate to open.
With babies and toddlers, their brain and bladder have not fully figured out how to work together, so the bladder will just release urine whenever it feels full.
As a child becomes older, their brain and bladder communicate better, and the child can urinate when ready.
Why do kids wet the bed?
There are a variety of bedwetting causes including:
- Being a deep sleeper. Your child may not feel the need to pee or find it difficult to wake up.
- Producing too much urine during the night.
- Having a small or “irritable” bladder. Your child’s bladder may contract too easily, or the nerves that control the bladder may be slow to mature.
- Genetics. Sometimes bedwetting runs in families. If you, your parents or your siblings had issues with bedwetting, it’s not surprising that your child is also wetting the bed.
If one parent wet the bed after 5 years old, their children have about 40% chance of bedwetting. If both parents wet the bed as children, their children have about a 70% chance of bedwetting.
- A medical condition. A urinary tract infection (UTI), constipation, bladder or kidney disease, a structural problem in the urinary system or nervous system, diabetes, obstructive sleep apnea, hormone imbalance, attention-deficit/hyperactivity disorder (ADHD), stress or anxiety could be causing bedwetting.
Will bedwetting go away?
Most children outgrow bedwetting on their own. Some need a little help, and some situations of bedwetting may need medical attention. See how you can tell if your child’s bedwetting has stopped for good.
What can you do to help your child?
First, reassure your child that bedwetting is a normal part of growing up. It’s not going to last forever, and isn’t not their fault.
You may attempt to:
- Watch fluids. Have your child drink more fluid earlier in the day and less in the evening/night.
- Practice bladder training. Train your child to hold their pee longer during the day so they are less likely to wet at night.
- Set a routine. Have your child attempt to pee 15 minutes before bed or at the beginning of their bedtime routine and again right before they go to bed.
- Wake your child before you go to bed or during the night. If the bed is wet when you wake them, wake them earlier. If they wet the bed after you wake them, wake them later. You may need to adjust to find the right time.
- Eliminate bladder irritants. Caffeine — found in chocolate milk, soda and cocoa — makes kids need to pee more often. You may also need to eliminate citrus juices, artificial flavorings, dyes (especially red) and sweeteners.
- Reward and praise your child. When they wake up dry, offer complimentary words or items such as stickers or a new book.
- Be sensitive to any teasing going on, especially with siblings. Let them know it’s not the child’s fault and even older kids sometimes wet the bed.
- Don't yell or punish. Instead, have your child help with clean up as much as they are able. Explain that this isn’t punishment and it’s not their fault.
- Use Goodnites® NightTime Underwear. The use of absorbent pants doesn’t prevent or delay toileting, and it can help reduce stress for you and your child.
When should you make an appointment with your child’s doctor?
Make an appointment with your primary care provider or pediatrician if your child:
- Is 5 years old or older and suddenly starts to wet the bed 2-3 times a week after they have not wet the bed for at least 6 months.
- Has daytime peeing accidents.
- Is 7 years old or older and is still wetting the bed.
- Snores and/or has pauses or gasps in breathing in their sleep.
- Complains of a burning sensation or pain when peeing, has to pee more often, is drinking or thirstier more often, and/or has pink or red urine or discharge.
- Has swelling of their feet or ankles.
- Complains of belly aches or back pains.
- Is having poop accidents.
Your doctor will discuss your child’s medical history and your family history, examine your child and likely perform lab work such as a urine analysis. If no medical issue (such as diabetes, sleep apnea or constipation) is found, they may recommend a “bedwetting alarm” system or medications. If these recommendations don’t succeed, then they may refer you to a urologist, who will do further testing.
Just remember that, for the most part, bedwetting is not something to be concerned about and your child most likely will outgrow it. There are many options, online and in stores, that claim to help with bedwetting. As a parent, you want the best for your child, but check with your child’s pediatrician before investing in these potentially ineffective programs.
Ultimately, your child’s pediatrician is your first place to go for help. Learn more about alternative methods for nighttime bedwetting.