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Bedwetting Causes & Treatments

Learn More About Why Children Wet the Bed

Howard J. Bennett, MD

Explore and understand the contributing factors that can lead to your child wetting the bed.

Parents who have a child experiencing bedwetting can feel confused, frustrated, and even isolated – it’s not a topic a lot of people talk about. Know that you’re not alone – many families manage bedwetting in their homes every day. Every day, 5 million American children wake up not knowing if their bed will be wet or dry. Although bedwetting is more common among younger children, it is a problem for all ages: 30% of 3-year-olds, 40% of 4-year-olds, 20% of 5-year-olds, 12% of 6-year-olds, 5% of 10-year-olds and 3% of 12-year-olds wet the bed. More importantly, since bedwetting is one of those hidden disorders of childhood, most children (and some parents) think they are the only ones with the problem.

Bedwetting is not a serious medical disorder, but it can be very difficult to live with. Wetting the bed may interfere with a child’s socialization and can lead to significant stress within the family. Because parents are often uninformed about bedwetting, children may be shamed or punished for being wet at night. Nighttime wetting is most often a developmental issue that is not their fault. It’s also something most children outgrow in time.

Factors That Contribute To Bedwetting

Bedwetting usually results from a maturational delay in the way the brain and bladder communicate with each other at night. There are three main factors that contribute to the problem.

  • Children who wet the bed usually have a smaller bladder capacity than their peers. This causes them to urinate more frequently during the day and their bladder has less room to “hold” urine at night.
  • The brain produces a hormone at night that reduces the amount of urine the kidneys make. Some children who wet the bed produce less of this hormone and thereby make more urine while they sleep.
  • Some children have trouble arousing at night. As a result, the brain may not respond when the bladder signals that the child needs to urinate.

Bowel Habits

Most parents pay little attention to the frequency or consistency of their children’s bowel movements once they are toilet trained. As a result, constipation is an underrecognized cause of bedwetting. If a child has a lot of stool in his rectum, it can push against the bladder. This can reduce how much urine the bladder can hold and may limit how well the bladder empties when a child urinates. It can also “confuse” the nerve signals that go from the bladder to the brain. This can cause unexpected bladder contractions that lead to daytime urgency and bedwetting.

Family History

Wetting the bed runs in families. Most children who wet the bed have at least one parent or another close relative who had the same problem growing up.

Psychological Factors

Although children may start wetting the bed after an episode of emotional stress, psychological problems are not a factor in kids who have wet the bed since early childhood. Examples of stressful situations that can trigger bedwetting include moving to a new home, changing schools or the death of a loved one. The wetting usually resolves when the stress passes.

Medical Disorders

Less than 3% of children with bedwetting have a medical problem that underlies their wetting. Bedwetting has been reported with sleep apnea, sickle cell disease, urinary tract infections, diabetes and neurologic problems. In most cases, these problems cause bedwetting in children who have been previously dry at night.

Natural History

After the age of six, 15% of children who wet the bed become dry each year without treatment. This fact is important when parents (and children) decide how to deal with the problem. In other words, the advantages and disadvantages of each treatment should be weighed against the natural tendency of bedwetting to resolve on its own.

Conclusion

Bedwetting is a common and embarrassing problem that can greatly affect children and families. It is neither the fault of the child nor the parent and is not usually caused by a serious medical disorder.

Dr. Bennett is the author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting and Max Archer, Kid Detective: The Case of the Wet Bed.

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