Bedwetting Information and Advice
Author: Kristen Hass, CPNP and Ben Spitalnick, MD
Last Updated: 10/20/2020
Reading time: 4.5 minutes
Word count: 1,122
What to consider if your child still is wetting their bed
Is your older child or teenager still wetting the bed? Should you be worried/concerned? When should you go see your child’s pediatrician/primary care provider or a specialist called a urologist? Here’s what you should know and what to consider:
Bedwetting, also known as nocturnal enuresis, is when a child, who is beyond age 5 years or older, is not able to control their bladder and urinates (pees) at night during their sleep.
Bedwetting is not only stressful, frustrating, and overwhelming for you, the parent, but also for your child. You and your child are not alone. Bedwetting is common for more than 5 million children in the U.S.
It is slightly more common in boys than girls. And children develop at different speeds; by age 5, 20% still wet the bed, 10% wet the bed by age 7, and by age 10, 5% wet the bed.
Bedwetting can even last through puberty, as 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. The bladder holds the urine. There is a muscle gate (sphincter muscle) that 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 and the bladder will just open the gate and release urine whenever it feels full.
As a child becomes older, their brain and bladder communicate better, and the child therefore can control their bladder and urinate when they are ready.
What is causing bedwetting?
- Your child may be a deep sleeper/difficult to wake up and does not feel the need to pee.
- Your child may have kidneys that produce too much urine during the night.
- Your child’s bladder is small or is too “irritable” and contracts too easily or the nerves that control the bladder may be slow to mature.
- Sometimes bedwetting runs in families and therefore, genetics plays a role. Did you, your parents, or your siblings have issues with bedwetting? If so, it’s not surprising that your child is also wetting the bed. If one parent wet the bed after 5 years old, then their children have about 40% chance of bedwetting and if both parents wet the bed as children, then their children have about a 70% chance of bedwetting.
- There are some medical conditions that could be causing bedwetting. For example: 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 and anxiety.
Will bedwetting go away?
Most children outgrow bedwetting on their own, some children who wet the bed need a little help, and some situations of bedwetting may be a sign that there is an issue that needs medical attention. See how you can tell if your child’s bedwetting has stopped for good.
What can you do to help your child through this life development stage?
First, reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever and that it is not their fault. And know that punishment is never the answer, your child is not doing this on purpose.
You may attempt to:
- Have your child to drink fluids 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.
- 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 in the middle of the night to try to pee. 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: Eliminate caffeine (such as chocolate milk, soda, and cocoa). caffeine 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 with items such as stickers or a new book.
- Be sensitive to any teasing going on, especially with siblings.Let them know it is not the child’s fault, and even older kids sometimes wet the bed.
- If your child wakes with wet sheets, don't yell or punish them. Instead, have your child help with clean up as much as they are able and explain that this isn’t punishment and it is not their fault.
- Use absorbent pants and other diaper-like products when needed: The use of absorbent pants does not prevent or delay toileting and continence control. These products can help reduce stress for you and your child.
When should you be a little worried and make an appointment with your child’s primary provider/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
- 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, drinking/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 stool/poop accidents
They will discuss your child’s medical history, your family history, examine your child, and most likely perform lab work such as a urine analysis. If no medical issue (such as diabetes, sleep apnea, constipation, etc.) is found, in some cases they may recommend a “bedwetting alarm” system, or medications. And if these recommendations do not succeed, then they may refer you to a urologist, who will do further research/testing for your child’s situation.
Just remember that, for the most part, bedwetting is not something to be concerned about and your child most likely will outgrow this issue. There are many options, online and in stores, that claim to help with bedwetting. And 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.