BED-WETTING

It may be an inconvenience for parents, but bedwetting is a common problem in children. Some children struggle to stay dry throughout the night from the day they are born and others are able to stay dry for several months, or years, and begin wetting the bed again.

Who Wets the Bed?

Approximately 15 percent of children wet the bed at age 5. That number decreases with age occurring in only 1-2 percent of children age 14 and older. Boys are twice as likely as girls to wet the bed. It happens more frequently in children with developmental delays and emotional and behavioral difficulties.

Why do kids wet the bed?

Children wet the bed for numerous reasons – here are a few of the most common:

  • Time. Some children need extra time to develop control of their bladder.
  • Genetics. Children who wet the bed tend to have a parent, aunt, uncle, or grandparent who wet the bed until a late age, suggesting a genetic component.
  • Sleep. Children whose sleep is disturbed by snoring, television or pets, and children who are deep sleepers are more likely to wet the bed.
  • Stress or life changes. Going through big changes like moving or a new sibling, or other stressors, can lead to children wetting the bed after being dry for a long period.
  • Medical. Medical reasons such as having a urinary tract infection (UTI), constipation, or differences in the way the body is built or functions – like a small bladder or making too much urine – could be the cause. In addition, Type 1 Diabetes can also first show up as bedwetting along with increased thirst and urination.

What should i do about it ?

  • Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day.
  • Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
  • Be encouraging. Make your child feel good about progress by consistently rewarding successes.
  • Eliminate bladder irritants. At night, start by eliminating caffeine (such as chocolate milk and cocoa). And if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate a child’s bladder.
  • Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
  • Consider if constipation is a factor. Because the rectum is right behind the bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one-third of children who wet the bed, though children are unlikely to identify or share information about constipation.
  • Don’t wake children up to urinate. Randomly waking up a child at night and asking them to urinate on demand isn’t the answer, either. It will only lead to more sleeplessness and frustration.
  • An earlier bedtime. Often children are deep sleepers because they’re simply not getting enough sleep.
  • Cut back on screen time, especially before bedtime. Improving sleep hygiene can help their minds slow down so they can sleep better.
  • Don’t resort to punishment. Getting angry at your child doesn’t help them learn. The process doesn’t need to involve conflict.

Medications: not usually recommended

Although there are medications (including a synthetic form of a hormone) that can address bed-wetting, Dr. Rhee doesn’t prescribe them unless a child was already put on the medication by another provider.

“There are side effects,” she says. “Plus it’s a temporary fix, a Band-Aid remedy, when what we want is an overall solution.”

When bed-wetting signals more serious issues

Occasionally, bed-wetting is a sign of something more significant, including:

  • Sleep apnea – If a child snores a lot or otherwise shows signs of sleep apnea, Dr. Rhee will investigate further. Otherwise, this isn’t a first course of evaluation of a child with bed-wetting issues.
  • Urinary tract infections (UTIs) – A urine sample can detect these infections, which is a typical test doctors will order when bed-wetting is an issue.
  • Diabetes – A urine sample can also detect diabetes in children.

Will bedwetting stay with my child into adulthood? 

Bedwetting almost always goes away on its own. Most children will grow out of it by the late teenage years or sooner. Secondary enuresis may go away when the cause is found. It is either treated, or it gets better on its own. If bedwetting has not stopped in the late teenage years, your child should be seen by a doctor.