Bedwetting can be frustrating for both parents and children. Being “dry” at night is hailed as a major milestone, so children who continue to wet the bed can suffer teasing and embarrassment. As a parent, you may feel guilty and wonder what other parents are doing that you aren’t.
Bedwetting in children is more common than you might think.
“We see several children for bedwetting (nocturnal enuresis) in our practice,” says
Linda Lopez, MD, FAAP, an Austin pediatrician. About 16 percent of 5 year olds have nighttime wetting, 10 percent of 7 year olds and 5 percent of 10 year olds. More boys have a problem with bedwetting than girls. Bedwetting decreases as a child gets older.
Why Does It Happen?
There are many reasons a child might have a bedwetting problem:
- Children who drink most of their liquids in the late afternoon and evening are more likely to wet the bed.
- Constipation can cause pressure on the bladder. Some signs of constipation in children are stomach pain and soiling.
- Children of a parent who had a bedwetting problem are 50 percent more likely to wet the bed. If both parents wet the bed, the child is 75 percent more likely.
- Physical causes, such as a small bladder or a bladder that hasn’t developed control, can make a child wet the bed.
- Medical conditions, such as urinary tract infection, pinworms, sleep apnea, diabetes and kidney disease, can cause bedwetting.
Should You Take Action?
Unless it is caused by a medical condition, bedwetting usually resolves without any special action by parents. And it may not be a problem, if it doesn’t bother your child. But if bedwetting causes embarrassment or keeps your child from socializing with friends, he needs help.
“It’s important to discuss bedwetting with your child’s pediatrician when it starts to interfere with social activities, such as an overnight stay at a friend’s house or camp,” says Dr. Lopez. “Parents often bring up this problem during a routine well-child checkup.
Evaluation can begin in the office. We start with a history from the parents and urine analysis.”
“Your pediatrician may identify an underlying medical condition and refer the child to a urologist if needed,” Dr. Lopez adds.
Contact your pediatrician if:
- Bedwetting is new (your child has been previously “dry”)
- There are new or unresolved daytime symptoms
- Your child snores
- Urination becomes painful
- Bedwetting is associated with a sudden increase in thirst, hunger or headaches
How Can You Help?
Remember that bedwetting is not your child’s fault. Never punish or belittle him for it.
Consult your pediatrician. Once medical conditions are ruled out, you can consider taking steps to help your child stay dry at night. For the steps to work, your child must be motivated and mature enough. Wait until he is ready.See the sidebar “Dry at Night: The Plan.” Keep a calendar of wet and dry nights, noting to help you figure out what works and what doesn’t.
If these suggestions don’t work, you may consider a bedwetting alarm or alarm clock. Medications are also available. Be sure to talk to your pediatrician to find out what is best for your child.
Dry at Night: The Plan
- Go Regularly. Have your child try to urinate regularly (4 – 7 times) during the day and just before bedtime. If he wakes up at night, he should go to the toilet. Sometimes parents have to help with this.
- Drink Liquids Earlier. Aim for taking in 40 percent of total daily liquids before noon, 40 percent in the afternoon (noon to 5 p.m.) and only 20 percent after 5 p.m. Getting enough liquids earlier in the day helps him avoid guzzling liquids at dinner and before bed. Don’t ban drinking liquids at night; it could be dangerous to his health.
- Reward Effort. Give rewards for behaviors such as going to the toilet before bedtime or drinking water at breakfast. Keep a record of his progress and give a reward for longer periods of being dry at night.
- No Sugary or Caffeinated Drinks. Don’t let your child have drinks high in sugar or caffeine (such as colas), especially at night.
- No Diapers or Pull-up. Don’t use diapers or pull-ups unless your child is sleeping away from home. This can interfere with his motivation for staying dry. Instead, use bed protection and washable linens.
- Don’t Punish. Don’t use penalties for wetting the bed, and don’t take away rewards.
Brenda Schoolfield is a freelance medical writer in Austin.