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Bedwetting is accidental urination during sleep. Children learn bladder control at different ages. Children younger than 4 often wet their beds or clothes because they can't yet control their bladders. But by age 5 or 6, most children can stay dry through the night.
In some cases, the child has been wetting the bed all along. But bedwetting can also start after a child has been dry at night for a long time.
Children don't wet the bed on purpose. Most likely, a child wets the bed for one or more reasons, such as having a small or overactive bladder, constipation, having too little of a certain hormone, or having emotional or social problems. An infection may also cause bedwetting.
There are often no other symptoms besides wetting the bed. If a child cries or has pain when urinating or has strong urges to urinate, bedwetting may be a symptom of another medical condition. Call the doctor if your child has any of these symptoms.
Any child older than age 5 or 6 who keeps wetting the bed may need to be checked by a doctor. A medical history and physical exam are used to diagnose bedwetting. A urinalysis may also be done.
Treatment usually isn't needed for bedwetting in children ages 7 and younger. Most children this age will learn to control their bladder without treatment. But treatment may help children older than 7 who wet the bed. Treatments include a praise and reward system, a moisture alarm, and medicine.
Help your child understand that bladder control will get easier as your child gets older.
Here are some other tips that may help your child:
Children don't wet the bed on purpose. Most likely, a child wets the bed for one or more reasons, such as:
Children whose nervous system is still forming may not be able to know when their bladder is full.
Some children may have a bladder that gets full quickly.
Pressure on the bladder from constipation can make it hard for the bladder to hold urine.
Many children who wet the bed sleep so deeply that they don't wake up to use the toilet.
This hormone level normally rises at night to tell the kidneys to release less water.
Children are more likely to wet the bed if a parent wet the bed as a child.
Children may be more likely to wet the bed if they have some stress.
Children who wet the bed after having had dry nights for 6 or more months may have a medical problem, like a bladder infection.
There are often no other symptoms besides wetting the bed.
A child may have other symptoms too, such as crying or complaining of pain when urinating, sudden strong urges to urinate, or increased thirst. In that case, bedwetting may be a symptom of some other medical condition. Call the doctor if your child has any of these symptoms.
Children may wet the bed several times during the night, and they may not wake up after wetting.
Children grow and develop at different rates, and bladder control is achieved at an individual pace. Bedwetting that continues past the age that most children have nighttime bladder control will usually stop over time without treatment.
Call your doctor or nurse advice line now or seek immediate medical care if:
Watch closely for changes in your child's health, and be sure to contact your doctor or nurse advice line if:
Any child older than age 5 or 6 who keeps wetting the bed may need to be checked by a doctor. The checkup should include a urinalysis.
A medical history and a physical exam are also part of a medical evaluation of bedwetting. If you are having your child assessed for bedwetting, keep a diary for a week or two before your visit. Write down when wettings occur and how much urine is released.
In some cases, a urine culture may be done to find out if your child has a bladder or kidney infection.
If a child has uncontrollable wetting both at night and in the day, other tests may be needed.
Most children gain bladder control over time without any treatment. Bedwetting that continues past the age that most children have nighttime bladder control—typically at 5 or 6 years of age—also will usually stop over time without treatment. If not, home treatment may be all that's needed to help a child stop wetting the bed.
If home treatment doesn't work, if the child and parents need help, or if the bedwetting may be caused by a medical problem, medical treatment may be helpful. With treatment, your child may wet the bed less often or may wake up to use the toilet more often.
Treatment for bedwetting is based on the:
Some treatments work better than others for children of a specific age group.
If gaining bladder control is seen as a normal process, it's usually easier for the child to stop wetting the bed.
If the child shares a bedroom with other children, certain techniques to arouse the child, such as some moisture alarms, may not be practical.
Treatment may help if bedwetting seems to be affecting your child's self-esteem or affecting how your child is doing with schoolwork or getting along with peers.
Treatment for bedwetting usually isn't a cure. The goal is to reduce the number of times the child wets the bed and to manage the wetting until it goes away on its own. Treatment may include:
With this method, parents encourage and reinforce a child's sense of control over bedwetting.
These alarms detect wetness in the child's underpants during sleep. They sound an alarm to wake the child.
These medicines increase the amount of urine that the bladder can hold or decrease the amount of urine released by the kidneys.
You may hear of other ways to help children who wet the bed. But not all of these treatments have good evidence that they help. Talk to your doctor before you spend time and money on these other treatments. Ask about the risks and benefits. Examples include:
It's not a good idea to have your child wear diapers or pull-ups at night on a regular basis. Using diapers can get in the way of proven treatments (such as motivational therapy and moisture alarms) that require a child to get up at night.
Counselling (psychotherapy) may be helpful for the child who has secondary enuresis or for bedwetting that is caused by emotional stress. Psychotherapy involves talking with a trained counsellor. The counsellor helps the child identify and deal with the stress that may be causing the bedwettings. The goal is to reduce or help manage the stress or to prevent stress from occurring.
Some children who finish a treatment and have dry nights for a while will start to wet the bed again. Repeating treatment, especially with a moisture alarm, usually helps bring back dry nights.
Treatment may be helpful if bedwetting seems to be affecting your child's self-esteem or affecting how your child is doing with schoolwork or getting along with peers.
The best solution may be a combination of treatments. Below are some suggestions for treatment options according to the age of your child.
Help your child understand that wetting the bed is a normal part of growing up. Encouragement and praise may be all that is needed to help your child wake up before wetting. Praise and reward your child for the steps he or she takes to have dry nights. And have your child take an active role in cleaning up after wetting.
If your child still wets the bed, a moisture alarm may help. Also, a medicine such as desmopressin can be helpful for occasional overnight events such as camp or sleepovers.
There can be major emotional effects if a child still wets the bed at this age, so treatment can be more aggressive. If consistent use of moisture alarms doesn't work, the doctor may suggest medicine, counselling, or both.
Most children gain bladder control over time without any treatment. A child should first be allowed to overcome bedwetting on his or her own. But there are things you can do to help manage your child's bedwetting.
As a rule of thumb, children should be encouraged to consume 40% of their total daily liquids in the morning, 40% in the afternoon, and 20% in the evening. Talk with the doctor about how much fluid your child needs.
Foods such as chocolate and beverages such as colas and tea may contain caffeine.
It may help to keep a night-light near or potty chair beside the bed.
Involve your child in planning the reward system. You may want to use a calendar and put stars or stickers on the days that your child does not wet the bed. You know your child. If you think a reward system will help your child, then try it. If you think it may make your child feel worse, then do not use a reward system.
For example, use washable sleeping bags as bedding so your child can easily replace one that is wet with one that is dry.
If your child wets the bed, don't blame yourself or the other parent. Don't punish, blame, or embarrass your child. Your child is neither consciously nor unconsciously choosing to wet the bed. Give your child understanding, encouragement, love, and positive support.
Medicines that either increase the amount of urine that the bladder can hold (bladder capacity) or decrease the amount of urine released by the kidneys may be used to treat bedwetting. These prescription medicines may be used to control bedwetting for a little while. They don't completely stop it.
Current as of: March 1, 2023
Author: Healthwise StaffClinical Review Board: Susan C. Kim MD - PediatricsJohn Pope MD - PediatricsKathleen Romito MD - Family MedicineMartin J. Gabica MD - Family Medicine
Current as of: March 1, 2023
Author: Healthwise Staff
Medical Review:Susan C. Kim MD - Pediatrics & John Pope MD - Pediatrics & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine
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