Bedwetting, also known as nocturnal enuresis, is a common condition in children. Most children learn to use the toilet between 2 and 4 years of age. Even after children are toilet-trained, they may wet the bed until they are older. It's common for 6-year-olds to wet the bed once in a while. Some children still wet the bed at age 12.
Understanding Bedwetting:
- Normal Development: Bedwetting is common among children, especially during their early years. Most children outgrow it as they get older but it can be normal until 12 years of age.
- Potential Causes: Various factors can contribute to bedwetting, including genetics, delayed bladder development, altered sleep patterns, hormonal imbalances, and psychological stress.
- Types of Bedwetting: Bedwetting can be classified as primary (when a child has never been consistently dry at night) or secondary (when a child starts wetting the bed after being consistently dry for at least six months).
REASONS FOR BEDWETTING:
We don't always know what causes bedwetting. Here are some possible reasons:
- There is a family history of bedwetting. (Most children who wet the bed have at least one parent who did it as a child.)
- Your child is a deep sleeper and doesn't wake up when he or she has to pee.
- Your child's bladder* is still too small to hold urine all night.
- Your child has trouble passing stool (poop) and gets constipated. This can put pressure on the bladder.
- Your child has a minor illness, is very tired, or is going through changes or stress at home.
Tips for Parents:
- Stay Supportive: Reassure your child that bedwetting is not their fault and that many children experience it.
- Limit Fluids Before Bed: Encourage your child to drink fluids earlier in the day and limit their intake before bedtime.
- Establish a Routine: Encourage regular bathroom breaks before bedtime and ensure your child uses the bathroom right before going to sleep.
- Protect the Bed and Wash Sheets: Use waterproof mattress covers or disposable absorbent underwear to protect the bed. Removing these do not encourage a child to stay dry - they do not make the choice to wet during sleep. Let your child help change wet sheets and covers. But don't force your child to do this. If you do, your child will think he or she is being punished.
- Avoid Punishment: Avoid punishing or shaming your child for bedwetting, as this can lead to increased stress and anxiety.
- Ensure sufficient sleep: Being overly tired can contribute to bedwetting, so make sure kids get the recommended 9-11 hours of sleep needed for age. Do not wake them to go to the bathroom because this disrupted sleep may increase tiredness. (If they wake to use the toilet on their own, that is okay, but waking them during sound sleep is not recommended.)
- Consider Bedwetting Alarms: Bedwetting alarms are devices that can help train children to wake up when they need to urinate. The alarm goes off when it gets wet so the child learns to wake up to use the toilet. It can take weeks or months to work. Bedwetting alarms tend to work best for children who have some dry nights. They can be effective for some children if the child is motivated to stay dry. They should only be used if the child wants to try them.
- Set a no-teasing rule in your family. Let others know that it's not the child's fault. Don't make bedwetting a big issue so your child won't either.
- Manage constipation: A large stool mass can put pressure on the bladder. Manage constipation with the tips on our Constipation Page .
- Medications: There are some medicines for treating bedwetting in older children. They do not cure bedwetting but they can help your child stay dry. Some kids use these medicines nightly and others only when they go to a sleepover or camp.
- DDAVP works by reducing the amount of urine produced by the kidneys, thereby decreasing the likelihood of bedwetting episodes. It is available in various forms, including tablets, nasal sprays, and dissolvable tablets.
- DDAVP is typically taken at bedtime.
- While using DDAVP, it's essential to monitor your child's fluid intake. Encourage your child to drink fluids earlier in the day and limit their intake before bedtime to reduce the risk of overhydration and potential side effects.
- Attend follow-up appointments every 6-12 months to monitor their response to DDAVP and make any necessary adjustments to the treatment plan.
- We recommend trials off DDAVP every month to see if it is still needed. Kids eventually outgrow bedwetting.
- DDAVP is generally well-tolerated, but some children may experience side effects such as headache, nausea, or abdominal pain. Contact us if your child experiences any adverse reactions.
- If DDAVP does not effectively reduce bedwetting or if your child experiences significant side effects, contact us for further instructions.
- Store DDAVP according to the instructions provided by the manufacturer and keep it out of reach of children.
When to Seek Medical Advice:
- If bedwetting persists beyond the age of 6 or 7 but it does not bother your child and there are no other concerning symptoms, ask about it at your annual well visit.
- If your child experiences fever, pain or other symptoms while urinating, schedule a sick visit.
- If your child starts wetting the bed after being consistently dry for at least six months (secondary enuresis), schedule a sick visit.
- If there are other concerning symptoms accompanying bedwetting, such as excessive thirst or frequent urination during the day seek immediate medical attention.
- If your child has daytime behavior changes, increased anxiety, or is worried about bedwetting, schedule a sick visit.
Conclusion:
Bedwetting is a common condition in children and usually resolves over time. However, it's essential for parents to provide support and understanding to their children who experience bedwetting. By implementing practical strategies and seeking medical advice when necessary, parents can help manage bedwetting effectively.
