Bed-wetting-loss of urine during sleep-can be a major problem for children. It is almost never done on purpose, and it is not due to laziness on the child’s part. The medical term for bed-wetting is enuresis (en-your-ee-sis).
Toilet training usually occurs around the age of four, and this is often followed by a brief period of wetting during the day or at night. If bed-wetting still occurs at age 6 or 7, you should speak to your family doctor or pediatrician.
If bed-wetting occurs with daytime wetting and/or bowel problems, it may be a sign of a more serious problem, so it is important to speak to your doctor or pediatrician. In some cases bed-wetting may be related to a urinary infection, so every child should initially have his or her urine tested by a doctor.
WHAT CAUSES BED-WETTING?
When older children continue to wet the bed, it may be due to one or more of the following reasons:
- Not waking up when the bladder is full
- Producing more urine during sleep than others
- Having a bladder that holds less urine than other children’s do.
Most bed-wetting is not a mental or learning problem, and punishing your child is never a solution. Punishment for wetting could cause emotional problems.
WHEN WILL MY CHILD STOP BED-WETTING?
It is hard to say when bed-wetting will stop, because every child is different. One out of five 5-year-olds wet their beds. By age 10, one in 20 have this problem. By age 15, only one to two out of 100 bed-wetting children still have the problem. Although very rare, bed-wetting may continue into adulthood.
ARE THERE TREATMENTS FOR BED-WETTING?
Yes. Your doctor is the best source of information. Doctors who care for children have experience with bed-wetting. Treatments that may help include the following:
- Limiting fluid before bedtime – By itself, this rarely works, but limitation of fluids, especially fluids containing caffeine, may help.
- Waking the child at set times during the night-This may help keep the bed dry, but rarely helps a child stop bed-wetting.
- Special exercises to stretch or condition the bladder-These are not usually successful. This should never be attempted if your child wets during the day, or has to rush to the bathroom.
- Moisture alarms – These devices, which are attached to the pajamas, can often help the child learn when wetting is about to happen. Sometimes the loud alarm will not wake the child, but if someone helps wake the child, this may be successful. Though it sometimes takes weeks or months, these alarms have good long-term success.
- Medications – Several types of medications have been used to treat bed-wetting, but some may have side effects. Your doctor may recommend a combination of treatments. Not all children respond to medications.
- Desmopressin-This is a hormone that causes people to make less urine during sleep.
- Imipramine-This medication has been used for many years, but it may affect the mood or behavior of some children and overdose may be dangerous. Parents should carefully supervise its use, it is safe.
- Anticholinergics-These medications relax the bladder and allow it to hold more urine. These are also used for daytime wetting.
- Hypnotherapy – Limited studies have shown that this helps some children, but further scientific study is needed.
- Herbal, acupuncture and chiropractic therapies – There is no evidence that these treatments are effective.
HOW SHOULD I TALK TO MY CHILD ABOUT BED-WETTING?
Talking openly with your child and any siblings about bed-wetting can help limit emotional problems sometimes associated with bed-wetting. You should reassure your child that bed-wetting is not his or her fault, and that it will go away in time. You may want to simply explain how the parts of the body work together to make urine:
- the kidneys must make the right amount of urine
- the bladder (like a water balloon) must hold it and tell the brain when it is full
- the brain must either keep the bladder closed until morning, or tell the child to wake and use the bathroom.
OTHER FACTS:
- If both parents were bed-wetters as children, there is a 70 percent chance that their child will wet the bed. If one parent was a bed-wetter, there is a 40 percent chance.
- Attention Deficit Disorder (ADD) is another common problem among children, though it is unlikely to have any relation to bed-wetting. A child with ADD, however, may be slower to respond to treatment.
- Children with developmental delays can become dry at night, but it may take longer, depending on the severity of the developmental delay.
- Most children who wet their beds do not have a kidney problem, although your doctor may want to check your child for a kidney problem.
- Sometimes added stress (a new school, a new baby in the family or a family crisis) may cause a child to begin bed-wetting. This is called secondary enuresis. Parents should respond with emotional support and reassurance, and talk with the child’s doctor if it continues.
- Absorbent products that protect the bed will often reduce the frustration of both parents and the child. Some experts think these may prolong bed-wetting, but this has never been shown in research.
WHAT IF I HAVE MORE QUESTIONS?
Your doctor is the best source of information about bed-wetting. You can also contact your local National Kidney Foundation affiliate at 800-622-9010
Updated: 06/07/04
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