Bed-wetting

Wetting the bed (also known as nocturnal enuresis) is a common problem among young children. It affects up to 20 per cent of 5-year-olds and 5 per cent of 10-year-olds.

Learning to recognise, while sleeping, that you have a full bladder and need to wake up and go to the toilet is a part of normal development. The age at which this happens varies from child to child, but most children will become dry at night on their own.

Causes of bed-wetting

Many children who wet the bed produce more urine than their bladders can hold overnight. This can be because they don’t produce adequate amounts of antidiuretic hormone to reduce their production of urine while sleeping.

Your child may also be at higher risk of bed-wetting if:

  • they sleep very deeply and are not awakened by the message from their bladder telling them that it is full;
  • they have a small or overactive bladder that is less able to store urine; and/or
  • there is a family history of bed-wetting.

Rarely, a medical condition, such as infection, diabetes or a problem with the bladder, may be causing bed-wetting.

When to see your doctor

See your doctor if your child:

  • is older than 6 -7 years of age;
  • starts wetting the bed again after a period when they were dry at night;
  • has problems with bladder control during the day after the age of 3 to 4 years;
  • has other symptoms such as painful urination or unusual thirst; or
  • is bothered by their bed-wetting and wants to become dry.

Effects of bed-wetting on children

Bed-wetting can cause feelings of anxiety and embarrassment and lead to low self-esteem. Older children may worry about wetting the bed during sleep overs or at school camps. Bed-wetting can also cause sleep disruption and tiredness.

It’s important for parents and carers to stay patient. Bed-wetting is not a behavioural problem, and your child is not wetting the bed on purpose. Don’t be critical or punish your child for wetting the bed as this can make the problem worse. Siblings need to know that it’s not okay to make fun of the situation.

Bed-wetting treatments

Most children become dry at night on their own without needing any treatment. However, if you (or your child) are frustrated by bed-wetting, several treatment options are available.

Bed-wetting alarms

Bed-wetting alarms are designed to wake your child when urine is first passed. The idea is that the child wakes, stops urinating and then goes to the toilet. These alarms are an effective long-term treatment for bed-wetting, but it can take at least 2 weeks to see a response, and up to 12 weeks before children are completely dry at night.

Medicines

Medicines are generally only used in children who don’t respond to a bed-wetting alarm. Sometimes treatment can involve medicines and a bed-wetting alarm together.

One option is a medicine called desmopressin (brand name Minirin), which can be given as tablets, a wafer or a nasal spray. It works by reducing the volume of urine produced at night. It tends to work well in the short term, such as for school camps, but must be used with caution.

Oxybutynin (e.g. Ditropan) is a medicine that can be used to reduce bladder contractions and increase bladder capacity in children with small, overactive bladders.

Self-help

Drinking plenty of fluids throughout the day is important. It may be tempting to try restricting fluids in the evening, but in fact this will not help and may even delay the process of staying dry at night. Drinks containing caffeine (e.g. tea, coffee, hot chocolate, cola) should be avoided at night.

Encourage your child to urinate regularly during the day. Remind your child that it’s okay to go to the toilet at night time and use a night light so that your child can easily find the way.

Positive encouragement

It’s important to praise your child’s efforts and progress, and try not to be negative on bad days. Praise and encouragement should be given for behaviours such as going to the toilet before bedtime, using the alarm correctly, taking medicines or helping to change wet sheets.

Last Reviewed: 8 April 2013
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References

1. Gibb S, Harari M. Constipation and continence. In: Thomson K, Tey D, Marks M, editors. Royal Children’s Hospital Melbourne Paediatric Handbook, 8th Edition. Wiley-Blackwell; 2009. p. 157-159.
2. Royal Children’s Hospital Melbourne. Bedwetting (updated Oct 2010). http://www.rch.org.au/kidsinfo/fact_sheets/Bedwetting/# (accessed Feb 2013).
3. MayoClinic.com. Bed-wetting (updated 12 Oct 2011). http://www.mayoclinic.com/health/bed-wetting/DS00611 (accessed Feb 2013).
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