Bedwetting

Key points about bedwetting

• bedwetting happens during sleep
• your child can't control their bedwetting - it is not their fault
• be patient
• most children grow out of bedwetting

How common is bedwetting?

Wetting the bed at night (nocturnal enuresis) is very common in young children. It affects approximately:

• 15 in 100 5 year olds
• 5 in 100 10 year olds
• 2 in 100 15 year olds
• 1 in 100 adults

Bedwetting occurs slightly more often in boys than girls.

Experts do not consider bedwetting a problem until children are about 7 years of age. That is a good age to introduce treatment programmes if your child wants to do something about it.

Almost all children grow out of bedwetting. About 1 in 100 adults may still have occasional problems.

Some children wet their pants during the day as well. See Daytime wetting.

What are the different types of bedwetting?

There are 2 types of bedwetting:

• children who have never been dry for more than a few months at a time have primary enuresis
• children who have been completely dry for more than 6 months and then start wetting the bed again have secondary enuresis

What causes bedwetting?

There is no universal cause of bedwetting but we know that:

• bedwetting runs in families
• the waking-up response to having a full bladder is not fully developed - your child does not have conscious control over bedwetting
• your child's bladder cannot hold the amount of wee (urine) that they produce overnight
• your child's bladder may be twitchy or overactive - this may cause wet pants or urgency (rushing off to the toilet) in the daytime
• restricting fluid in the evening and at night does not stop bedwetting
• constipation can lead to bedwetting
• bedwetting is rarely due to urine infection, disease or child abuse

What can I do to help my child's bedwetting?

• be patient and understanding - reassure your child, especially if they are upset
• praise and reward your child for getting up to use the toilet
• respond gently when your child wets the bed - even if you feel angry
• prepare the bed and your child- use a heavy plastic mattress cover and protect the mattress with absorbent pads or towels
• wearing extra-thick underwear and pyjamas may help to stop your child flooding the bed
• give your child plenty of fluid during the day - this helps their bladder to get used to holding bigger amounts of urine
• avoid giving any drinks containing caffeine such as tea, chocolate or fizzy drinks
• do get your child to wee before bedtime
• if you wake your child up to wee after they have been asleep for several hours, it is important to make sure they are fully awake
• shower or bath your child in the morning before they go to school - otherwise the smell of urine might embarrass them and lead to teasing

You could watch a video with your child. 'A wee secret' is a story about Jet Johnson who has a secret. Find out how he bravely gets the help he needs (Continence NZ video).

What are some things I shouldn't do if my child wets the bed?

• don't punish your child for what they can't control
• don't use nappies or plastic pants if your child is over 4 years old and they are embarrassed

When should I get some professional help for my child's bedwetting?

• if your child is wetting during the day
• if your child has been dry at night for over a year and suddenly starts to wet the bed again
• if your child is still wetting the bed after the age of 6 or 7 years, and it is upsetting them
• if the bedwetting is causing problems in the family

If bedwetting is a problem, you can contact your school nurse or family doctor. Your family doctor will examine your child for any underlying cause of bedwetting and may refer you to an appropriate service.

Will my child have to have any special tests for their bedwetting?

In most cases, your child won't need any special tests for bedwetting.

Staff at the laboratory may test your child's blood and wee to rule out a medical condition if:

• there is daytime wetting
• scans or x-rays are not usually needed

Your child shouldn't need any scans or x-rays.

How do you treat bedwetting?

There are several ways to treat bedwetting and your child can help to decide what is best for them at this time.

Understandably, some children do get upset if there is teasing, bullying or punishment because of bedwetting.

If you have tried one of the treatments before (when your child was younger) and it did not work, it might be worthwhile trying it again.

Under 7s

Children under 7 years old may not see the need to do anything

Alarms

An alarm that awakens your sleeping child as soon as they wet the bed is a good long-term treatment. The alarm trains the child to wake up before they wee. Alarms have a 70 in 100 success rate. They are more likely to work if your child is keen and if you have professional support.

Medicine

Your child's doctor may arrange medicine for your child to use for overnight stays and school camps.

Constipation treatment

Constipation treatment may stop bedwetting in some children.

Behaviour modification

Your child's doctor may suggest a behaviour modification program for your child.

Night waking

Waking your child up during the night to go to the toilet might help but your child could end up missing too much sleep.

Specialist help

Your family doctor may refer your child to a paediatrician (child health specialist) or urologist (a doctor specially trained in bladder and urinary system conditions).

Psychological problems

If a psychological problem is present, your family doctor may refer your child for help. Psychological problems are very rarely the cause of bedwetting.