Bedwetting In Children

Key points about bedwetting

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

How common is bedwetting?

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

• 15% of 5 year olds
• 5% of 10 year olds
• 2% of 15 year olds
• 1% of adults

Bedwetting occurs slightly more often in boys than girls.

Experts do not consider bedwetting a problem until tamariki 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 tamariki grow out of bedwetting. About 1% of adults may still have occasional problems.

Some tamariki wet their pants during the day as well. 

Daytime Wetting

Types of bedwetting

There are 2 types of bedwetting.

Primary

Primary bedwetting (primary enuresis) is when a child has never been dry overnight for more than a few months 

Secondary

Secondary bedwetting (secondary enuresis) is when a child starts wetting the bed again after having more than 6 months of being completely dry overnight

Causes of 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
• tamariki do 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 you can do to help your child's bedwetting

Be patient

Be patient and understanding. Reassure your child that it is OK, especially if they are upset. Respond gently when your child wets the bed - even if you feel angry.

Positive feedback

Praise and reward your child for getting up to use the toilet.

Be prepared

Prepare the bed and your child before they go to sleep. 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. Encourage your child to wee before bedtime.

Give plenty of water

Give your child plenty of fluid during the day - this helps their bladder to get used to holding bigger amounts of wee . Avoid giving any drinks containing caffeine, such as tea, hot chocolate or fizzy drinks.

Getting up overnight

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.

Wash in the morning

Shower or bath your child in the morning before they go to school. Otherwise, the smell of wee might embarrass them and lead to teasing. 

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

Your child can’t control their bedwetting, so do not punish them. Don't use nappies or plastic pants if your child is over 4 years old if they are embarrassed.

When to get professional help for your child's bedwetting

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.

Reasons for seeing a healthcare professional include: 

• 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 (secondary enuresis)
• 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 whānau (family)

Possible tests for children with bedwetting

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

If your child has daytime wetting, the doctor or nurse may ask your child to do a urine test and sometimes a blood test. Staff at the laboratory can test these samples. These tests can help rule out any medical conditions.

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

Managing 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 tamariki 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

Tamariki under 7 years old may not see the need to do anything. Many tamariki will grow out of bedwetting.

Alarms

An alarm that awakens your sleeping child as soon as they wet the bed is a good long-term treatment. The alarm can train your child to wake up before they wee. Alarms have a 70%  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

If your child has constipation, treating the constipation may stop bedwetting in some tamariki. 

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.