Key points about bedwetting
- bedwetting is common in tamariki
- your child cannot control their bedwetting - don’t punish them or get angry
- regular drinks and toilet visits during the day can help
- constipation and daytime bladder problems may need treatment
- bedwetting alarms and medicines can help some tamariki
- you can seek advice at any age if you are concerned
How common is bedwetting?
Wetting the bed during sleep is called nocturnal enuresis. It affects about:
- 15% of 5 year olds
- 5% of 10 year olds
Staying dry at night often takes longer than staying dry during the day. Most tamariki grow out of bedwetting, but some need treatment and support.
Many younger tamariki only need reassurance and practical help. If bedwetting is upsetting your child or affecting family life, talk with a health professional.
Some tamariki also wet during the day.
Types of bedwetting
Primary bedwetting
Primary bedwetting means your child has not yet been dry overnight for at least 6 months in a row.
Secondary bedwetting
Secondary bedwetting means your child starts wetting the bed again after being dry overnight for at least 6 months.
If this happens, see a health professional. They can check for possible causes.
Causes of bedwetting
Bedwetting happens when a child does not wake in response to signals from their bladder. They may also:
- make more wee overnight than their bladder can hold
- have a bladder that holds a smaller amount of wee
- have an overactive bladder that squeezes before it is full
- be a very deep sleeper
Bedwetting often runs in families. It is not caused by laziness or poor toilet training.
Constipation can contribute to bedwetting. Sometimes other conditions are involved. This includes urinary tract infections (UTIs) and obstructive sleep apnoea.
Stress or changes in a child’s life can sometimes contribute, particularly when wetting starts again after a dry period.
What you can do to help your child’s bedwetting
Be patient and reassuring
Let your child know that bedwetting is not their fault and that many tamariki also wet the bed.
Respond calmly to wet beds.
Encourage regular drinks and toilet visits
Offer water regularly throughout the day. Encourage your child to spread their drinks through the day rather than having most of them in the evening. Encourage regular toilet visits during the day and a wee just before bed.
Avoid drinks containing caffeine, such as tea, coffee, cola and energy drinks.
Use positive encouragement
Praise your child for following their plan, such as using the toilet before bed.
A star chart can help encourage these routines. Give stars for your child’s efforts, rather than for dry nights.
Make wet nights easier to manage
Use a waterproof mattress protector and keep spare bedding and pyjamas nearby.
Protective underwear or absorbent bed pads may help. Involve your child in choosing something comfortable and discreet.
Help your child wash and change into clean clothes in the morning.
Waking your child overnight
Waking your child or carrying them to the toilet may reduce wet beds temporarily. It does not help them develop lasting nighttime bladder control.
When to get medical help for your child’s bedwetting
Talk with a health professional if:
- bedwetting is upsetting your child or affecting whānau (family) life
- your child starts wetting again after at least 6 months of dry nights
- your child also has daytime wetting, urgency or difficulty weeing
- your child also has constipation or soiling
- your child snores loudly or has pauses in their breathing during sleep
- things are getting worse
When to seek urgent help
Seek medical advice promptly if your child has pain when weeing, a fever or seems unwell. They may have a urinary tract infection (UTI).
Urinary Tract Infection In Children
Assessing your child’s bedwetting
Your child’s health professional will ask about their wetting, daytime toilet habits, bowel movements and sleep. They may also examine your child.
A diary of wet nights, drinks and toilet visits can help them understand the pattern and plan treatment.
Tests for children with bedwetting
Most tamariki who wet the bed and are otherwise well do not need tests.
Your child’s health professional may arrange a urine test if:
- wetting has started recently
- your child has daytime problems
- there are signs of infection
- there are signs of another medical condition
Most tamariki who wet the bed don’t need blood tests or scans.
Managing bedwetting
Your child’s healthcare team can help you choose a plan that suits your child and whānau.
If your child is comfortable waiting and there are no other concerns, reassurance and practical support may be all that’s needed.
If bedwetting is bothering them, treatment can help. The choice depends on their age, readiness and how much it’s you affecting your child and your whānau.
Treating constipation and daytime bladder problems
Your child’s healthcare team will check for constipation and daytime bladder problems. Treating these can help bedwetting.
Constipation Treatment For Children
Bedwetting alarms
A bedwetting alarm makes a sound or vibrates when wetting starts, to wake your child. At first, you may need to help your child wake when the alarm goes off and get to the toilet. Over time, it can help your child respond to their bladder and stay dry.
Alarms need regular use and family support. Improvement can take several weeks, and treatment often continues for a few months.
Your child’s healthcare team will explain how to use the alarm and review progress. They will usually recommend continuing until your child has at least 2 weeks of dry nights in a row.
Wetting can return after stopping. Using the alarm again may help.
Medicine
Your child’s health professional may prescribe medicine to help with bedwetting. This can be useful for sleepovers and school camps.
Follow the instructions carefully, including any advice about how much your child can drink before and after taking the medicine.
Further support
If things are getting worse, your child’s health professional may refer your child to a continence service or child health specialist.
More information
This video, 'A wee secret' is a story about Jet Johnson who has a secret. Find out how he bravely gets the help he needs.
Source: Continence NZ
A video explaining why daytime and bedtime wetting happens and what you can do to help.
Source: Primary Children's Hospital (USA)
Acknowledgements
This page has been produced by the Paediatric Society of New Zealand in collaboration with the Enuresis Guideline Team, KEEA (Kiwi and Enuresis Encopresis Association) NZ and NZCA (The New Zealand Continence Association).
