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ERIC / Bedwetting / Info for Parents /

Info for Parents

Bedwetting is common in childhood but dealing with bedwetting every day can have a big effect on children, young people and their families.

Bedwetting happens when a child involuntarily wets whilst sleeping and because they are asleep, they don’t have the awareness they have whilst awake. It is not a child's fault they wet at night, nor are they being lazy.

ERIC can help children and their families understand, manage or resolve childhood bedwetting problems.

The medical name for bedwetting is nocturnal enuresis. If a child has never been dry at night it is called primary nocturnal enuresis. If a child has been dry for 6 months or more and begins wetting at night again, this is called secondary nocturnal enuresis.

What we know

boy breaking out We know that boys are more likely than girls to wet the bed up to the age of 12; but for 12-16 year olds there are proportionally more girls who wet the bed. As children get older they are more likely to become dry at night.

More about what ERIC knows about bedwetting.

How the bladder works.

Why does a child wet the bed?

group of children When children are potty trained they learn to recognise the sensation of a full bladder and develop the ability to hold-on until they get to a toilet or potty. Most children gain day-time control by the age of 3, but night-time control takes a little longer - girls often achieve this earlier than boys.

It is part of some children’s normal development to be later getting dry at night. Just as the age at which a child becomes toilet trained in the day varies considerably, the age at which a child becomes dry at night also varies considerably.

It is quite normal for 4 year olds to be wetting the bed and for some children, night time wetting accidents may occur from time to time for a number of years. For some children there is no reduction in wetting at night and when the child is ready to become dry parents may seek intervention to resolve the problem.

Bedwetting happens as the result of one or more of the following:

Lack of ability to wake from sleep to the signal to empty the bladder
Lack of the hormone vasopressin
An overactive bladder
Constipation
A urinary tract infection (UTI)
Anxiety and stress
Small bladder size
Inherited tendency to wet at night

Overcoming bedwetting

Parents sometimes don’t seek help to deal with the problem of bedwetting due to feelings of shame or embarrassment or because they believe that they must wait for their child to grow out of it, or think there is nothing that can be done. Sometimes parents believe that their child is being lazy and could stop wetting if they tried.

Getting professional help

An appointment with a school nurse or bedwetting (enuresis) clinic will begin with an assessment to identify the pattern of the wetting, how much your child is drinking, a urine test (if necessary) and to exclude any underlying health problems. Charts are often used to make an accurate record of wetting and drinking.

If your child is wetting in the day or has constipation, these problems will be treated before tackling the night time wetting. Night time dryness can follow when other toileting issues are resolved.

Treatment

There is good evidence that treatment can be very effective in resolving bedwetting and is recommended if bedwetting continues on a regular basis beyond the age of seven. Providing a child is ready and motivated to be involved in resolving the problem, treatment for bedwetting will often help to improve the lives of children and their families.

An individual assessment, ideally in a clinic setting, will usually help to decide the best approach for the individual child and their family and is the key to successful treatment.

It is very important that the child has sufficient understanding and motivation to engage in a plan of treatment and parents and carers need to be understanding and supportive.

Whatever treatment is chosen it is important to remove nappies or pull ups before beginning treatment to avoid giving the child mixed messages.

Bedwetting Alarms

alarms Bedwetting alarms work by helping the child recognise the sensation of a full bladder during sleep and wake up to go to the toilet or learn to hold on. Bedwetting alarms can be very successful in resolving bedwetting provided the child is ready to work towards becoming dry and is involved in resolving the problem.

Medicine

Two types of prescribed medication are commonly used to help children become dry at night. Desmopressin, an artificial form of the natural hormone vasopressin, helps the kidneys make less wee during the night. And muscle relaxants such as Oxybutynin will help the bladder relax and enable them to fill. Very occasionally, both medications will be prescribed for use at the same time.

Bladder training

Some children who have both daytime wetting problems and bedwetting problems may benefit from a bladder training programme. An individual assessment will usually determine whether bladder training may help the child.

Bladder training usually consists of establishing a regular toilet routine – often starting by going to the toilet at hourly intervals and building this up over time to two hourly intervals.

Drinking

water Encourage your child to drink regularly throughout the whole day. Water based drinks are best.

How much your child should drink each day.

Getting ready for night time dryness

If a child is between 3 and 4 years of age and has been dry during the day for a while and is occasionally or regularly waking up with a dry nappy in the morning, it may be a good time to try removing the nappy at night.

If your child is interested (they often provide a clue by commenting on wet beds or nappies), let your child know what you are going to do and explain that your child needs to get up when he wants a wee at night.

Remove the nappy and put on ordinary pants, leave a night light on and a potty beside the bed. Give plenty of praise and encouragement, even if there few dry nights begin with.

More about when a child is ready to work at stopping bedwetting.

The speed at which children achieve night-time dryness does vary, often starting with one or two dry nights a week and building up slowly to complete dryness over a number of months.

Not ready to become dry at night?

If your child doesn’t have a dry night after trying for two or three weeks it may be that your child is not yet ready to become dry at night – you can try again in 2 or 3 months when your child is a little older.

Making it easy to get up at night.

Praise

Always give lots of praise if your child has any dry nights, or if he wakes by himself to use the toilet or potty during the night. Try not to show your frustration at wet beds, even though you may be feeling this way.

Secondary Nocturnal Enuresis

Lifting