Advice for children with night time wetting

Some children have bladder problems in the daytime too:

• This might include frequency/urgency/daytime wetting.
• Urinary Tract Infections (UTIs) can also cause night time wetting.
• Daytime bladder problems need to be sorted before investigating night time issues. Read ERIC’S Advice for Children with Daytime Bladder Problems to find out how the bladder works and how to look after it, following the 4 steps to a healthy bladder.

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Healthy bladder management and still wet?

It’s time for a bedtime checklist:

• Work on getting the drinking right in the daytime – plenty of it, evenly spread out, and thinking about what they drink – but also work on a good bedtime drinking routine. STOP drinks one hour before bedtime, every night, and no more after that until morning.
• Practise a good bedtime toileting routine. Schedule a relaxed toilet sit as part of preparing for bed, and pop back to the toilet just before sleep if it’s more than ½ an hour later.
• Have a trial without nappies. Even if nappies are always wet, try removing them for at least a week, preferably two, otherwise your child will never feel wet when they wee. It may be just the trigger they need to wake up.
• Protect the bed. Take the stress out of bedwetting by investing in a waterproof mattress cover, and waterproof duvet and pillow protectors if your child is really wet. Use an absorbent sheet to contain the wee too. Visit ERIC’s online shop for a wide range of bedding protection.
• Prepare your child for sleep. Unwind with a book or listen to music with the lights turned low. NO screens – so no TV, iPad, computer games in the hour before sleep, or the brain will get the wrong message.
• Help your child to practise taking themselves to the toilet if they wake. Think about a gentle night light or a torch so it’s not too dark. Should they go to the bathroom or use a potty/bucket/bottle in their bedroom? Are they in bunk beds? Make sure it is the bottom bunk. Practise pulling pyjamas up and down, and changing them if they get wet.
• Avoid lifting – in other words waking your child to take them to the toilet. It might keep the bed dry, but it encourages the child to wee during sleep as they don’t really wake up.
• Reward each step along the way – such as getting the drinking right, doing a bedtime wee and using the toilet at night.

If bedwetting persists after working on the 4 steps to a healthy bladder and practising a really good bedtime routine using the bedtime checklist, then it’s time to see the GP or nurse at a bedwetting clinic. Treatment is available from 5 years old.

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What else causes bedwetting?

Some children find it hard to wake up when they need a wee.

It’s not because they are too fast asleep – it's because their brain just doesn’t recognise the signal of a full bladder during sleep. This is often called 'poor arousability'.

How will I know?

• Sleeping though wetting
• Wetting later in the night
• Moderate sized wet patches
• Normal concentration wee

Some children get really wet.

We all make vasopressin – a special hormone – at night. It tells our kidneys to make less wee while we sleep. Some children don’t yet make enough vasopressin so their kidneys produce lots of dilute wee – too much to fit inside their bladder.

How will I know?

• Wetting in the first 2 – 3 hours after going to sleep
• Large volume wetting
• Dilute wee

Some children's bladders don't stretch enough to hold all the wee they make at night.

How will I know?

• Wetting more than once at night
• May wake after wetting
• Small volume wetting
• Normal concentration wee

Some children are wet for more than one of these reasons.