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Bedwetting

By Child and Youth Health
 
 

Why does bedwetting happen? 
What parents can do 
School camps and sleepovers 
What not to do 
If your child is over seven 
Reminders

Bedwetting is sometimes called nocturnal (night-time) enuresis. Childhood bedwetting happens in many families. While a lot of children grow out of wetting the bed by the time they start school, many children of primary school-age still wet the bed. Most children stop daytime wetting by about three years of age and wetting at night by the time they are five, although most preschoolers wet their bed from time to time.

About 1 in 5 five-year-old children wet the bed, 5% of 10-year-olds and 1% of 15-year-olds. That means that if your primary school-aged child wets the bed he is probably not the only one in his class or amongst his friends who is wetting.

Why does bedwetting happen?

Bedwetting is nobody’s fault. It is not caused by laziness or done to get attention. It is something over which a child has no control.

  • Bedwetting happens when a child does not wake up when his bladder is full at night.
  • Many children who wet the bed seem to sleep more heavily and be harder to wake than other children. They are not able to wake up when they have a full bladder.
  • Many children who wet the bed produce more urine (wee) at night than others, due to a low level of a hormone which controls how much urine is made while the child is asleep.
  • A few children who wet the bed have bladders which cannot hold a large amount of urine.
  • Occasionally bedwetting can be due to a medical problem and for this reason it is wise to have a check by your doctor.
  • Often bedwetting runs in the family and you may find that dad, mum, uncle or aunt used to wet the bed and may still have to get up at night to go to the toilet.
  • Most children who wet the bed ‘grow out’ of it, but their self-confidence can be harmed while they are wetting, so it's worth looking into ways of helping your child to stop wetting at an earlier age rather than later. When children stop wetting, their self-confidence usually returns.   
  • Sometimes children who wet the bed stay dry when sleeping in a strange place. This may be because, when they are worried about sleeping in a strange place, they sleep more lightly for the first few nights. When they are at home again and relaxed they often wet the bed again.
  • Some children who have been dry might start wetting the bed again if something happens to make them very stressed, e.g. a family break-up or starting school, or if they are not well. In this case the bedwetting will usually stop when the child begins to feel more secure.
  • If a child who has been dry starts to wet the bed again it is important to have a medical check to see if there is an infection or other health problem.

What parents can do

  • Reassure children that bedwetting is normal, there is nothing to be ashamed about, and they will grow out of it in time. It can be very helpful for them to know if someone else in the family used to wet the bed.
  • Do not limit how much your child drinks during the day or evening. Children need to have at least five or six drinks every day. Soft drinks that contain caffeine are not a good idea because they increase the amount of urine produced and children need to go to the toilet more often.
  • Explain to your child simply some of the reasons for bedwetting. For example, ‘While you are asleep your brain isn’t getting the message that you need to go to the toilet and so you don’t wake up’. Or you could say, ‘Your bladder, where your wee is stored, hasn’t grown enough yet to hold all the wee through the night, but this will change as your body grows’.
  • If bedwetting seems to be causing stress or worries, do what you can to make your child feel better. Let him know that the bedwetting will stop in time so that this doesn’t become an added worry.
  • Some parents find it helpful to take their child to the toilet two or three hours after he goes to sleep. For others, this doesn’t work. To help save washing:
    • cover the mattress with a plastic or waterproof sheet
    • put plastic over the bottom sheet and a piece of towelling on top of the plastic
    • put thick underpants or ‘pull ups’ on your child.
  • Leave a soft light on so it is easy and ‘safe’ for your child to go to the toilet.
  • Make sure your child has a shower in the morning to feel fresh and clean and not smelly to others, which can sometimes lead to teasing by other children.
  • Give your child lots of encouragement especially after accidents. Children need to feel loved and lovable.
  • It is not a good idea to make young children clean up after themselves. They might see it as a punishment for something they have no control over - and changing their own bed linen won't make them stop wetting. Children often feel sad when they wake up in a wet bed and the last thing they want to do is upset you. 
  • Older children are able to help by changing their beds and putting their wet sheets and clothes in the laundry.
  • Alarm systems help many children who are about seven years old or more. 
  • Behaviour change programs such as star charts cannot work because your child cannot control the bedwetting.
  • Check with your doctor if:
    • your child is still wetting in the day by school age
    • your child who has been dry starts wetting again for more than one or two nights 
    • you or your child are becoming very upset by the bedwetting
    • you have any other concerns about bedwetting.  

School camps and sleepovers

  • Children often worry about wetting the bed at school camps or at sleepovers and may try to avoid going.
  • If your child is very anxious about camp or sleepovers there is a hormone medication (which is sprayed into the nose) that can decrease the amount of urine produced at night.
  • See your doctor a couple of weeks before the camp or sleepover to see if this may help your child.
    • They should be encouraged not to miss out on these fun times.
    • Teachers are used to dealing with these situations at camp without embarrassing the child. Have a private discussion with your child's teacher about how the bedwetting can be managed. Then talk with your child about what he can do if it happens at camp.
    • If your child is going on a sleepover in someone else's home, discuss with the parent how to best manage the bedwetting.
    • Night time ‘pull-ups’ might help and there are ‘nappies’ for older/bigger children.

What not to do

  • Don’t punish, criticise or tease your child and don’t let others do this to your child. This can make children tense and anxious and make the problem worse. Remember young children cannot control their bedwetting.

If the child is over seven

  • If the bedwetting is not too worrying for your child or you, you might be happy to just wait until he grows out of it. But many children hide their distress, so think about trying something to help.
  • If your child is over seven he may be helped by a bladder training program and/or a bell/alarm program. These programs are often successful and you can find out more about them from your local community health centre, pharmacy (chemist) or doctor.
  • Other treatments, such as medicines and hypnosis, may help. These treatments work for most children.
  • It's important to use a treatment that does not add to your child’s discomfort.

Reminders

  • Reassure your child that bedwetting is common and nothing to be ashamed of.
  • Don't punish, criticise, tease or offer rewards for something your child cannot control.
  • Get a medical check-up to be sure there is no physical cause.
  • Consider using a bladder training or bell/alarm program if your child is over seven and worried.
  • Help your child feel as comfortable as possible about going to school camps and sleepovers.
  • Bedwetting is something that children cannot help and they almost always grow out of it.
 
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  • Last reviewed16-05-2006
  • References

    Glazener, C.M.A., & Evans, J.H.C. (2006). Desmopressin for nocturnal enuresis in children. In The Cochrane Database of Systematic Reviews. Issue 2. The Cochrane Collaboration. John Wiley & Sons, Ltd.

    Moulden, A. (n.d.). Primary nocturnal enuresis. Melbourne: Royal Children's Hospital.

    National Kidney Foundation (n.d.). When Bedwetting Becomes A Problem. Retrieved 10 March 2006 from http://www.kidney.org/atoz/pdf/bedwetting.pdf.

    Oberklaid, F., & Efron, D. (2002). Controlling the alarm on enuresis. Australian Doctor, 8 March, 45.

    Rushton, H. (1997). Pediatric urology. Pediatric Clinics of North America,44(5), 1065-1343.