Bedwetting
bedwetting; wetting; enuresis; toilet; training; urine; bed; alarm ;
Contents
Bedwetting is sometimes called nocturnal (night-time) enuresis. Childhood bedwetting happens in many families. Most children stop daytime wetting by about three years of age and wetting at night (bedwetting) by the time they are five, although most preschoolers wet their bed from time to time.
However many children of primary school age still wet the bed.
- About one 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 she is probably not the only one in her class at school or amongst her friends who is wetting.
Most children who wet the bed 'grow out of' wetting, but their confidence in themselves can be harmed while they are wetting. Usually when they stop wetting their self confidence returns, but there are several things that can help this happen earlier, and it is worth trying them if your child is over about 7 years old because just waiting may mean that they go on wetting for several years longer.
Why does bedwetting happen?
Bedwetting is nobody’s fault. It is not caused by laziness or to get attention. It is something that a child has no control over. Often bedwetting runs in the family and you may find that dad, mum, a grandparent, uncle or aunt used to wet the bed and may still have to get up at night to go to the toilet.
Bed wetting happens when children do not wake up when their bladder is full at night, and the bladder 'automatically' releases the urine.
- 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.
- Some children who wet the bed are also constipated. It would be worthwhile to get your doctor to check whether your child is constipated, and if he is work on reducing the constipation (see the topic 'Constipation').
- Sometimes children who wet the bed are dry when sleeping in a strange place. This may be because, when they are a bit 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, eg 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 any infection or other health problem.
 |
The Brain
- tells the kidneys to make less urine at night
- tells the bladder when to empty (do wee).
The Kidneys
- help clean the blood
- get rid of waste as urine.
The Bladder
- holds wee until a suitable time to
get rid of it
- tells the brain when it is full
- may empty by itself if the brain
doesn't wake up the child at night |
What parents can do
Children need to know that bedwetting is a common childhood problem.
- Reassure children that bedwetting is normal, there is nothing to be ashamed about, and they will grow out of it in time. It may be very helpful for them to know if someone else in the family used to wet the bed.
- It is not helpful to punish children who wet the bed no matter how desperate you feel about the extra washing. There is no instant cure for wet beds when the child has not yet reached the stage of development needed to stop bedwetting.
- Behaviour change programs such as ‘star charts’ cannot work because your child cannot control the bedwetting.
- Make your child has enough to drink during the day and evening. Children need to have 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 help your child feel feel less distressed. Let her know that the bedwetting will stop in time so that this doesn’t become an added worry.
- To help save washing:
- Cover the mattress with a plastic or waterproof sheet
- Put plastic over the bottom sheet where it is likely to get wet, and a piece of towelling on top of the plastic, or use a second mattress protector and another sheet. The towelling can be removed and replaced, or the top mattress protector and sheet can be removed leaving the bed ready for sleep again.
- Put thick underpants or 'pull ups' on your child.
- Some parents find it helpful to take their child to the toilet two or three hours after he goes to sleep (when the parents are going to bed). For others, this doesn’t work.
- 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 to be smelly to others. This 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 can easily see it as a punishment for something they have no control over.
- Making young children change their own bed cannot make them stop wetting.
- Children are often sad when they wake up in a wet bed. It will only make them sadder to have 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 over about 7 years old (see below).
- 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 1 or 2 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.
- 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. Discuss with the teacher in private how this can be managed. Then talk with your child about what he can do if it happens at camp.
- Do the same in advance with the parent where the sleepover is to be.
- 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 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 bell/alarm program. These programs are often successful and you can find out more about them from your local community health centre, doctor or pharmacy (chemist).
- Using an alarm system leads to a child developing the skills needed to wake during the night when the bladder is full and to go to the toilet.
- On average children need to use the alarm for at least 10 weeks, and many need it for several more months.
- Using a bedwetting alarm is more successful if you have ongoing support from a nurse or doctor.
- There are other treatments such as
- some medicines - these do not lead to ongoing dry nights. The children are likely to start bed wetting again when the medicines stop.
- hypnosis (this does not work for some children).
The important thing to remember is not to use a treatment that adds to your child’s discomfort.
- 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 the child to 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.
Resources
- Parent Helpline (South Australia) 1300 364 100
- National Continence Helpline (Australia) 1800 330 066 for confidential support and advice.
Cutting DA, Pallant JF, Cutting FM 'Nocturnal eneurisis: application of evidence-based medicine in community practice' Journal of Paediatrics and Child Health 43 (2007) 167-172
Royal Children's Hospital (Melbourne) 'Fact sheet - Bedwetting' (2005).
http://www.rch.org.au/kidsinfo/factsheets.cfm?doc_id=3716
National Kidney Foundation 'When Bedwetting becomes a problem', (USA).
http://www.kidney.org/patients/bw/index.cfm
Oberklaid F, Efron D, 'Controlling the alarm on enuresis', Australian Doctor 8 March 2002, p45.
http://www.australiandoctor.com.au/
Written in partnership with Parenting SA
Related Parent Easy Guide (Parenting SA website - PDF format)
The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).
This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.