You’re frustrated. You’re exhausted. Your child is already in school — but they’re still wetting the bed at night. You’ve tried limiting liquids after dinner. You’ve woken your child up in the middle of the night to use the bathroom. Still, no luck.
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But you aren’t alone. Parents often worry about bedwetting in their children, a problem defined as “involuntary urination in children 5 years of age or older.” But in reality, about 15% of children in the U.S. are still wetting the bed at age 5.
To help parents deal with this challenge, we turned to pediatric nephrologist Charles Kwon, MD, and pediatric urologist Audrey Rhee, MD.
What age is bedwetting a problem?
When your child is older than age 7 and still wetting the bed, you might want to talk with their primary care physician or a pediatric nephrologist or urologist.
Also, keep in mind that about 15% of children age 5 or older actually stop wetting the bed each year.
“When I meet a child who is wetting the bed, it’s twice as likely to be a boy. He usually presents with no other medical problems,” Dr. Kwon says.
What causes bedwetting?
“The underlying issue is usually a bladder that’s not yet matured,” says Dr. Kwon.
Other possible causes for bedwetting include hormone imbalance, constipation or more serious issues, shared below.
Your child may be at a higher risk for wetting the bed if:
- They experience a lot of stress and anxiety.
- There is family history of childhood bed-wetting.
- They have ADHD (attention-deficit/hyperactivity disorder).
How to stop bedwetting
To combat bedwetting, doctors suggest:
- Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day, stopping fluid intake after dinner.
- Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
- Be encouraging and positive. Make your child feel good about progress by consistently rewarding successes.
- Eliminate bladder irritants. Start by eliminating caffeine (such as chocolate milk and cocoa). And if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate their child’s bladder.
- Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
- Constipation may be a factor. Because your rectum is right behind your bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one-third of children who wet the bed, though children are unlikely to identify or share information about constipation.
- Don’t wake children up to urinate. Randomly waking up your child at night and asking them to urinate on demand isn’t the answer. It’ll only lead to more sleeplessness and frustration for you and your child
- An earlier bedtime. Often, children are deep sleepers because they’re simply not getting enough sleep.
- Cut back on screen time, especially before bedtime. Improving sleep hygiene can help their minds slow down so they can sleep better.
- Never resort to punishment. Getting angry at your child doesn’t help end bedwetting. The process doesn’t need to involve conflict.
Are there medications for bedwetting?
“Although there are medications (including a synthetic form of a hormone) that can address bedwetting, I don’t prescribe them unless a child was already put on the medication by another provider,” says Dr. Rhee.
“There are side effects,” she says. “Plus, it’s a temporary fix, a quick remedy, when what we want is an overall solution.”
Is my child bedwetting on purpose?
Families often wonder if a child is bedwetting on purpose. Dr. Kwon often tells parents that it’s typically not their fault nor is it their child’s fault. “I tell them not to get too stressed because this issue often resolves on its own,” he says.
Dr. Rhee adds that it’s also important to talk to your child to see if there’s motivation to change. If they’re motivated to change, a bedwetting alarm can be the solution.
You can clip the alarm to your child’s underwear or place it on the pad on the bed. Once the device detects any moisture, the alarm goes off. But if your child isn’t independently motivated, the alarm may have no benefit and may just further frustrate the family.
“If they’re still sneaking drinks late at night and eating what they shouldn’t, then it doesn’t make sense to invest in an expensive bedwetting alarm. So, I directly ask a child if bedwetting bothers them, to find out if it’s the parents’ frustration that brought the child to the appointment or their own,” Dr. Rhee says.
As your child gets older and has opportunities to go to slumber parties and weekend trips, bedwetting can affect their confidence and social life. This’ll most likely motivate your child to solve the problem and avoid feeling embarrassed.
Is bedwetting serious?
Occasionally, bedwetting is a sign of something more significant, including:
- Sleep apnea. If your child snores a lot or otherwise shows signs of sleep apnea, further investigation through your child’s pediatrician should be pursued. Otherwise, this isn’t a first course of evaluation of your child’s bedwetting issues.
- Urinary tract infections (UTIs). A urine sample can detect these infections, which is a typical test doctors will order when bedwetting is an issue.
- Diabetes mellitus. A urine sample can also detect diabetes in children.
Bedwetting may be a sign of a sleep disorder, as well, in which case, a sleep study can be conducted.
If you have additional concerns about your child’s bedwetting, make an appointment with your pediatrician.