It’s no surprise to anyone that babies wear diapers. What does sometimes surprise people is that even after being potty trained during the day, it’s still normal for children to wet during the night until six years-of-age. If your child is wetting after age six, see your pediatric healthcare provider.
The medical name for bedwetting is nocturnal (nighttime) enuresis (wetting). If your child has always been a nighttime wetter, it’s primary nocturnal enuresis, which is the focus of this article. If your child has achieved nighttime dryness consistently for at least six months, but starts wetting again, it’s secondary nocturnal enuresis. A medical consultation is indicated for both types.
Bedwetting can be traumatic for children and frustrating for parents. It’s difficult to have to change the bed frequently. It’s embarrassing for the child, who doesn’t want to wet at night. Your child isn’t doing it on purpose, and the wetting can keep him or her from going to sleepovers or camp. Your child may feel guilty or anxious about wetting. It can be reassuring to children that the wetting will eventually go away, although it may take years.
Approximately five to seven million children over age five wet the bed. The rates decrease with age: 16 percent of 5-year-old children wet, 2-3 percent of 10-year-old children wet, and only 1-2 percent of 15-year-old children wet the bed.
There are several reasons why kids wet. Children may wet due to a small bladder. They also may have a very low level of a hormone called vasopressin, which regulates nighttime urine production. Constipation may play a role for children, as well as food sensitivities. We know that bedwetting runs in families. If both parents wet, there’s a 77 percent chance that the child will wet. If one parent wet, then there’s a 44 percent chance that the child will wet.
It’s reassuring to know how old the parents were when the wetting stopped, as this is likely the age that the child will outgrow the wetting. We know that at some point, the child will grow out of this wetting. However, it can last well into the teenage years in some children.
As a parent you can provide emotional support. You can reassure your child that this won’t last forever. You can share that others in your family have gone through this and explain the age that they stopped wetting. You can purchase pull ups and waterproof mattress pads so that you don’t have to strip the entire bed each night.
For sleepovers, you can show your child how to slip into their pullups while inside their sleeping bag (where you’ve hidden them with a Ziplock). In the morning, they can simply slip the wet pullup into the Ziplock and roll up the sleeping bag.
You can limit fluids (especially caffeinated beverages) during the evening. You can remind them to go to the bathroom before bed. You can treat constipation with MiraLAX and dietary changes. You can praise dry nights. You can reassure following wet nights. You can explain that some kids need glasses or hearing aids. This is no different. It’s a medical condition which, luckily enough, they will just outgrow.
There are treatments for bedwetting. There are great alarms that train the child, with the help of the parent, to wake-up and go to the potty. Desmopressin (DDaVP) is a medication for wetting available by prescription in tablets or nasal spray. Children must limit fluids after taking the medication each evening.
Always have a medical evaluation for any child that is still wetting at night after age six years. Call your pediatric healthcare provider as well if there is daytime wetting, painful or burning urination, increased thirst, weight loss, or swelling of the feet or hands as these can be signs of illness.
Above all, don’t blame the victim. Please do not punish him or her for wetting. Your sweet child certainly doesn’t want to wet the bed. After all, they were asleep when it happened. It’s not their fault. They will outgrow this. Be understanding. Seek medical options. You can stay afloat during nighttime wetting. Here’s to drier days ahead.
Recommended books for parents: Seven Steps to Nighttime Dryness, by Renee Mercer, CPNP, and Getting to Dry by Dr. Max Maizels and for children with constipation: Bedwetting and Accidents aren’t your fault, by Steve Hodges MD.