Passing urine during sleep is called “bed-wetting” when it occurs after age 5 or 6. Children are usually expected to have nighttime bladder control by this age. Bed-wetting is a very common problem. In the U.S., about 5 million children have it.
Enuresis is a medical term for bed-wetting.
{Note: Bed-wetting can damage a child’s self-image. Explain that bed-wetting is not their fault and that it will get better in time.}
Causes
Children don’t wet the bed on purpose. These are some causes of bed-wetting:
A full bladder does not wake the child up due to miscommunication between the brain and the bladder.
A child’s small bladder does not hold urine for an entire night.
Other conditions, such as a urinary tract infection and diabetes. (Daytime wetting and other symptoms occur with these conditions.)
For children who have been dry at night for 6 or more months, sometimes, emotional upsets and major changes can cause bed-wetting. An example is having a new baby in the house.
Children are more likely to wet the bed if both parents did when they were children.
Sleep apnea, when a child’s breathing gets interrupted when they sleep.
Treatment
Most of the time, children outgrow bed-wetting. Until then, self-care measures help with the problem. Medication can be prescribed when no other treatment works.
Self-Care
Be patient and give your child lots of support. Children who wet the bed can’t help it. Do not blame or punish your child for wetting the bed.
Limit fluids in the evening, especially 2 hours before bedtime. Ask your child’s doctor how much your child should drink. Don’t give drinks with caffeine.
Have your child urinate in the toilet right before getting into bed.
See that your child can easily get to the toilet during the night. Keep the path clear. Use night lights, etc. If needed, put a portable potty close to your child’s bed.
Tell other members of the household that “teasing” about bed-wetting is not allowed. Respect your child’s privacy and feelings.
You may want your child to use pull-up (training) pants when sleeping away from home, camps, etc. On a regular basis, encourage your child to wake up to use the toilet.
Place a waterproof mattress cover under the sheets.
Keep a change of pajamas, clean sheets, dry towels, etc., near your child’s bed. Show your child how to use these when he or she wets the bed. Let your child help in the clean-up process.
Have your child rehearse getting up from bed and using the toilet. Do this at bedtime. Do it during the day when your child gets the urge to urinate. Have your child lay down in his or her bed, wait a few minutes, and then get up to urinate in the toilet.
If your child is 5 years old or older and he or she agrees to it, get a bed-wetting alarm. The child wears the alarm on his or her underwear. The first drop makes the alarm buzz. This wakes the child up. After awhile, the child learns to wake up when he or she has to urinate. Some of these alarms help prevent wet beds 85 to 90 percent of the time.
Triage Questions
Question 1
Does your child have these symptoms of diabetes?
Drinks a lot of liquids
Goes to the bathroom more than normal in the day or night
Acts very tired
Eats a lot more than normal and gains or loses weight