Bedwetting: A Guide to Causes and Treatments

Written by: Jamie Neal Lewis, Nurse Practitioner, Nephrology

Bedwetting is a common childhood problem, which affects 5-7 million children in the United States each year. By age 7, about 5-10 percent of all children are still wet at night. While 15 percent of kids will outgrow bedwetting without intervention every year, waiting and watching to see what happens could delay children getting dry at night. So when should you worry that bedwetting is a bigger problem?

What causes bedwetting in children?

Parents often tell me their kids wet the bed because they’re lazy or too tired to get up and go to the bathroom during the night. I don’t believe kids wet themselves on purpose, especially when they are asleep. There are several factors that may be contributing to the problem.

Constipation

A lot of parents may be surprised to learn that not having a bowel movement every day can affect their child’s bladder. The colon and bladder are located near each other in the body and if the colon isn’t moving or emptying regularly then the stool can get backed up and push on the bladder. If your child’s bladder is being pushed on, then they may not be able to store urine as well.

Family History

Frequently, bedwetting runs in the family. However, since it’s a sensitive subject, most people don’t talk about it. So, you may not know that your cousins, aunts and uncles also wet the bed when they were younger.

Overactive Bladder

An overactive bladder occurs when the child can’t store urine in their bladder very well. They may need to go to the bathroom more often than what is considered normal, about eight times a day. Not only do they wet the bed at night, but most likely they’ll need to pee more often during the day, feel urgent every time they need to go, leak pee or have accidents during the day too.

How to help prevent bedwetting

Have your child practice good daytime bathroom habits. Your child should pee at least every two hours when he/she is awake and that means making sure they can use the bathroom as frequently as needed at school too. Encourage your child to relax so they can empty their bladder. One trick to encourage relaxation is to have your child take deep breaths five to ten times after peeing, like they’re blowing out candles on a birthday cake.

You also need to watch what they’re drinking. Believe it or not, some drinks can irritate your child’s bladder, which prevents it from working as well. Avoid these drinks if your child frequently wets the bed.

• Carbonated drinks (soda, flavored waters, diet drinks)

• Caffeinated drinks (tea, coffee, chocolate, soda, energy drinks)

• Citrus juices (orange, lemon, grapefruit, tomato)

• Drinks with red dye (Gatorade, Kool-Aid, other red colored drinks)
  
  

Note: Make sure to check the ingredient label, because red dye can be present even if the drink isn’t red. For example, the orange Gatorade has yellow dye in it.

When to seek treatment

Bedwetting is not considered abnormal until after five years of age. That being said, there isn’t a specific age when you should become overly concerned about the issue. The rule of thumb is you should seek treatment for your child when he/she starts to worry about wetting the bed or you start to worry about the issue. That usually happens when your child wants to start sleepovers or go away to camp for the night.

There are a couple different treatment options available if focusing on daytime bathroom habits and bladder emptying isn’t working.

Bedwetting Alarms

This is the most successful treatment and there are no side effects. A moisture alarm helps your child learn to wake up during the night and use the toilet when they first feel a full bladder. It does not stop them from wetting the bed. A sensor is attached to the underwear and an alarm is attached to the shirt. The alarm will sound if it becomes wet. Eventually the brain will start to avoid the alarm going off, so your child will wake up before they’re wet and eventually they’ll hold their pee all night.

When used correctly, the moisture alarms have a 70 to 80 percent success rate. On average, it takes 12-16 weeks to become consistently dry. Most children will sleep through the alarm for the first few weeks, so motivation from the parents and the child is important to getting dry with the alarm.

Medications

For some patients, medication may be an option. It doesn’t cure bedwetting, but it can help control it. A side effect from some of the medication is constipation, which as mentioned earlier can trigger bedwetting. Some children take medications daily, while others choose to only take it when they want to participate in overnight activities such as a sleep over.

Bedwetting can be stressful to children and families. Each child is different. It’s important to work with your pediatrician or specialists to decide the best treatment plan for you and your child.