Bedwetting, also known as nocturnal enuresis, is a common issue for children. It involves involuntarily urinating during sleep and is often a source of stress for both children and their parents. It’s important to recognize that while bedwetting is quite common, especially in younger children, and it often resolves on its own as the child grows. The key is to understand when bedwetting is part of normal development and when it may be time to seek professional advice.
When is Bedwetting Normal?
Children develop bladder control at different ages, and it’s important to remember that each child is unique. Most children achieve nighttime dryness between the ages of 3 and 5, but it can take longer for some. A child’s ability to control their bladder at night is influenced by both physical and neurological development, which can vary. Bedwetting is completely normal in children under the age of 5. At this age, many children have not yet developed the ability to recognize when their bladder is full during the night. Their bladder muscles may not be strong enough to hold urine until morning, and their bodies might not yet produce enough of the antidiuretic hormone (ADH) that helps prevent nighttime urination. Bedwetting also often runs in families. If one or both parents experienced bedwetting as children, there’s a higher chance that their child will also go through it. In many cases, children with a family history of bedwetting will outgrow it naturally by age 7 or older. It can also occur during times of stress or significant changes in a child’s life, such as starting school, moving to a new home, or experiencing a family disruption. This type of bedwetting may resolve once the child adapts to their new circumstances.
When Should You Be Concerned?
While bedwetting is typically harmless, there are times when it may indicate an underlying issue. Here are some situations when you should consider seeking help from a healthcare professional:
Persistent Bedwetting After Age 7
By age 7, most children have developed bladder control and are able to stay dry at night. If a child is still wetting the bed consistently after this age, it may be worth consulting a pediatrician. Persistent bedwetting at this age could be linked to physical or emotional factors that need to be addressed.
Sudden Onset of Bedwetting in Older Children
If a child who has previously been dry at night suddenly starts wetting the bed again, this could indicate a medical or emotional issue. Conditions like urinary tract infections (UTIs), diabetes, constipation, or sleep apnea can cause bedwetting in older children. Additionally, sudden stressors such as bullying, a death in the family, or trauma can contribute to the recurrence of bedwetting.
Daytime Wetting
While nighttime bedwetting is more common, daytime wetting can also be a cause for concern. If a child is wetting themselves during the day, it may be a sign of a medical condition, such as a urinary tract problem, or it could indicate that the child is having difficulty with bladder control. A healthcare provider can help rule out conditions like overactive bladder, bladder infections, or bladder dysfunction.
Signs of Pain or Discomfort
Bedwetting that is accompanied by pain or discomfort, such as burning sensations during urination or a frequent urge to urinate, could point to a urinary tract infection (UTI) or another medical issue. UTIs are more common in girls but can affect boys as well. If your child complains of pain while urinating or shows signs of fever, irritability, or a change in the color of their urine, it’s essential to seek medical attention.
Bedwetting Combined with Other Symptoms
If bedwetting is associated with other symptoms, such as excessive thirst, fatigue, weight loss, or difficulty waking up in the morning, it could be an indication of a more serious condition like diabetes. It’s important to consult a doctor if these symptoms occur in conjunction with bedwetting.
What Can you Do to Help Your Child?
• Be Patient and Supportive – Bedwetting is not something children can control, and it’s important for parents to be patient and understanding. Avoid punishing or shaming a child for wetting the bed, as this can create anxiety and make the problem worse. Offer comfort, encouragement, and positive reinforcement when progress is made.
• Establish a Routine – Encourage your child to use the bathroom before bed, and limit their intake of liquids in the evening. Creating a consistent bedtime routine can help a child develop better bladder control over time.
• Consider a Bedwetting Alarm – For children older than 6 who continue to experience bedwetting, a bedwetting alarm may be a helpful tool. These alarms detect moisture and sound an alert, helping to train the child’s brain to wake up when they need to urinate.
• Talk to Your Doctor about Medication – Several medications are commonly used to treat bedwetting in children, and the choice of medication depends on the specific situation and causes of the bedwetting. Medications for bedwetting are typically used when non-medical treatments have not been successful or when there is a specific medical issue contributing to the problem. Desmopressin, oxybutynin, and imipramine are the main options available, and each works in different ways to address the root causes of bedwetting.
Bedwetting in children is a common issue that typically resolves with time. It is often linked to normal developmental stages, family history, or temporary stress. However, if bedwetting persists beyond the age of 7, reoccurs after a period of dryness, or is accompanied by other concerning symptoms, it may be a sign of an underlying medical condition. By being patient, supportive, and proactive, parents can help their children navigate this challenge with confidence.
Dr. Joe Gleason is a pediatric Urologist at the Conrad Pearson Clinic and is experienced in treating children who struggle with bedwetting. It is important to talk with the doctor before starting any medication, and ensure that it is part of a comprehensive treatment plan that includes behavioral interventions and lifestyle changes for the best chance of success.
