Every child wets the bed now and then, especially children who are five years old or younger. But when your older child experiences nighttime bedwetting (enuresis), you might be concerned about their health.
Irina Stanasel, M.D., pediatric urologist at Children’s Health℠ says parents don’t need to be too anxious about nighttime accidents.
“Nighttime wetting is considered abnormal after five years of age, but it is largely not related to scary medical conditions,” Dr. Stanasel says. “Every year that passes, more and more nighttime wetting resolves. Some kids just take longer to stop wetting the bed.”
What can I as a parent do to help stop bedwetting?
While bedwetting is not connected to serious medical conditions, it may be connected to less serious issues such as bladder-bowel dysfunction.
Children with bladder-bowel dysfunction may experience constipation during the day. They may also hold their urine too long during the day, putting them at risk for urinary tract infections. Dr. Stanasel says parents should help address this dysfunction by working with their child’s doctor and establishing healthy bathroom habits.
Dr. Stanasel suggests these steps for addressing bladder-bowel dysfunction:
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Have your child evaluated for the condition by their pediatrician.
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Have your child go to the restroom every two to three hours.
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Ensure your child eats plenty of fruits and vegetables to help with constipation.
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Help your child drink plenty of fluids throughout the day for help with constipation and urine holding behaviors.
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Get a step stool for the toilet so children’s feet aren’t dangling when they use the restroom. Step stools can help them have a bowel movement more easily.
After weeks of these healthy habits, bedwetting should slowly stop.
What if my child doesn’t have bladder-bowel dysfunction?
If your child doesn’t have constipation or other problems related to bladder-bowel dysfunction, you will need to decide if you and your child are ready to address bedwetting issues. These strategies work best when done consistently and when your child is ready.
The first steps to take are to change behaviors before bedtime. Dr. Stanasel suggests that your child stops drinking fluids at least two hours before bedtime. They should also use the restroom right before going to bed.
“For some kids, these things don’t work,” Dr. Stanasel says. “They are heavy sleepers, and their brain hasn’t learned how to respond to the urge to urinate. For these kids, it can be harder to get nighttime wetting under control.”
A bed alarm is a good option for stopping bedwetting. The bed alarm attaches to your child’s underwear and sits up by your child’s head. When the child wets the bed at night, the alarm goes off to wake them up. Even though children have already wet the bed, they should get up and go to the bathroom.
After a few months, the bed alarm can retrain your child’s brain to wake up when your child feels the urge to urinate. It is important to consistently use the alarm every night and for your child to get up every time.
Dr. Stanasel says the bed alarm is more effective than simply waking your child up to use the bathroom in the middle of the night because it trains their brain to make a long-term change. Once your child has stopped wetting the bed, you can stop using the bed alarm and the change should be permanent.
If children are older and the bed alarm or other tactics have failed, certain medicines can help stop bedwetting safely and effectively. However, children may experience bedwetting again when they stop taking the medicines.
When is bedwetting a cause for medical concern?
If your older child is having accidents while awake and asleep, it may be cause for concern. Daytime problems like urinating frequently or have strong urges to use the bathroom could be signs of problems like Type 1 diabetes or an anatomical problem.
Frequent urinary tract infections also need attention from a doctor, especially if they have a fever.
How should I handle bedwetting with my child?
Still, Dr. Stanasel stresses that bedwetting alone, with no other problems, will likely go away over time.
“I think that the number-one thing to do is support your child,” Dr. Stanasel says. “This is not their fault. I would recommend against a reward or punishment system. Bedwetting is not something they can control.”
Dr. Stanasel says punishment and rewards could be detrimental to a child and encourages parents to simply support their kids.
“A lot of kids just take a lot longer to resolve nighttime wetting, sometimes even up into the teenage years,” says Dr. Stanasel. “We can speed it up as best we can, but bedwetting is a lot more common than most parents realize.”
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