Soggy sheets, soaked pajamas, an embarrassed child—and it’s only 3 a.m. For many families, this scenario is all too familiar.
Bedwetting, or nocturnal enuresis, affects approximately one out of every four children at age 5. Although the exact cause is unknown, there are various factors that may contribute to the condition. For instance, your child’s bladder may not be developed enough to hold all the urine produced during the night. Also, if the nerves that control the bladder are slow to mature, a full bladder might not arouse your child from sleep. Stressful events, such as welcoming a new baby to the home, starting a new school or sleeping away from home may also trigger bedwetting.
There are some risk factors that have been identified as well. Perhaps the greatest predictor of who will wet the bed is family history. If both of a child’s parents wet the bed as children, the child has an 80-percent chance of wetting the bed, too. Also, children with attention deficit/hyperactivity disorder (ADHD) are at increased risk, and gender plays a role because approximately two-thirds of children who suffer from repeated bedwetting are boys.
While this is a trying situation to deal with, it is important for parents to keep in mind that it is not the child’s fault. Children do not wet the bed intentionally to irritate their parents. In fact, your child most likely finds this problem as frustrating as you do. There are several things a parent can do to help a child cope. For instance, be sensitive to your child’s feelings and encourage him or her to talk. Also, enlist your child’s help with clean up. Perhaps your child can rinse his or her wet underwear and pajamas or place these items in a container for washing. Taking responsibility for bedwetting may help your child feel more control over the situation. Finally, parents should celebrate effort. Do not punish or tease your child for accidents; instead, praise your child for following the bedtime routine and helping clean up after accidents.
Small changes in the child’s bedtime routine may help him or her avoid accidents at night. First, limit your child’s fluid intake in the evening and avoid beverages with caffeine. Also, encourage your child to urinate at the beginning of the bedtime routine and again right before getting into bed. Remind your child that it is okay to use the toilet during the night if needed. Finally, have your child urinate regularly throughout the day/evening to avoid a feeling of urgency.
While most children outgrow bedwetting without treatment, parents should seek medical attention if the child is age 7 or older and wets the bed two or three times per week. The pediatrician may suggest behavioral therapy such as a moisture alarm. This device senses wetness at the start of urination and sets off an alarm that awakens the child, giving him or her time to get to the bathroom. Another alternative is medication to slow nighttime urine production and/or calm the bladder. Children should see the pediatrician sooner if both day and night wetting occur after age 5 or if bedwetting is accompanied by painful urination, pink urine, unusual thirst or snoring.
Keep in mind that although bedwetting is frustrating, the problem is only temporary. Soon it will be a memory, and both you and your child will be sleeping through the night.
This article was written by Kathy Quirin, RN, an Answer Line nurse at St. Louis Children’s Hospital. For more information about bedwetting contact our Family Resource Center.