Bedwetting

Bedwetting, also called Nocturnal Enuresis, is very common in young children and in some cases may even last into pre-teen or teenage years.  Nocturnal Enuresis is usually “normal” in the sense that it is not caused by an underlying medical problem, however, the condition can still be very difficult to manage both mentally and physically for the family and child.  

Who does it affect?  Nocturnal enuresis is common and occurs in about 1 in every 5 children at age 5, 1 in every 10 child at age 7 and as many as 1-3% of teenagers.  It is 2-3 times more likely to occur in boys.  

Bedwetting is not the child’s fault or under their control.  Discipline, punishment, or shaming should never be used for bedwetting and will not help decrease episodes. 

There are 2 ways that pediatricians classify bedwetting or nocturnal enuresis –  

• Primary Nocturnal Enuresis is bedwetting in a child who has never had consistent bladder control at night. 
  • This is the most common type of bedwetting and is eventually outgrown. 
• Secondary Nocturnal Enuresis means the child previously had consistent control without bedwetting for at least 6 months but is now having new bedwetting episodes.  
  • This may be a sign of urinary infection, neurological problems, stress, constipation, or other medical problems and should be evaluated by your pediatrician.  
  • In addition to secondary enuresis, you should also see your pediatrician for evaluation if your child has bedwetting and is 7 years old or older, has pain or difficulty passing urine, constipation or hard stools, change in urine color, excessive thirst, weight loss, signs of stress/anxiety, or snoring.  
  • Evaluation to determine the cause of nocturnal enuresis usually starts with a history and physical examination and may include collecting and testing a urine sample, blood work, screening for anxiety or stress causes, imaging studies, or referral to a specialist.  

Prevention and Treatment: 

• Limit fluids before bedtime and avoid food and drinks with caffeine altogether. 
• Avoid sugary drinks and salty snacks, especially in the evening. 
• Have your child urinate regularly during the day, about every 2-3 hours, and always right before bed. 
• Try waking your child once during the night to have them urinate, but never more than once to avoid disrupting sleep patterns.  

Bed-wetting or moisture alarms – Research shows that these devices can be effective when used properly and consistently.  They buzz, alarm, or vibrate when moisture from a pad attached to the child’s pajamas or underpants is detected.  This helps to train the brain to wake up when feeling the sensation of needing to pee.  It may work within weeks or take up to 1-3 month to be effective.  

Medications are sometimes used, especially in older children, which may be prescribed daily or in some cases for short periods like vacations/trips, or sleep overs.  They do not cure the bedwetting, but instead treat the symptoms.  Therefore, when stopped bed-wetting usually returns.  

Resources: 

HealthyChildren.org Nocturnal Enuresis in Children and Teens 

Bedwetting: 3 common causes and what families can do