Key points to remember
- bedwetting happens during sleep
- your child can't control their bedwetting - it is not their fault
- be patient
- most children grow out of bedwetting
Wetting the bed at night (nocturnal enuresis) is very common in young children. It affects approximately:
- 15 percent of 5 year olds
- 5 percent of 10 year olds
- 2 percent of 15 year olds
- 1 percent of adults
Bedwetting occurs slightly more often in boys than girls.
Bedwetting is not considered to be a problem until children are about 7 years of age. That is a good age to introduce treatment programmes if your child wants to do something about it.
Almost all children grow out of bedwetting. About 1 percent of adults may still have occasional problems.
Some children wet their pants during the day as well. See Daytime wetting.
Types of bedwetting
There are 2 types of bedwetting:
- children who have never been dry for more than a few months at a time have primary enuresis
- children who have been completely dry for more than 6 months and then start wetting the bed again have secondary enuresis
What causes bedwetting?
There is no universal cause of bedwetting but we know that:
- bedwetting runs in families
- the waking-up response to having a full bladder is not fully developed; your child does not have conscious control over bedwetting
- your child's bladder cannot hold the amount of urine that they produce overnight
- your child's bladder may be twitchy or overactive - this may cause wet pants or urgency (rushing off to the toilet) in the daytime
- fluid restricting in the evening and at night does not stop bedwetting
- constipation can lead to bedwetting
- bedwetting is rarely due to urine infection, disease or child abuse
What can I do to help?
- be patient and understanding - reassure your child, especially if they are upset
- do praise and reward your child for getting up to use the toilet
- do respond gently when your child wets the bed - even if you feel angry
- do prepare the bed and your child. Use a heavy plastic cover mattress and protect the mattress with absorbent pads or towels. It might help to stop your child flooding the bed if they wear extra-thick underwear and pyjamas
- do give your child plenty of fluid during the day. This helps their bladder to get used to holding bigger amounts of urine
- do avoid any caffeine-containing drinks such as tea, chocolate or fizzy drinks
- do get your child to wee before bedtime
- if you wake your child up to wee after they have been asleep for several hours, it is important to make sure they are fully awake
- do shower or bath your child in the morning before they go to school - otherwise the smell of urine might embarrass them and lead to teasing
What are some things I shouldn't do?
- don't punish your child for what they can't control
- don't use nappies or plastic pants if your child is over 4 years old and they are embarrassed
When should I get some professional help?
- if your child is wetting during the day
- if your child has been dry at night for over a year and suddenly starts to wet the bed again
- if your child is still wetting the bed after the age of 6 or 7 years, and it is upsetting them
- if the bedwetting is causing problems in the family
If bedwetting is a problem, you can contact your school nurse or GP (general practitioner). Your GP will examine your child for any underlying cause of bedwetting and may refer you to an appropriate service.
What tests are needed?
Special tests are not usually needed in bedwetting.
lab tests on blood and urine may be performed to rule out a medical condition if there is daytime wetting or bedwetting starts up after more than a year of dry beds
- scans or x-rays are not usually needed
How is bedwetting treated?
There are several ways to treat bedwetting and your child can help to decide what is best for them at this time.
- children under 7 years old may not see the need to do anything
- an alarm that awakens your sleeping child as soon as they wet the bed is a good long-term treatment. The alarm trains the child to wake up before urination occurs. Alarms have a 70 percent success rate. They are more likely to work if your child is keen and if you have professional support
- the doctor may prescribe your child a medicine to use for overnight stays and school camps
- treatment of constipation may stop bedwetting in some children
- a behaviour modification program may be suggested
- waking the child up during the night to go to the toilet might help but your child could end up missing too much sleep
- your child may be referred to a paediatrician (child health specialist) or urologist (a doctor specially trained in conditions of the bladder and urinary system)
- if a psychological problem is present, your child may be referred for help. Psychological problems are very rarely the cause of bedwetting. Understandibly some children do get upset if there is teasing, bullying or punishment because of bedwetting
If you have tried one of the treatments before (when your child was younger) and it did not work, it might be worthwhile trying it again.
This fact sheet has been produced by the Paediatric Society of New Zealand in collaboration with the Enuresis Guideline Team, KEEA (Kiwi and Enuresis Encopresis Association) NZ and NZCA (The New Zealand Continence Association).
Paediatric Society of New Zealand. 2005. Best practice evidence-based guideline. Nocturnal enuresis "bedwetting". http://www.paediatrics.org.nz/files/guidelines/Enuresisguidelinefinalendorsed.pdf (PDF, 220KB) [Accessed 23/03/2015] NB: This 37-page document is aimed at health professionals but may be of interest to those parents who want more detailed information on bedwetting.