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Bedwetting


Disclaimer: This fact sheet is for educational use only. Please consult your doctor or other health professional to make sure this information is right for your child.

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


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About bedwetting

Wetting the bed at night (nocturnal enuresis) is very common in young children. It affects approximately:
  • 15 percent of five-year-olds
  • five percent of ten-year-olds
  • two percent of 15-year-olds
  • one percent of adults
Bedwetting occurs slightly more often in boys than girls.  
 
Bedwetting is not considered to be a problem until children are about seven 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 one percent of adults may still have occasional problems.
 
Some children wet their pants during the day as well. See Daytime wetting.
 

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Types of bedwetting

There are two 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 six months and then start wetting the bed again have secondary enuresis

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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

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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 before bedtime
  • 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

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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 the child is over four years old and they are embarrassed

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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 six or seven 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.
 

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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

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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 seven 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 per cent 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. 
 

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Where to go for more information

On this website
 
Children’s Health Camps
This site describes the programme that is used for children who are bedwetters and who attend health camp. http://www.healthcamps.org.nz/
 
KEEA (Kiwi Enuresis Encopresis Association) NZ
Provides a range of information and links to other New Zealand information. The website has a database of bed alarm services by region.
Call free on 0800 KEEA NZ (0800 533 269)
Email: keea@xtra.co.nz
Website: http://www.keea.org.nz/
 
NZCA (The New Zealand Continence Association)
There is a children’s incontinence section1 on the NZCA website.
Call free on 0800 650 659
Email: jan@continence.org.nz or Sonja@continence.org.nz
 
Parent to Parent
Parent to Parent offers a support service to parents of children with a range of conditions and can put you in touch with parents experiencing similar situations.
 
Paediatric Society NZ. 2005. Best practice evidence-based guideline2: Nocturnal enuresis "bedwetting". 
This 37-page document is aimed at health professionals but may be of interest to those parents who want more detailed information on bedwetting.
 
International websites
 
ERIC (Education and Resources for Improving Childhood Continence)
ERIC has a number of leaflets that can be downloaded. It provides information for parents, children and adolescents and for health professionals.
 
Wetbusters
This site has a range of information and interactive pages for children, adolescents, and parents, to help stop bedwetting. It includes games to assist children.
 

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Acknowledgements

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).
 

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Links   (these are the web addresses for the numbered links in the text above)


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Endorsement

This fact sheet was endorsed by PSNZ - 31/08/2007

Copyright

Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2010


The Paediatric Society of New Zealand
http://www.paediatrics.org.nz 		Starship Foundation
http://www.starship.org.nz