Health Topics: /Bed wetting

While bedwetting can be a symptom of an underlying disease, a large majority of children who wet the bed have no underlying disease that explains theirbedwetting. In fact, an underlying condition is identified in only about 1% of children who routinely wet the bed.

That does not mean that the child who wets the bed can control it or is doing it on purpose. Children who wet are not lazy, willful, or disobedient. Bedwetting is most often a developmental issue.

Types of Bedwetting

There are 2 types of bedwetting: primary and secondary. Primary means bedwetting that has been ongoing since early childhood without a break. A child with primary bedwetting has never been dry at night for any significant length of time. Secondary bedwetting is bedwetting that starts up after the child has been dry at night for a significant period of time, at least 6 months.

What Causes Primary Bedwetting?

The cause is likely due to one or a combination of the following:

·         The child cannot yet hold urine for the entire night.

·         The child does not waken when his or her bladder is full.

·         The child produces a large amount of urine during the evening and night hours.

·         The child has poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can. Parents usually are familiar with the leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine.

What Causes Secondary Bedwetting?

Secondary bedwetting can be a sign of an underlying medical or emotional problem. The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting. Common causes of secondary bedwetting include the following:

·         Urinary tract infection: The resulting bladderirritation can cause pain or irritation with urination, a stronger urge to urinate (urgency), and frequent urination(frequency). Urinary tract infections in children may indicate another problem, such as an anatomical abnormality.

·         Diabetes: People with diabetes have a high level of sugar in their blood. The body increases urine output to try to get rid of the sugar. Having to urinate frequently is a common symptom of diabetes.

·         Structural or anatomical abnormality: An abnormality in the organs, muscles, or nerves involved in urination can cause incontinence or other urinary problems that could show up as bedwetting.

·         Neurological problems: Abnormalities in the nervous system, or injury or disease of the nervous system, can upset the delicate neurological balance that controls urination.

·         Emotional problems: A stressful home life, as in a home where the parents are in conflict, sometimes causes children to wet the bed. Major changes, such as starting school, a new baby, or moving to a new home, are other stresses that can also cause bedwetting. Children who are being physically or sexually abused sometimes begin bedwetting.

Is Bedwetting Inherited?

Bedwetting does tend to run in families. Many children who wet the bed have a parent who did too. Most of these children stop bedwetting on their own at about the same age their parent did.

 

Introduction 

Bedwetting (nocturnal enuresis) can be worrying and frustrating, but it's common for children to accidentally wet the bed during the night. The problem usually resolves in time.

Bedwetting is common in young children but it gets less common as a child gets older.

In the UK, it's estimated that about:

  • 1 in 12 children wet the bed regularly at four and a half years old (regularly is defined as at least twice a week)
  • 1 in 40 children wet the bed regularly at seven and a half years old
  • 1 in 65 children wet the bed regularly at nine and a half years old

About 1 in 100 people continue to wet the bed into adulthood.

Bedwetting is slightly more common in boys than girls.

When to see your GP

Bedwetting is only really a problem if it begins to bother the children or parents. Only rarely will this be considered a problem in children under 5 years old. Many families first seek treatment when the bedwetting affects a child's social life (for example, preventing sleepovers).

Medical treatments aren't usually recommended for children under five (although exceptions can be made if a child finds bedwetting particularly upsetting).

If your child frequently wets the bed and finds it upsetting, speak to your GP for advice.

Read more about the symptoms of bedwetting.

Why does my child wet the bed? 

There's usually no obvious reason why children wet the bed and it's not your child's fault. In many cases, the problem runs in families.

Bedwetting could be caused by your child:

  • producing more urine than their bladder can cope with
  • having an overactive bladder, meaning it can only hold a small amount of urine
  • being a very deep sleeper so they don't react to the signals telling their brain their bladder is full

Constipation is frequently associated with bedwetting, especially in children who don't wet themselves every night. In these cases, bedwetting may happen during the night when the child has not had a poo during the day. Sometimes, treating constipation is all that's needed to treat bedwetting. Untreated constipation makes any treatment of bedwetting much harder.

Occasionally, bedwetting can be triggered by emotional distress, such as being bullied or moving to a new school.

In rare cases, bedwetting may be the symptom of an underlying health condition, such as type 1 diabetes.

Soggy sheets and pajamas — and an embarrassed child — are a familiar scene in many homes. But don't despair. Bed-wetting isn't a sign of toilet training gone bad. It's often just a normal part of a child's development.

Bed-wetting is also known as nighttime incontinence or nocturnal enuresis. Generally, bed-wetting before age 7 isn't a concern. At this age, your child may still be developing nighttime bladder control.

If bed-wetting continues, treat the problem with patience and understanding. Bladder training, moisture alarms or medication may help reduce bed-wetting.

    Bed-wetting is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected.

    Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bed-wetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

    When to see a doctor

    Most children outgrow bed-wetting on their own — but some need a little help. In other cases, bed-wetting may be a sign of an underlying condition that needs medical attention.

    Consult your child's doctor if:

    • Your child still wets the bed after age 7
    • Your child starts to wet the bed after a few months or more of being dry at night
    • Bed-wetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring

      Bedwetting is an issue that millions of families face every night. It is extremely common among young kids but can last into the teen years.

      Doctors don't know for sure what causes bedwetting or why it stops. But it is often a natural part of development, and kids usually grow out of it. Most of the time, bedwetting is not a sign of any deeper medical or emotional issues.

      All the same, bedwetting can be very stressful for families. Kids can feel embarrassed and guilty about wetting the bed and anxious about spending the night at a friend's house or at camp. Parents often feel helpless to stop it.

      Bedwetting may last for a while, but providing emotional support and reassurance can help your child feel better until it stops.

      How Common Is Bedwetting?

      Nocturnal enuresis (the medical name for bedwetting) is involuntary urination that happens at night during sleep after the age when a child should be able to control his or her bladder. It's a common problem in kids, especially those under 6 years old. About 13% of 6-year-olds wet the bed, while about 5% of 10-year-olds do.

      Bedwetting often runs in families: many kids who wet the bed have a relative who did, too. If both parents wet the bed when they were young, it's very likely that their child will.

      Coping With Bedwetting

      Bedwetting usually goes away on its own. But until it does, it can be embarrassing and uncomfortable for your child. So it's important to provide support and positive reinforcement during this process.

      Reassure your child that bedwetting is a normal part of growing up and that it's not going to last forever. It may comfort your child to hear about other family members who also struggled with it when they were young.

      Try to have your child drink more fluids during the daytime hours and less at night (and avoid caffeine-containing drinks). Then remind your child to go to the bathroom one final time before bedtime. Many parents find that using a motivational system, such as stickers for dry nights with a small reward (such as a book) after a certain number of stickers, can work well. Bedwetting alarms also can be helpful.

      When your child wakes with wet sheets, don't yell or punish. Have your child help you change the sheets. Explain that this isn't punishment, but it is part of the process. It may even help your child feel better knowing that he or she helped out. Offer praise when your child has a dry night.

      When to Call the Doctor

      Bedwetting that begins suddenly or is accompanied by other symptoms can be a sign of another medical condition, so talk with your doctor.

      The doctor may check for signs of a urinary tract infection (UTI),constipation, bladder problems, diabetes, or severe stress.

      Call the doctor if your child:

      • suddenly starts wetting the bed after being consistently dry for at least 6 months
      • begins to wet his or her pants during the day
      • snores at night
      • complains of a burning sensation or pain when urinating
      • has to pee frequently
      • is drinking or eating much more than usual
      • has swelling of the feet or ankles
      • is 7 years of age or older and still wetting the bed

      Also let the doctor know if your child is under a lot of stress, if you're feeling frustrated with the situation, or if you could use some help. In the meantime, your support and patience can go a long way in helping your child feel better about and overcome the bedwetting.

      Image result for bed wettingImage result for bed wettingImage result for bed wetting

Treating bedwetting

The recommended plan is usually to try a few measures yourself first, such as limiting the amount of liquid your child drinks in the evening, and making sure they go to the toilet before going to sleep.

Reassuring your child that everything is okay is also important. Don't tell them off or punish them for wetting the bed as this won't help and could make the problem worse. It's important for them to know they're not alone, and it will get better.

If these measures alone don't help, a bedwetting alarm is often recommended. These are moisture-sensitive pads a child wears on their night clothes. An alarm sounds if the child begins to pee. Over time, the alarm should help train a child to wake once their bladder is full.

If an alarm doesn't work or is unsuitable, medication called desmopressin or oxybutinin can be used. 

Most children respond well to treatment, although bedwetting sometimes returns temporarily.


NHS Choices/Web MD/Mayo clinic

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