A wee problem: How to prevent bedwetting

I see a lot of families who are concerned about their son or daughter wetting the bed. Although it is an inconvenience to have to do extra laundry and change sheets in the middle of the night, it’s actually pretty common.

While most kids are potty trained between the ages of 2 and 4 years old, some kids are unable to stay dry at night until they are older. Approximately 20 percent of children wet the bed at age 5 and boys are twice as likely as girls to wet the bed. We also see that kids with developmental delays and emotional and behavioral difficulties can struggle with bedwetting.

Don’t worry, there are things you can do to help curb bedwetting. But first, let’s look at the common causes of bedwetting.

Causes of bedwetting

Time: Often, it’s just a matter of the body maturing. It can take some kids extra time to develop control of their bladder. This can be a frustrating answer, but up to 5 percent of 10-year-olds still wet the bed.

Sleep: Many times kids are deep sleepers and will sleep through a full bladder. Also, kids whose sleep is disturbed by snoring or restless sleep can be bedwetters. If your child has snoring or restless sleep you should contact their doctor. Other distractions such as watching television or using devices (think iPads, Kindles, phones) in bed can cause kids to miss cues that they need to go to the bathroom.

Genetics: Children who wet the bed often have a family member who did, too.

Stress: Did you just move? Did you welcome a new sibling? Is there something causing anxiety at school or among friends? Life changes such as those, even happy events, can create stress in a child and cause bedwetting.

Medical: Various medical conditions, such as urinary tract infections and constipation,  can causing  bedwetting. Additionally, a small bladder or the child’s body making too much urine can cause accidents. Rarely, bedwetting is the first sign of type 1 diabetes due to increased thirst and urination.

What to do

• Reduce drinks before bed and if your child drinks caffeinated drinks, eliminate them. Caffeine can act as a mild diuretic, which can make you need to urinate more.
  
  
• Encourage your child to use the bathroom 15 minutes before bed and then again right before bed. Sometimes kids urinate initially just enough to no longer feel the urge but don’t completely empty their bladder.
  
  
• Remove distractions from your child’s room — TVs, electronics, even pets. Removing distractions from their room will help your child get a good night’s sleep.
  
  
• Waking your child in the middle of the night to use the toilet can help until they are able to stay dry through the night.
  
  
• Be positive. Reward your child for dry nights. Offer support for wet nights. Tracking dry and wet nights can help you understand if the problem is getting better or worse and identify patterns.
  
  
• Have patience. This is the biggest thing I stress with parents. Never blame your child. It could just be that your child’s body needs a little extra time to catch up. Let your child know that it’s not their fault and that most kids outgrow bedwetting. Never punish your child for wetting the bed, which can teach your child to hide their accidents. Also, don’t let other siblings tease your child for bedwetting.

Practical advice

• Training pants such as Pull-Ups can help prevent accidents from spilling onto the sheets and can be used in younger children.
  
  
• Have a waterproof mattress pad on your child’s bed to protect the mattress from getting wet.

Medicines

There are some medicines available to help kids who are 6 and older. While these medicines rarely cure bedwetting, they can be helpful for events such as sleepovers or overnight camp. Your pediatrician can talk you through the benefits and identify any possible side effects these medicines may have on your child.

Bedwetting alarms

If you feel like you’ve tried everything, you can look into bedwetting alarms. They work by sensing urine and waking your child up to use the bathroom. These tend to be most helpful for older children who can understand the concept of waking up with the alarm and stopping the process of bedwetting.

If you have any concerns about your child’s bedwetting, it’s always best to discuss them with your pediatrician. We can work with you to help resolve this issue — and don’t worry, it will be resolved!

For more information, I recently spoke about bedwetting on TMJ4's Live at Noon. 

Patrick Lehman, MD Pediatrician Bayshore Pediatrics

Children’s Wisconsin has more than 20 primary care offices conveniently located throughout the Milwaukee area and southeast Wisconsin. Find a pediatrician near you.