Bedwetting in Children and What to do About it
It’s 2 am, you just fell asleep and suddenly you hear it. Your child is crying and you know what’s up before your feet hit the floor. It’s time again for the nightly routine, strip the bed of the wet sheets, put on the dry ones, bath, and dry pajamas and one more try at a full night’s sleep.
Bedwetting can get frustrating for even the most patient parents. What causes it? How can we stop it from happening? Is it time to talk to the doctor?
What causes it?
When you’re potty training your child you may mistakenly think you’re teaching them to “go” in the potty. What they’re really learning is not to “go” unless they’re on the potty. These may seem to be the same thing, but they are not. You see children already know how to “go”, but until their nervous system and muscles and brains synch up correctly, they don’t know how to “stop” or “hold it”. A child may be better able to notice the urge when awake than when they are asleep, in fact, this is true for most children. So while a child may be a perfect potty user during the day, problems may continue at night in the form of bedwetting.
Bedwetting is just another developmental stage, while it can happen more often in boys than girls due to differences in neurological development, it is also often hereditary. If the parents wet the bed, it’s likely the child will as well.
Setting reasonable expectations
Most kids still wet the bed up to age 4-5 and another 5 million of them will continue until they are 6. It’s not laziness or defiance that causes it, just different developmental timelines. Studies show that most kids will be able to stay dry through the night by age 7 and most doctors won’t intervene before that age because it’s probably just something they’ll grow out of. Little bladders may not hold enough to make it through a whole night before then. It’s important to remember that your child may feel upset about having accidents and it’s your job to make sure they know it’s normal, that it won’t last forever, and that you support and love them even if you’re both tired of it happening.
What definitely doesn’t work is shame and punishment. Since your child is not in control of their bladder at night, shaming them or punishing them won’t help anything because they literally can’t fix this. Encouraging them about their successes can help combat their own bad feelings about the situation.
Coping skills at home
Until your child can make it through most nights without an accident it’s important to do what you can to lessen the damage from incidents. Make sure your child’s mattress has a waterproof pad, buy extra sheets, and a few extra sets of pajamas. There is overnight underwear that is super absorbent and even moisture alarms you can buy to help your child learn to wake up when they have to go.
Keeping a nightlight on in the bathroom can make things less intimidating for late night trips and teaching your child where to put dirty pajamas can help them to take some control over the situation if they need to change and don’t want to wake you up.
It may be helpful to limit liquids up to 2 hours before bed, to remember to try to go to the restroom just before bed and to keep track of stress levels to see if there’s a correlation.
Your child may feel shame and embarrassment about bedwetting which can cause them to try to hide it, leading to rashes and other skin irritations. Keep lines of communication open so they know they can come to you if they need to talk or need help.
Some kids may feel they cannot go to slumber parties or campouts due to their bedwetting, but with some prior planning and patience they can join in. Make a plan about what they will do if they have an accident away from home. Remember to pack overnight underwear and extra pajamas and a plastic bag for trips to friend’s houses so accidents can be handled discreetly if needed. Confide in the adults about your worries, their child may be experiencing the same thing and it’s easier for your child to ask for help if they know they won’t have to explain things from the beginning.
When to see the doctor?
It can be tempting to try to find a solution to bedwetting through your doctor, but it’s important to remember that the solution may just be time. However, if things are not improving after a while, a visit to the pediatrician can be in order. Discussing bedwetting with your doctor shouldn’t be embarrassing or difficult as this is a developmental stage almost all kids go through. Don’t be alarmed if your doctor treats it like it’s not a big deal.
Most children outgrow wetting the bed by the time they are 7. If it continues past that point, it’s time to talk to the doctor. Some children have physical or emotional problems that can contribute to bedwetting, like not producing a certain hormone that helps “hold it” at a high enough level, having sleep apnea, or even having anxiety about getting up at night to use the toilet when the house is quiet, or even ADHD. Your doctor may prescribe medication or behavioral therapy to help your child stay dry all night.
If your child has been able to stay dry at night but suddenly started bedwetting again, it’s time to talk to the doctor as well. Your child could have an acute problem like a urinary tract infection, chronic constipation, or disorders of the urinary system. In these cases, your doctor may order lab tests or imaging studies to see what’s going on. Your child may need to take medication like antibiotics to end an infection or may need a medical procedure to correct problems.
In the end, it’s up to you and your child to pay attention to changes, to figure out what works best in your family, and to remember that bedwetting usually goes away on its own.