Bedwetting: Why It Happens and What Parents Need to Know
There are several reasons your child is having nighttime accidents.
Waking up to pee-soaked sheets isn’t pleasant for your child or you, but take heart: Bedwetting is very common among children. In fact, every night, some 6 million kids in the U.S.—most of them ages 7 and under—wet the bed. Here, Melissa Young, MSN, RN, CPNP, a nurse practitioner of pediatric urology at Riley Hospital for Children at IU Health, answers common questions about bedwetting and offers smart advice.
What causes bedwetting?
There are several reasons your child is having nighttime accidents, Young says. These may include:
- Sleep/arousal disturbance, meaning your child doesn’t sense when their bladder is full while sleeping
- A small-capacity or overactive bladder, which could also be the culprit behind daytime accidents
- Holding urine too long during the day
- A urinary tract infection
- Sleep apnea
- Age—very young children (think ages 5 and under) have a tougher time controlling their bladder during sleep
- A lack of antidiuretic hormone (ADH), which slows down the production of urine at night
- Life changes, such as divorce, a death in the family, a new school, abuse or illness
- Structural problems in the urinary tract or nervous system
What is the best way to handle this issue?
Getting into the right mindset can go a long way. “Do not punish your child for accidents. Realize that it’s no one’s fault and you are not alone,” Young advises.
It also helps to keep a voiding diary so you’re able to track the frequency and urgency of bathroom visits as well as any accidents. Be sure to reward your child for any positive changes, like remembering to use the bathroom before leaving the house. And enlist their help with clean-up—it can help them feel more in control.
How can you prevent accidents?
Young suggests instituting a care plan and sticking with it. She recommends encouraging your child to go potty every two hours throughout the day and also right before bed. Increase their fluid intake during the day—your child should aim to drink at least 4-8 oz. every two hours—and limit fluids to 8-12 oz. from 4 p.m. through dinner time. Restrict drinks after dinner (or two hours before bedtime), and limit drinks with carbonation, caffeine, colored dyes and citric acid. “They’re known to irritate the bladder, often causing increased urinary frequency and urgency,” Young says.
Also, keep an eye on your child’s bowel movements. Constipation can cause stool to build up, which can in turn squish the bladder and decrease its capacity. It can also decrease your child’s ability to sense when they need to pee. Ultimately, stool should be soft and regular (read: daily). Your family doctor can help you manage any issues with constipation.
A bedwetting alarm can be useful, she says. Most are equipped with a special sensor that’s placed inside your child’s pajamas and detects moisture. When your child begins urinating, they’re woken up by a sound or buzz so they can finish voiding in the toilet. They’re available online—no prescription is necessary—and a good quality model costs around $35, Young says. “However, these products are not recommended for children under the age of 5,” she adds.
When does bedwetting become a cause for concern?
Sometimes, bedwetting, along with other urological symptoms, can be a sign of a larger, more serious issue, says Young. A call to your pediatrician may be in order if your child is experiencing any of the following:
- Frequent urination, feelings of urgency, or accidents during the day (a voiding diary can help track this)
- Unmanageable constipation
- Urinary tract infections
- Consistent nighttime accidents after consistently staying dry at night
- Accidents even after following the care plan listed above.
-- By Bonnie Vengrow