Conditions — Children

Bedwetting, also called nighttime enuresis, affects many children, teenagers, and some adults. This is when there is leakage or incontinence of urine while sleeping. It can be frustrating, but it’s usually not a sign of a major problem.

Is something wrong?

Probably not. Bedwetting is rarely due to a physical problem. For many children who wet the bed, their bladders simply need more time to mature. Some children sleep so deeply that they don’t wake up when they need to use the bathroom. If a child wets the bed after being dry for a while, the cause is often a lifestyle change (such as starting school) or a stressful event (such as the birth of a sibling).

Why see a urology specialist?

A urology specialist will work to rule out health problems that may cause bedwetting. After health problems have been ruled out there are behavior modifications that may be suggested by your provider.

Your Child’s Evaluation

An exam will be done to look for physical problems. Your child may require diagnostic testing. You and your child may be asked to keep a log of their urinary patterns for a few days.

Your child’s healthcare provider may ask the following questions:

• How often does your child urinate? How much?
• What color is your child’s urine?
• Are there any symptoms while urinating, such as burning or pain?
• Has your child had any constipation or daytime accidents?
• Does your child have any health problems?
• Were any other family members bedwetters?
• Has bedwetting affected your child’s self-esteem or relationships with other kids?

Treatment Options

The Self-Awakening Routine

To overcome bedwetting, your child must learn to wake up when it’s time to urinate. These tips will help:

• If your child wakes up for any reason, they should get out of bed and try to use the toilet.
• If your child wakes and the bed is wet, they should help change the sheets and wet pajamas before returning to bed.
• Each evening, have your child lie on the bed, pretending to sleep, and imagine they have to urinate. The child should get up, walk to the bathroom, and try to urinate. This helps teach the habit of getting out of bed to use the toilet.

Bedwetting Alarms

A specially designed alarm may help teach a child to wake up to urinate. These are available at drugstores, medical supply stores, and on the Internet. Bedwetting alarms help your child learn to wake up to use the bathroom. Here’s how they work:

• The alarm contains a sensor. It attaches either to the underwear or to a pad on the bed. A noisy alarm may be worn around the wrist or on the shoulder near the ear. Or, a vibrating alarm may be placed under the child’s pillow.
• If the child begins to urinate, the alarm goes off. This wakes the child up. They can then get up and use the toilet.
• Some children sleep through the alarm at first. You may need to wake your child when you hear the alarm.

Other Lifestyle Changes

• Limit fluids in the evening. This may help keep the bladder empty during the night. Don’t limit fluids altogether. This can cause dehydration. Instead, have your child drink more during the day and less in the evening.
• Limit caffeinated drinks in the evening. Caffeine stimulates urination. 
• Limit chocolate in the evening because it contains caffeine.
• Encourage your child to use the bathroom regularly during the day.

Medications

Medications come in nasal spray, pill, or liquid form. They may reduce the amount of urine the body makes overnight. They may also help the bladder hold more fluid. Medications can give your child extra help staying dry during vacations or overnight stays away from home. But keep in mind that medications don’t cure bedwetting, and they’re not a long-term solution. Also, medications can have side effects. Talk to the doctor about using them safely.

Tips That May Help

• Get your child involved. Encourage your child to take responsibility for changing a wet bed during the night.
• Put up a calendar or chart and give your child a star or sticker for nights that they don’t wet the bed.
• Put night lights in the bedroom, hallway, and bathroom. These may help your child feel safer walking to the bathroom.
• Keep a plastic bag or laundry basket in the room to hold wet sheets and pajamas.
• Protect the mattress with a waterproof cover. Put an absorbent pad on the bed or keep extra sheets or dry towels in the room. If the child wets during the night, he or she can get up and remove the pad, change the sheets, or put a dry towel over the wet spot.
• Make overnight trips as easy as possible. If your child goes to a slumber party, hide a disposable diaper in the bottom of the sleeping bag. This can be slipped on under his or her pajamas. Also ask the doctor about medications that may help control bedwetting for a night or two.
• Keep in mind that waking your child up to use the bathroom may prevent a wet bed that night. But it won’t make your child outgrow the problem any faster.

• Bedwetting isn’t something your child does on purpose. Never punish or tease a child for wetting the bed. This could make the problem worse by making your child feel ashamed and embarrassed. Instead, be positive and supportive. Praise your child for success and even for trying hard to stay dry.