Many families have been there: soggy pajamas and wet sheets, and a very embarrassed child. But bedwetting is a natural part of development, and there are ways to help kids who are having issues with wetting the bed. In fact, Nemours Children’s Specialty Care in Jacksonville, Fla., addresses concerns for kids and their parents with its Continence Clinic, which is the first nurse-run clinic of its kind for children in the U.S.
According to a study by The National Sleep Foundation, 14% of preschoolers and 4% of school-age children wet the bed a few nights per week or more and 21% of preschoolers and 7% of school-aged children do so once a week or more.
What is Bedwetting?
Bedwetting, which your provider may also call nighttime incontinence or nocturnal enuresis, is when kids who are old enough to control their bladder pee at night during sleep. Bladder control is a complex process that involves coordinated action of the muscles, nerves, spinal cord and brain.
Bedwetting may occur at any point during the night but usually takes place during the first few hours of sleep. It is a common problem in kids, especially those younger than six years old. Most children wet the bed occasionally or even nightly during their potty-training years; controlling bladder function during sleep is usually the last stage of the process. Although bedwetting is most common in young kids, it can last into the teen years.
To understand how to help kids who are wetting the bed, it’s best to understand the two types of bedwetting:
- Primary bedwetting: Your child has never had nighttime control over urination.
- Secondary bedwetting: Occurs after your child has been dry during sleep for six or more months. It may be caused by psychological stress but could also be the result of an underlying medical condition.
Millions of families face bedwetting every night and it can be very stressful for everyone. Your child may feel guilty about wetting the bed and become anxious when faced with spending the night at a friend’s house or away at camp. Often times, parents feel helpless to stop it.
Try not to worry! Bedwetting isn’t a sign of poorly executed toilet training. In most cases, it is not a sign of any deeper medical or emotional issues. Keep in mind that bedwetting can also run in families. Many children who wet the bed have a relative who did too. Also, if both parents wet the bed when they were young, it’s more likely their child will.
Tips for Parents of Kids Who Wet the Bed
Here are some tips for parents to help your kids make it through the night without wetting the bed.
- Offer plenty of patience and understanding.
- Reassure your child that he or she is not alone.
- Encourage your child to drink more fluids during the daytime hours and less at night.
- Make sure your child avoids drinks with caffeine, carbonation and red food dye.
- Establish a regular bedtime routine that includes going to the bathroom twice before bedtime.
- Make sure your child has access to the toilet.
- If your child has an accident, have him or her help you with any remaining clean up duties in the morning, but without yelling or punishment.
- Praise your child when he or she makes it through the night dry.
- Develop a reward system to encourage your child, such as stickers for dry nights.
When to Seek Treatment for Bedwetting
If your child wets the bed more than two to three times per month after the age of six, parents should consult a care provider. Also, consult a provider if any of the following occurs:
- Your child starts to wet the bed after six months of being dry at night.
- Your child experiences painful urination, daytime urgency and frequency, unusual thirst, pink or red urine, hard stools / constipation or snoring.
- Your child begins to wet his or her pants during the day.
- He or she is drinking or eating much more than usual and / or has swelling of the feet or ankles.
When kids are seen for bedwetting, they’ll experience something similar to the kids who visit the Continence Clinic in Jacksonville. Explains Kelly Ezzell, ARNP, one of the directors of the clinic, “When kids come in, we’ll take a history and conduct a physical.” The provider may check your kids for signs of a urinary tract infection (UTI), constipation, bladder problems, diabetes or psychosocial concerns. “We’ll talk to the kids and their family about the mechanics behind bedwetting. And then we’ll discuss a plan of care and treatment options with both parents and kids,” says Kelly.
Lifestyle changes, bladder training, wet stop alarms and sometimes medication may help reduce bed-wetting.
Some of the treatment options that your child might receive are:
- Bed Alarm (aka Wet Stop Alarm) Therapy
When your child receives bed alarm therapy, a special sensor is placed in his or her pajamas that triggers an alarm to go off at the start of urination. This alarm works best if a parent is awakened by it. The parent then has three minutes to bring the child fully awake to attempt to pee in the bathroom. When used nightly for a minimum of 12 weeks, the bed alarm is 85% effective in treating bedwetting.
- Self-hypnosis and acupuncture have been shown to be effective treatments.
Symptom Control Options
- Your provider may prescribe certain medications. Medications are not a treatment for nighttime wetting but they can help your child remain dry overnight.
Kids who wet the bed feel socially isolated. When a child visits the Continence Clinic in Jacksonville, they will encounter two large ocean-themed mural canvases on the wall. When a child who visits the clinic has overcome their accidents, they choose a magnetic sea creature to add to the mural. This piece serves as a reminder to the other kids who come in that they are not alone.
Parents should also make an effort to make sure their kids feel like they have support. Emphasize to your children that they have help, accidents are out of their control and that with some hard work, their effort will pay off.