Accessibility Tools
Bed Wetting (Nocturnal Enuresis)

What is Bed Wetting? 

Bed wetting is involuntary urination by your child while asleep. It is common and normal among children below 7 years and is considered a normal part of their development. While most children outgrow bed wetting as they get older, a few face problems with the condition. 

When is Bed Wetting Worrisome?

Bed wetting may become a medical issue if your child continues to wet the bed during sleep after 7 years of age. This can be embarrassing or upsetting for children and parents alike. Your child may even experience anxiety, feel guilty and develop low self-esteem. Therefore, you need to work with your physician or a provider and take necessary steps that can help improve the condition.

Types of Bed Wetting

There are 2 types of bed wetting:

  • Primary bed wetting: Involuntary night-time urination without a break where your child has never had a dry night. 
  • Secondary bed wetting:  Onset of involuntary night-time urination where your child has started wetting the bed again after a dry period of at least six months. 

Risk Factors or Causes of Bed Wetting

Exact causes of bed wetting are not known, but various factors play a role. They include but are not limited to the following:

  • Gender (more common in boys)
  • Deep sleep or lengthy sleep 
  • Relatively smaller bladder size
  • Urinary tract infection (UTI)
  • Stress or anxiety, fear or insecurity
  • Excessive urine production at night 
  • Chronic constipation or bowel issues 
  • Over exhaustion / hyperactivity 
  • Family history (genetical factor)
  • Underlying medical problems
  • Hormone imbalance (like melatonin)
  • Sleep disorder (insomnia or apnea) 
  • Faulty urinary tract or system
  • Underdeveloped nervous system
  • Abnormalities in the spinal cord

Treatment of Bed Wetting

Typically, bed wetting is expected to go away on its own. However, treatment may become necessary if your child does not stop wetting the bed after 7 years of age. Certain remedial measures at home like behavioral therapy is known to significantly improve the condition and help teach your child not to wet the bed. 

Behavioral therapy mainly involves lifestyle changes such as:

  • Limiting intake of fluids well before their bedtime 
  • Avoiding salty snacks or sugary drinks during the evening
  • Making it a habit to urinate right before going to sleep
  • Encouraging regular toilet use all through the day

Additionally, parents need to follow the below tips for a better outcome:

  • Be sensitive to your child's feelings or emotions
  • Be honest and talk to your child about what is going on 
  • Never blame or punish your child as it is not premeditated  
  • Be positive, offer support and reward your child for dry nights

Basically, your child needs to know that their bed wetting is not his or her fault and is expected and accepted before it disappears on its own or with treatment.

If the results are not encouraging after trying behavioral therapies, your child may require the intervention of your physician or a provider for treatment. 

Depending on the severity of bed wetting, your healthcare provider may recommend any one or combination of the following.

Bed wetting alarm: This is a small, battery-operated device connected to your child’s pad or underwear. When your child urinates, the moisture-sensitive device vibrates, buzzes and sets off an alarm so the child can wake up to use the toilet.

Bladder training: This technique aims to increase intervals between your child’s bathroom visits and helps them become used to holding urine for a longer time. This aids in stretching and enlarging the bladder to allow it to hold more urine.

Medication: If none of the above is helping, your doctor may prescribe medications as a last resort.  These medications force the body to make less urine at night and eventually stop bed wetting. 

Note that medication may lead to certain side effects. Moreover, bed wetting will typically return once the medication is stopped making it a short-term option.

Your doctor is the ideal source for advice about treatment and the right person to decide on what works best for your child. With appropriate treatment and support, your child can look forward to dry nights in the bed.