Bedwetting

Bedwetting is common.

By the age of five, the majority of children will be dry at night.

But some won’t be.

Those that haven’t reached the milestone of consistently dry nights are said to be experiencing primary nocturnal enuresis. Children who revert to bedwetting after being dry for a significant period of time (greater than 6 months) are said to be experiencing secondary nocturnal enuresis.

It’s likely that up to 20% of five-year-olds, and somewhere around 1 in 6 children between the ages of 4 and 12, experience bedwetting. It’s common, it can be a struggle for parents to deal with and it can be an embarrassment. But, it’s important to remember that achieving a dry night is just a development milestone, and like all the other milestones for children, every child has their own timeline for achieving them.

(If either of a child’s parents were slow to achieve this milestone, it is quite likely the child will have the same experience.)

A child who bed-wets is not being lazy, wilful or naughty, because they wet the bed when they are asleep. The child doesn’t want to wet the bed (which is why offering rewards for a dry night is a mostly ineffective strategy – the child already wants to be dry).

A child’s inability to hold urine for an entire night is likely due to one or a combination of:

• the child not being able to wake when their bladder is full (the connection between their brain and bladder not being fully developed);
• the child producing a large amount of urine during evening hours and at night or having a small functioning bladder capacity;
• the child’s pituitary gland not producing quite enough anti-diuretic hormone; or
• the child having poor daytime toilet habits (like ignoring or postponing the need to urinate).

There is almost never an underlying medical issue with primary nocturnal enuresis. In fact, an underlying condition is identified in about 1% of children who routinely wet the bed. (Secondary nocturnal enuresis can be an indication of an underlying medical or emotional problem so advice from a professional may be advisable.)

The options for a parent to influence bedwetting are limited to restricting fluid intake a few hours before bed, ensuring the child’s bladder and bowels are empty at bedtime, and using a plastic sheet to protect the mattress. (Lifting a child during the night may be counter-productive as the child’s bladder may not be full and they don’t get the opportunity to learn to respond to the sensation of a full bladder.)  Other more invasive options include bedwetting alarms and medications.

Bedwetting can be an emotional and frustrating experience for all concerned. It’s important to remain cool, calm and patient during this stage.

Your child will grow out of it.