Bedwetting and Incontinence – Why Do Children Wet The Bed?
Children wet the bed when their body is unable to hold pee. Inability to hold urine is called urinary incontinence, enuresis, or commonly known as bedwetting. Wetting the bed during the night is called nocturnal enuresis. Boys under age 6 and girls under age 5 may wet the bed overnight because they are still developing bladder control. Occasional accidents are common for small children. Child bedwetting and incontinence does not mean that toilet training has failed. Children who have never achieved bladder control at night have primary nocturnal enuresis. Children who stayed dry at night for at least 6 months before wetting the bed have secondary nocturnal enuresis.
Bedwetting is not under the child’s conscious control and is not done on purpose. Nocturnal enuresis typically goes away on its own as the child grows older. Parents should not hesitate to consult with the pediatrician about bed wetting to find the solution that works best for their child. Children in their late teen years or who started wetting the bed after staying dry for long periods should be carefully evaluated to rule out possible physical or mental health problems.
Common Causes & Risk Factors
It is not uncommon for children to start wetting the bed as they struggle to deal with stressful events such as divorce, changing schools or losing a loved one. Bedwetting can be caused by any type of stress. Deep sleepers are less able to awaken from sleep in response to a full bladder. Children are also more likely to wet the bed if one or both parents has a history of nocturnal enuresis.
Overactive bladder is a common cause of bed wetting in preschool children. Symptoms of an overactive bladder include urinating more frequently than usual, rushing to the bathroom, and daytime incontinence. Pediatric sleep apnea is often due to large tonsils and adenoids, and parents may notice that the child snores loudly overnight. Sleep apnea causes increased urine production during the night and can cause nocturnal enuresis. Constipation can cause bedwetting due to pressure on the bladder from an enlarged bowel. Excessive urine production during the night from kidney disease or hormone imbalance can also lead to nocturnal enuresis.
Talking with your Doctor about Children Incontinence and Bedwetting
Parents should let the pediatrician know about bed wetting after age 7, enuresis after long periods of staying dry. The pediatrician will ask about the child’s medical history and urinary symptoms. A urine sample may be collected to check for a bladder infection or kidney disease.
Important symptoms to report:
- Pain or burning with urination
- Unusual thirst and excessive urination
- Significant weight gain or loss
- Dark, cloudy, discolored or foul-smelling urine
- Loud snoring with daytime sleepiness
- Numbness, tingling and pain in the legs
Helpful information includes:
- Frequency of bedwetting episodes
- Daytime urination patterns
- Daily fluid intake, especially afternoon/evening
- Psychosocial concerns
Protecting the child’s feelings – Being Aware Of Social Situations
Bedwetting can make children feel embarrassed and anxious. This can lead to low self-esteem and quality of life. Schoolwork and friendships may be affected. Children cannot control bedwetting and nighttime incontinence is not their fault. Parents should maintain a caring, patient attitude rather than shaming or punishing the child. This will help to instill confidence and motivate the child to remain optimistic about nighttime dryness. Parents can encourage older children to help clean up and assist with laundry. This will help them to take responsibility with a feeling of empowerment.
Preventing Your Child from Bedwetting – Tips & Treatment Options
Basic interventions that can help prevent bedwetting or incontinence:
- Eat a healthy diet to prevent constipation
- Avoid caffeine, carbonated drinks, and citrus juices
- Increase fluid intake during the day
- Scheduled bathroom use every few hours during the day
- Limit fluid intake after school, in the evening, and before bed
- Use the bathroom twice before going to bed
- Nightlights in the bathroom and hallway
Parents may wake the child once during the night to urinate. A diary may be used to track wet and dry nights to determine which interventions are helpful. Regularly scheduled bathroom trips timed at increasing intervals will help the child’s bladder become used to holding urine for longer periods of time. Counseling may be beneficial for children who are struggling with stress and anxiety. Medications may be used for older children to treat bedwetting caused by bladder infection, kidney disease or hormone imbalances..
Disposable incontinence underwear can help children sleep comfortably through the night. Protective creams may be needed to prevent skin breakdown. A waterproof incontinence mattress or mattress cover is extremely helpful for easy morning clean up, odor prevention, and to keep the mattress sanitary and free from germs and mold.
References
American Academy of Pediatrics (2019). Bedwetting in children & teens: Nocturnal enuresis. Retrieved from
Children’s Hospital of Philadelphia. (2021). Bed-wetting (Nocturnal enuresis). Retrieved from
https://www.chop.edu/conditions-diseases/bedwetting-nocturnal-enuresis
Mayo Clinic. (2017). Bed-wetting. Retrieved from https://www.mayoclinic.org/diseases-conditions/bed-wetting/symptoms-causes/syc-20366685
National Kidney Foundation. (2021). Questions kids ask about bed-wetting. Retrieved from https://www.kidney.org/patients/bw/BW_faq
National Kidney Foundation. (2021). Secondary nocturnal enuresis. Retrieved from https://www.kidney.org/patients/bw/BWbedwetSecondary
University of Rochester Medical Center. (2021). Urinary incontinence (Enuresis) in children. Retrieved from https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=90&contentid=p03083
Virtual Medical Centre. (2012). Impact of bed wetting. Retrieved from https://www.myvmc.com/lifestyles/impact-of-bed-wetting/#:~:text=A%20Hong%20Kong%20study%20looking,didn’t%20wet%20the%20bed.
WebMD. (2020). Enuresis in children. Retrieved from
https://www.webmd.com/mental-health/enuresis#1
WebMD. (2020). Helping your bedwetting child maintain self-esteem. Retrieved from https://www.webmd.com/parenting/bedwetting-self-esteem#1
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