Enuresis :: Nationwide Children's Hospital

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Enuresis (Bedwetting)

Enuresis (en yur EE sis) is the medical term for wetting the bed. It means a child urinates without meaning to. Bedwetting at night is called nocturnal enuresis.  Nocturnal enuresis does not mean there is a medical problem.   Children do not wet the bed on purpose. Bedwetting is not a behavioral problem. No one can control what happens when sound asleep. Some children have daytime bladder issues that can contribute to problems during the night. 

Nighttime bedwetting is fairly common. About 15 per cent of all 5-year- olds, 7 per cent of all 8-year-olds, and 3 per cent of 12-year-olds wet the bed. About 99 per cent of children who wet the bed will outgrow it by the time they are 15 years old. Children with ADHD may outgrow bed wetting later than their peers.

What Causes Enuresis

Image of urinary system

The exact cause of nocturnal enuresis
is still unknown. Some similarities seen
in children with bedwetting are:

  • difficulties waking from sleep
  • slower development of the central nervous system which can allow the bladder to empty at night
  • kidneys that produce more urine when they are asleep
  • having relatives who wet the bed growing up. 

If You Think Your Child Has Enuresis

If your child is 8 or 9 years of age and continues to have nighttime wetting, make an appointment with his primary care provider.

The Treatment Plan

Nocturnal enuresis is not a medical problem. Treatment usually means helping a child to form habits that will allow him to control his need to urinate. Here are some things you can do to help:

  • Limit fluids 2 hours before bedtime
  • Make sure your child goes to the bathroom right before he goes to bed
  • Avoid caffeine
  • Never punish your child for wetting the bed. A child needs assurance that bed wetting is normal. It is not because he has done anything “bad” or wrong.
  • After a certain age, medicine can sometimes be prescribed to help a child make less urine overnight. This does NOT cure bedwetting. Talk to your doctor to see if this medicine might help your child. 

Bedwetting Alarm

At about 9 or 10 years of age, we suggest using a bedwetting alarm. The alarm consists of a clip-on sensor that attaches to the child’s underwear. The alarm is triggered by moisture. It sounds a loud alarm or a vibration to the body in an attempt to wake the child to get up and urinate. The bedwetting alarm slowly teaches the brain to respond to messages from the bladder that come during sleep. In the beginning, parents may need to help their child wake up when the alarm sounds.

Here are some resources for buying a bedwetting alarm:

The Bedwetting Store - http://bedwettingstore.com/Bedwetting_Alarms/malem_bedwetting_alarm.htm

PottyMD - http://www.pottymd.com/

Palco Labs - http://www.quickmedical.com/Pediatric/wet_stop.html

Follow-Up Care

Nocturnal enuresis can be hard to treat. Praise your child because he is trying to be dry, not just because of dry nights. If your child begins having problems with day time wetting, please discuss these issues with his doctor. 

How the Kidneys and Bladder Work

You can use this information along with Picture 1, page 1 to explain to your child:

  1. Blood flows through the kidneys.
  2. The kidneys filter the blood to make it clean.
  3. The waste products and water that the body does not need go into the bladder. This is urine.
  4. When the bladder gets filled with urine, signals are sent to the brain. Then the child feels the need to go to the bathroom while awake.

Recommended Reading

Seven Steps to Nighttime Dryness: A Practical Guide for Parents of Children with Bedwetting (Paperback) by Renee Mercer

Waking Up Dry: A Guide to Help Children Overcome Bedwetting (Paperback) by Howard J. Bennett, MD, FAAP

No More Bedwetting: How to Help Your Child Stay Dry (Paperback) by Samuel J. Arnold

 

HH-I-34 Enuresis (Bedwetting) (PDF) 2/80, Revised 12/15  Copyright 1980, Nationwide Children’s Hospital 

 

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