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 the child urinates without meaning to.  Bedwetting at night is called nocturnal enuresis.  After age five, most children stay dry during the night. 

Nighttime bedwetting is fairly common.  At five years of age, one of every six children has this problem, but most children eventually outgrow it.  It is more common in boys than in girls.  If one or both parents wet the bed when they were young, there is a good chance their children will too.

Picture 1 - The bladder fills with urine from the kidneys and is released by the urethra when the bladder is full.
Image of urinary system

What Causes Enuresis

There may be several reasons for bedwetting:  your child’s bladder may be too small to hold as much urine as children who do not wet the bed; he may sleep too soundly or not being able to tell when his bladder is full; or during times of stress.  Very rarely bedwetting is caused by a physical problem or a disease.

The doctor may be able to find out why a child is wetting the bed, but in some cases the cause is not known.

If You Think Your Child Has Enuresis

If your child is 5 years old or older, make an appointment with his doctor.  The doctor will examine your child and ask you both some questions.  Be sure to let your child answer as many questions as he or she can.  It is important to include your child in the discussion and treatment plan.

The Treatment Plan

Depending on the reasons for enuresis, different treatment plans may be tried.  Some treatment plans may include medicine or urinary alarms.  The following plan is often used by doctors.  It seems to help most children who wet the bed at night.  (Be sure to follow the suggestions of your child's doctor in managing your child's bedwetting.)

  • Talk with your child and ask him if he wants to stop bedwetting.  If he does, tell him that you want to work with him to overcome the problem.
  • You may want to try limiting fluids after the evening meal.  This works for about 20% of children.  Don’t continue to limit fluids if there is no change after several weeks.
  • Make sure your child goes to the bathroom right before he goes to bed.
  • Wake your child 2 to 4 hours after he has gone to bed.  Help your child get up and go to the bathroom or set an alarm clock to waken him.  After he urinates, have him wait a few seconds and then try again to make sure the bladder is completely empty.
  • Every child likes to see how well he is doing on a project and everyone likes to be rewarded for success.  Each time your child has a dry night, praise him and give a reward (see The Rewards below).
  • When your child wets the bed, let him change his own sheets and pajamas, or let him help you change the bed.
  • Never tease or punish your child if he wets the bed.  Your child needs your patience and support during this time.

The Rewards

Picture 2 - Reward your child's successes.
Image of rewarding your child
  • Select a simple, affordable reward that your child enjoys (such as a penny, favorite TV show or sticker).
  • Use a calendar to keep track of the dry nights.  When your child has a dry night, let him mark the calendar.  Then give him the reward (Picture 2).
  • At first, give the reward every day he has a dry night.  After several dry nights, agree on a reward for a dry week, then a reward for 2 dry weeks.  After a few dry weeks, agree on a greater reward for a dry month.
  • Make sure you are consistent with the reward system, especially during the early months of the reward program.  For most children, after a while the dry nights will become a habit.

Follow-Up Care

Be sure to keep your follow-up appointments with your doctor.  The doctor will work with you to help your child overcome this problem.

How the Kidneys and Bladder Work

You can use this information to explain to your child (Picture 1, page 1).

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

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

Enuresis (Bedwetting) (PDF)

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