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Guide to Bedwetting

Ease your child's bedwetting angst and keep him dry all night long with these helpful tips and tools.
 

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You expect nighttime accidents when they’re toddlers. But it’s perfectly normal for grade-schoolers to have them, too. Though most kids will outgrow it by age 5, there’s no reason you and your child have to wait out the cycle of frustration and embarrassment (not to mention laundry). Read on for the tips and tools you need to keep your child dry all night long. Knowing what you’re dealing with can help ease the angst that often accompanies bedwetting. Here, the most important facts:

Bedwetting is not . . .

Intentional. Kids who wet the bed have no control over when it happens. On the nights a child stays dry, it’s usually because she’s sleeping less soundly — and therefore wakes up more easily when she needs to pee, says pediatric nephrologist Elizabeth C. Jackson, M.D., director of the Healthy Bladder Clinic at Cincinnati Children’s Hospital. It’s not because she’s being lazy or spiteful, says Dr. Jackson.

A bad sign. “The overwhelming majority of children who wet the bed don’t have an underlying medical problem,” assures Howard J. Bennett, M.D., author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting.

Bedwetting is . . .

Developmental. For your kid to stay dry at night, the muscles and nerves in his bladder need to be mature enough to either hold urine till morning or send a wake-up call to his brain. When he has nighttime accidents, it means his brain isn’t getting the message that his bladder is full. His brain and bladder will eventually get their signals straightened out; it just happens at different times for different kids. In fact, “most pediatricians don’t even label a child as having nocturnal enuresis — medspeak for bedwetting — until they’re 6 years old,” says Dr. Jackson.

Biological. A few things can increase a kid’s chance of soaked sheets. Simply being male is a factor — before age 13, boys have nighttime accidents twice as often as girls, according to a study in the Journal of Pediatrics. Meanwhile, some kids produce an excessive amount of urine at night, or their “gotta go” signal comes on too fast and strong, says Dr. Jackson. And for about 40 percent of bedwetters, heredity plays a role. Translation: If you did it as a child, your kid is more likely to do it, too.

4 Tips for Dry Nights:

You can treat bedwetting at any age, especially if it’s distressing your child. But if he’s over 6 and wets the bed frequently, it’s time to take action.

1. Bring on the love. Believe us, we know that wet sheets + wet child + 2 a.m. = huge annoyance. “Even the most well-meaning parents can find it hard not to show their disappointment,” says Dr. Jackson. But try hard not to give in to your frustration. “Belittling or punishing will only chip away at your child’s self-esteem, which can actually prolong bedwetting,” she says. “As with any other skill, your child may give up trying if there’s criticism or anger over something he can’t control.” Instead, counter accidents with something uplifting, like “I know you’re bummed, but we’ll try again for dry sheets tomorrow night.” Also keep reminding him that he’s not alone. If you suffered, share your experiences again and again!

2. See the doctor. Think of your pediatrician as your partner in Operation Dry Nights. Along with giving you and your child a dose of reassurance, the doctor can rule out physical conditions that interfere with bladder control, including urinary tract infections and, in particular, constipation. “The rectum is situated behind the bladder, so if a child is storing poop in there, the pressure makes it harder to hold urine in, especially at night,” Dr. Bennett explains.

The problem is so common that a recent study of bedwetters found that every participant had retained stool. Within three months of treatment with laxatives or enemas, 83 percent of the bedwetters were accident-free, says Steve J. Hodges, M.D., lead author of the study. While your doctor won’t necessarily recommend you go that route, it can’t hurt to gradually work more fiber into your kiddo’s diet.

Doctors can help in another important way: a backup plan. Certain medications can stop the flow short-term for, say, a sleepover or summer camp. They don’t work for every kid, but they’re worth asking about.

3. Offer more fluids. “I always tell the kids I treat, ‘If you don’t pay attention to your bladder when you’re awake, your brain won’t pay attention to it at night,’” says Dr. Bennett. In other words: Kids should drink up, since the more they pee during the day, the better in tune they’ll be with the signal that it’s time to go.

4. Try an alarm. For 7- to 12-year-olds, a wearable alarm that goes off when it detects urine in the underpants can help, since the first step to staying dry is waking up, Dr. Bennett explains. Indeed, a review in the Canadian Medical Association Journal found that over 10 weeks, 66 percent of kids over age 5 who wore an alarm managed to stay dry for a two-week period — compared with 4 percent of kids who slept without. Though alarms cost $50 to $150, they’re an investment that may finally bring dry and happy mornings.

4 Helpful Products to Stock Up On:

Pull-ups: Big-kid diapers are a great way to keep sheets dry, says Dr. Jackson. Try skipping them for a week every three months. “Some kids are able to become dry when they stop, perhaps because they can better sense the wetness.”

Mattress Cover: “Cheap ones can leak, so consider one from a medical supply company,” says Dr. Bennett.

Washable Pads: Put the pad on top of the mattress cover. That way, you can strip it off (along with the fitted sheet) in the middle of the night.

Urine Neutralizer: Natural enzyme products (available at pool stores) remove urine odor. Toss ¼ cup in the washer with bedding on the short cycle, then follow with a regular cycle using detergent.

Strategies you can skip:

  • Waking your kid up in the middle of the night to pee
  • Banning liquids after dinner

Neither of these commonly touted “techniques” does anything to teach your child how to stay dry. Plus, limiting fluids can actually make the situation worse, by reducing the amount of urine that your child’s bladder can hold.

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