Bed Wetting
Why is my child still wetting the bed?
Bedwetting is far more common than many parents realise. In this post, we explore the developmental and genetic factors behind bedwetting, when to seek support, and how to protect a child’s confidence while managing night-time accidents. This is not usually a behavioural issue.
Bed wetting is far more common than you might think. So if your school-age child still wets their bed, they are not alone!
Did you know?
20% of 5-year-olds wet the bed
10% of 7-year-olds wet the bed
1 in 75 teenagers wet the bed.
Girls tend to be dry at night sooner than boys, but this isn’t always the case!
There are two types of bed wetting
- Bed wetting when a child has never been dry at night. [Primary enuresis]
- Bed wetting when a child was dry at night and then started to wet the bed again. [Secondary enuresis]
The biology of bed wetting
During sleep, just as during the day, the brain receives a signal that the bladder is full. For many children, it’s not until they are older that their nighttime brain receives this signal.
Our bodies naturally produce a special hormone called vasopressin or antidiuretic hormone. This hormone reduces urine production at night. Vasopressin production starts in infancy but some children produce it at a later age than others.
If your child is still producing a lot of wee during the night especially if it is very dilute, then it’s highly likely that their vasopressin production hasn’t yet kicked in.
Some children have very small or “sensitive” bladders. They might have accidents during the day as well as wetting the bed at night.
Constipation can cause bladder problems and bed wetting. This is due to the enlarged bowel pressing on the bladder and reducing its size and ability to expand. Constipation is often the cause of both primary and secondary enuresis.
A urinary tract infection [UTI] can also cause bed wetting.
Emotional factors
Bed wetting is mostly caused by physical or developmental factors, but sometimes stress or anxiety can play a part. This is often the case in secondary eneuresis. Things like starting school, a new baby arriving or parents splitting up can cause a previously dry child to start wetting the bed again.
Anxiety can affect the production of vasopressin, meaning that an anxious child produces too much urine at night.
If your child has got a lot going on in their life and has started to wet their bed, it is likely that the cause is emotional and with time and your understanding approach, it will pass.
But it’s also important to seek medical advice, to rule out causes such as constipation, UTI or diabetes.
Important things to remember:
• Your child doesn’t wet the bed on purpose. They are not being naughty or lazy.
• If your child is late achieving nighttime dryness, it’s is not your fault! Some parents think they’ve left it too late/introduced too many changes in their child’s life/ been too relaxed etc. None of these things have caused your child to wet their bed.
• Having dry beds is a developmental milestone that like all the others, children reach at different times.
• Wetting the bed again when they were once dry may be down to emotional factors but it’s important to rule out physical causes.
How to help - Daytime
Give your child all they need for a healthy bladder and bowel!
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- • Encourage them to drink enough during the day [6-8 glasses.] The bladder needs the exercise of filling up and emptying out!
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- • Avoid fizzy or caffeine-rich drinks which can irritate the bladder.
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- • If they are at school, about half of their liquid intake will happen there, so it is really important that they refill their water flask. Ask your child’s teacher or TA to keep an eye on this.
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- • For good bowel health, give them a diet rich in fibre, plenty to drink and plenty of exercise.
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- • Restricting daytime fluids can cause the bladder to be less efficient so don’t go down this route!
- • Talk openly to your child about their wet beds. Reassure them that it’s ok and that lots of other children of their age wet the bed.
- • Explain that when they are older, they will grow out of it.
- • Let them know you’re on their side. Help them but don’t put pressure on them.
At bedtime
• An hour before bedtime discourage them from drinking.
• Have a calming and familiar bedtime routine.
• Use the toilet just before getting into bed.
• Use waterproof bed protection and have spare bedding to hand.
• Leave a soft [red] light on and if the toilet is not easily accessible or if they are scared at night, have a potty or wee bucket in their room.
• Many parents choose to lift their children and put them on the toilet later in the evening when they are asleep. Nowadays this isn’t considered to be a good idea, as the child doesn’t learn about bladder control, and it just teaches them to wee in their sleep.
• From a sleep point of view, it is not good to disrupt that very special and precious deep sleep that happens at the start of the night either. There is also the risk that rousing a child out of deep sleep can cause distress and confusion.
If they wet their bed
• Let them know it’s okay, it’s not their fault and you’re not cross.
• Encourage them to go to the toilet to see if they have any more wee left.
• Change the bedding with as little disruption as possible. Then re-settle them to sleep.
• If they manage a dry night, praise them gently but don’t overdo it! They might feel they’ve let you down if they wet their bed next time.
• Don’t use a reward chart. Night-time dryness is not something that is entirely within their control.
• But you can praise them for doing their best – and the things that they have done to help themselves. For example – “You waited until morning to have a drink!” “You went to the toilet when I asked you to!” etc.
When to get professional help
If they are still regularly wetting their bed after the age of 5, or if they were dry for at least 6 months and have started wetting again, talk to your GP or school about getting a referral to a bed wetting clinic.
In the UK, these clinics will usually only see children over the age of 5.
The bed wetting clinics offer both assessment and treatment, often with a bedwetting alarm or medication. They also offer advice about sleepovers, school trips etc.
The important message here is that even if bed wetting goes on for a long time, children do achieve dry beds in the end. Until that happens, neither they nor you should feel embarrassed or ashamed. ♥
Further help
If you’re struggling with your child’s sleep either now or in the future, I am here to help you.
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They are available in all formats from Amazon and other booksellers.
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