Bedwetting amongst kids 5 years and up is oftentimes a difficult issue to tackle at home. Should you worry? Should you leave it alone? We’ll help answer your questions. Read on.
The Familiar Story Of Sue, A Parent Just Like You
Sue loves being a mom!
Of course, she’s always the first one to say that it’s never easy and she’s had her fair share of difficult moments; but overall, she’s never felt as complete or as fulfilled.
Sue could honestly say that one of the happiest day of her life was when she and her husband, Paul, welcomed their son Liam. Both Sue and Paul weren’t prepared for the exhaustion of it all, but they took everything in stride and Liam soon grew up to become a happy, well-adjusted toddler.
Little Liam met all his milestones at the right age and aside from the occasional harmless bump on the forehead or a stuffy nose, he never had any health issues more serious than a fever for a day or two.
Sue was so proud during Liam’s first day at pre-K. She baked him a cupcake and Paul took the morning off from work so they could both be around for his first day.
Fast forward to the present, Liam is just a couple weeks’ shy from his 5th birthday.
An active, sociable boy who’s crazy about trucks, books and dinosaurs, there is now one thing that his parents are beginning to worry about.
Sue noticed that for an average of 3 or 4 nights a week, Liam still wets his bed.
He’s outgrown diapers, he was properly toilet-trained and he seems to have no problem running to the bathroom to pee during daytime, it was only at night time that he seems to be having issues with.
Sue and Paul are understandably concerned. Also, it’s no fun changing sheets and drying out Liam’s bed in the mornings or being woken by a wet, crying, embarrassed Liam in the middle of the night. They’re now considering buying a second mattress for Liam so they could wash his other mattress more thoroughly.
They are also both worried about Liam’s self-esteem? What if he sleeps over at his aunt’s house (which they are thinking of allowing him to do to spend time with his cousins) and he wets the bed?
What should Sue do? At the moment, she is at a loss for because she’s tried every home remedy she could think of.
Sue is now actively looking for other solutions and she will soon schedule a visit with Liam’s doctor.
What Sue may not know is that many other parents and several children Liam’s age (some a bit older) are dealing with bedwetting challenges.
If you’re a mom just like Sue, then you should know that you are not alone. In fact, a quick 10-second Google search about bedwetting among children will show you considerable results with varied tips and advice but sometimes, the articles you find just aren’t as comprehensive or as complete as you’d want them to.
That’s why we’ve writing this evidence-based guide on bedwetting. We’ve compiled as much information as possible including causes, tips and warning signs of bedwetting with the aim of giving you a deeper and clearer understanding of how to handle bedwetting in children.
By the end of this article, you should be able to take away the following points:
To set the stage and give bedwetting a bit more perspective, let’s begin with the facts:
What Is Bedwetting?
Bedwetting, also known as Nocturnal Enuresis, is the involuntary nighttime urination that affects both children and adults. For the purpose of this article, however, we will only discuss bedwetting in children.
It is a common bladder problem especially in children ages 5 to 7 years old. Day time wetting may also happen.
Bedwetting is also divided into two types:
Primary Bedwetting – refers to ongoing bedwetting since early childhood. In other words, the child has not had a dry night for at least 6 months.
Secondary Bedwetting – when a child has achieved control over their bladder during nighttime for more than 6 months but then experiences a relapse due to possible stressful life changes or medical reasons
By comparison, while Primary Bedwetting is still a cause of concern for many parents, research shows that parents whose children experience Secondary Bedwetting might feel more alarmed especially after long periods without a single nighttime bedwetting episode.
Why does bedwetting happen?
Bedwetting occurs because young children have not yet achieved full bladder control especially when they are deep asleep. This is simply because their bodies aren’t physiologically mature enough to send signals to their brain and wake them up in time for them to quickly head to the bathroom.
Urine control is actually a complex process and takes a bit of time to learn. While infants seem to pee every 2 to 3 hours, as soon as they grow into toddlerhood, their bodies begin to produce a substance that stimulates urine production called the Antidiuretic Hormone or ADH. The ADH in our body is what signals our brain to go do the No. 1 in the bathroom. Experts say that children who wet their beds may not yet be producing enough ADH and therefore, may not yet be attuned to their bodies’ signals to head to the toilet.
It’s also good to remember that bladder control at night is part of the last stages of potty training. This means that even when a child has been successfully potty trained and has no issues urinating during the daytime, they can still experience bedwetting episodes at night.
Learning to pee while you’re deeply asleep is quite challenging for children and requires lots of time and patience from parents and caregivers.
That said, it’s perfectly natural for children between the ages of 5 to 7 to have episodes of bedwetting. One or two episodes isn’t a cause for worry and is typically not considered a problem as it is a part of the natural course of a child’s development.
By the age of 7+ years, children will have usually outgrown bedwetting.
When is bedwetting considered a problem?
- If your child is over 7 years old and is still having bedwetting episodes.
- If you suspect your child has an underlying medical condition such as a urinary tract infection.
- If your child has recurring episodes of bedwetting after several months of being “dry” at night.
- If your child is also having “wetting accidents” during daytime; especially at school or in public places.
Should your child be experiencing any of the above, it’s best to consult your pediatrician or you can ask for an evaluation from a pediatric urologist.
To wrap up this section, a word to parents:
We just want to let you know that if your child wets his bed, it’s definitely not a sign of bad parenting nor is it a reflection of how you are as a parent.
It’s normal for parents to question their individual parenting choices. In fact, it’s a sign of amazing parenting when you take a step back and ask yourself – am I being a good parent? But your child wetting the bed isn’t a gauge for “good parent” or “bad parent”.
On that note, young children aren’t also being “bad” or “lazy” when they wet their bed and shouldn’t be called so. As mentioned above, their bodies are still growing, developing and they are still learning how to do certain bodily functions properly.
To help illustrate just how common bedwetting is among children, let’s have a look at the numbers:
- An estimated 13-20% of 5-year-olds, 10% of 7-year-olds, and 5% of 10-year-olds still wet their beds.
- 10% of the U.S. population of children wet their beds frequently. To further put a figure on it, that’s between 5 to 7 million American children.
- Of children that experience bedwetting, approximately three quarters show primary bedwetting symptoms. The rest exhibit secondary bedwetting symptoms.
To sum it up, the top spot in the statistics of children wetting their beds is taken by 5 year olds. This means that as children grow older, the occurrence of bedwetting happens less and less.
As bedwetting is experienced by millions of children in America, then it only tells us that many families have successfully dealt with it. It also means that doctors and medical experts have effective treatments to help parents overcome any bedwetting issues.
Who Is More Prone To Bedwetting?
It’s important to understand and recognize if your child is more prone to bedwetting. It will give you ideas for possible treatment or simply give you that reassuring “a-ha” moment and realize that you don’t actually need to be too worried:
- Genetics. This means that if you or your spouse (or both) have a family history of bedwetting, then it’s most likely to happen to your child, as well.
The positive thing about having someone close to you experience something similar is that you have a go-to person to ask for advice or just have someone close and comfortable to talk to.
- Compared with girls, boys are most likely to wet their beds. According to a recent study, in “more than 6,000 children, researchers found that about seven out of 100 boys and three out of 100 girls wet their beds at least once a month.” The study concluded that the reason for this is that girls mature faster than boys, hence, boys may also a bit delayed in their physiological functions, as well.
- Deep sleeper. Studies show that sleeping and bedwetting are related. However, we’re not going to go into that in detail because that is going to be another entire article’s worth of information, as well. To keep it short and simple, we’ll again reiterate that young children’s bodies are not mature enough to control their bladder especially when asleep. This immaturity in their bodily functions coupled with deep sleep will then result in bedwetting as their brains do not get the signals in time for them to urinate. You can learn more about the connection between deep sleep and bedwetting here.
- Snoring and Sleep Apnea. Does your child snore and also wet the bed? You may want to check in with your pediatrician to see if your child has sleep apnea. Since sleep apnea causes breathing difficulties, the brain then focuses more on making sure oxygen is properly distributed to the rest of the body and signals to the brain for other bodily functions like urination may take a back seat. As a result, children with sleep apnea will also more likely wet the bed.
- Special needs. Children with special needs and developmental delays have a bit more complex issues with certain bodily functions and may have more unique challenges with bedwetting, as well. They will usually require assistance from a caregiver or may need therapy. Some children with special needs may not learn how to control their bladder until they reach their teen years or well into adulthood. Children diagnosed with ADD or ADHD are also prone to bedwetting which experts find is due to the delayed development of their central nervous system.
- Stressful life changes. A new baby sibling, a recent divorce, moving to a new house… these life changes can cause stress and anxiety in children. A recent study published in the Journal of Pediatrics and Child Health showed that emotional problems were linked to bedwetting in children over 10 years of age. However, it’s not the stressful situation that directly causes bedwetting but changes in a child’s routines and behavior can lead to bedwetting. They may forget their bedtime routines such as going to the bathroom before bed. Just like adults, children can also become prone to stress eating – which can mean more soda, chocolate or eating salty chips. Coupled with stress and sleeping problems, this can result into nighttime (or daytime) bedwetting.
- Medical conditions. Urinary Tract Infection, Diabetes and Chronic Constipation sometimes cause bedwetting. If your child is over 7 years old and still wetting their bed, you may want to check with your doctor if your son has any of these medical issues for proper treatment.
- Structural issues in the urinary tract or nervous system. This can happen very rarely but, through laboratory testing, doctors might be able to diagnose any structural problems within the urinary tract and in the nervous system that can possibly cause bedwetting.
As mentioned in the above sections, if your child is younger than 7 years old and has had a few bedwetting episodes, there is no real cause for worry as their bodies will soon develop and the link between the bladder and the brain will soon mature. They’ll be just fine.
But if your child is older than 7 or you feel that your child has other underlying symptoms like pain or day wetting, it’s time to consult a physician.
Other than medical consultation, though, there are treatments available and home solutions that can help you train your child to wake up at night time and head to the bathroom. Jump over to the next section to find out.
Before diving straight into the “meat” of this section, let’s talk about a few basic points relating to potty training, in general. This is especially helpful for new, first-time parents or may serve as gentle reminders for parents potty training their 2nd or 3rd child:
- Potty training takes time. It can take up around 3 to 6 months for most children, and a bit longer for others. This depends on lots of factors. The most common one being gender; girls tend to develop and mature faster, hence they’re quicker to potty train while boys need to catch up a bit.
- Please note that if your child is diagnosed with developmental delays or was born premature, they may not follow the same developmental curve as full-term babies. it’s best to consult your doctor to find out what is the appropriate age to begin potty training preemies or children with special needs.
- Aside from time, potty training needs patience – a LOT of patience. Why? Because it needs a lot of teamwork between you and your child. Luckily several tools and resources are available for both parents and children to refer to during the potty training years such as books, toys, and videos. We also have great articles for you, too! Click here and here for some potty training basics from the Kinacle team.
The Potty Timeline
The below is a general potty training timeline for most children aged 2 to 5 years old:
- Around the age of 2 to 2.5 years old, most parents would now be potty training their child. Scientific evidence shows that girls mature earlier than boys, as a result, girls can then be potty trained right around 2 years old while boys usually start a bit later, at 2.5 years old.
- By the age of about 3 to 3.5 years old, children will most likely be experts in heading to the toilet and doing the No. 1 or No. 2 in their potties. Around this age, parents will also start gradually teaching them to do their thing while seated on the “grown up” toilet seat.
- By the age of 4 to 5 years old, children will then be old enough sit on the toilet seat themselves and clean up after themselves, too.
- At night, 2.5 to 3.5 year olds (sometimes even as old as 4 years old), still wear pull-ups as these ages are normally too young for parents to teach their child to wake up in the middle of a deep sleep to go potty.
- After 4 years old, children are usually now uncomfortable or a bit too old to be wearing pull-ups to sleep and should be able to wake up to head to the bathroom.
Quick Myth Busting:
The general assumption is that if a child is old enough to ditch diapers then they are also old enough to wake up from deep sleep and head to the bathroom.
That isn’t actually true. Children younger than 5 years old still need help in going potty at nights and you should still expect to be woken up some nights by a crying, wet child because they can’t seem to control themselves yet. As we have mentioned in the above sections, this is simply because the signals in the body responsible for alerting the brain to get up and urinate while they are deep in slumber isn’t developed enough.
So, a fully daytime potty-trained, un-diapered child below 5 years old may still have bedwetting episodes. It’s important, however, to begin nighttime potty training at around 4 years old. This will ensure dry (and peaceful) nights soon after your child’s 5th birthday.
Tips To Avoid Bedwetting
Let’s start off with bedwetting-avoidance tips for children ages 3.5 to 5 years old:
- Watch your child’s diet. Look out for bladder irritants in your child’s diet and ensure they eat less of it, especially a few hours before bedtime. Some commonly known bladder irritants include cocoa, chocolate milk, citrus drinks, food with artificial flavorings, food with red dyes (strawberry drink or cherry-flavored sweets), and food or drink with artificial sweeteners. Also be careful with salty food as this can only be dispelled by the body through urine and it makes your child extra thirsty, too which then makes them drink more liquids and… You guessed it! This will then make them pee more, as well.
- Monitor your child’s liquid intake during the day. If your child goes to daycare or preschool, it’s a good idea to have them take a water bottle that they can take sips from during their active day. This helps make them less thirsty when they come home from school. And again, as mentioned from the first bullet point, when giving younger children after-school snacks, make sure to eliminate any bladder irritants to minimize any urges to drink lots of liquids before bedtime.
- Don’t overdo liquids during bedtime. Almost every parent of a 4-year-old goes through “Mom, Dad, can I have a glass of water?” just when you’ve get them all tucked up in their PJ’s, bedtime book returned to the shelf and everyone’s ready for bed. It’s a normal part of childhood, and they will soon get over it. But, should they ask for water, keep it to a minimum. While water is healthy for children, you don’t want them to sleep with a full bladder and end up wetting the bed. Two to three sips would do if your child ask for a before-bedtime glass of water.
- Schedule bathroom breaks. Parents who are potty training toddlers may already have a set schedule for bathroom breaks. Some parents, however, may stop scheduled potty time as soon as their child goes over the age of 3 thinking that they are now “old enough”, especially for little girls. But to avoid bedwetting (and day wetting, as well), it’s still important to keep up the scheduling. If you’re already doing an every 3 to 4 hours’ bathroom schedule, that will work just fine. The more children stick to a consistent bathroom schedule, the better they will be to stay dry at night.
- Set a reward system. Many experts support reward systems at home for parents potty training their children as these are proven to be effective. As your toddler grows a bit older, nighttime bladder control is still part of the final stages of potty training and reward systems are recommended at this age, too; most especially if they have bedwetting episodes a few times in a month. This time, however, you can change the reward system to giving star stickers if they achieve only one (or none at all) dry night per month. Keeping a “Dry Diary” is also a reward in itself. You and your child can keep track of dry nights and they’ll feel a sense of great accomplishment if they can track and compare their progress.
- Check with your doctor. Even if your child is below 5 years old and bedwetting isn’t considered too much of an issue at this age, it’s still best to have a chat with your doctor about your child’s potty habits. They might want to do an evaluation and check if everything is going just fine. As mentioned in the above sections, you’ll want to rule out any underlying medical conditions that result in bedwetting as a symptom.
- Always remain calm, use kind words, exercise empathy and BE PATIENT. Children below 5 years old are still learning all about how their bodies work. Even beyond potty training, patience and empathy is necessary. It isn’t easy being 5 in a great big world full of grownups who expect young children to suddenly become “big kids”.
Just like Sue in our introductory story above, as soon as your child hits their 5th year of life, you begin to have certain expectations around potty training and it may cause you to worry if they are still wetting their bed, even if they successfully go potty during daytime.
Most of the above suggestions for below-5’s is applicable to the above-5’s, such as:
- Watching their diet and liquid intake
- Scheduling bathroom breaks during the daytime
- Setting and continuing to use a reward system
- Consult with a doctor to verify any underlying medical conditions
- Extend compassion and empathy during any nighttime bedwetting episodes
Per the above statistics section of this article, the percentage of children who wet their beds beyond the age of 7 years old rapidly decreases, however, if your child is more than 6 years old and is still having bedwetting episodes, here are a few more few additional tips to help treat and prevent bedwetting:
- Try a bedwetting alarm. Highly recommended by pediatric urologists, a bedwetting alarm is a device attached to your child’s pajamas that buzzes as soon as it detects the first sign of moisture which then wakes the child with enough time to run to the bathroom and continue urinating. However, for the bedwetting alarm to be effective, it must be used properly and with guidance. You can buy a bedwetting as a home treatment for your child but it’s best to consult a health expert before using it.
- Take a step back and recognize if there are any life changes that may cause your child to wet the bed. This was briefly mentioned above in the section “Who Is More Prone To Bedwetting?” and we will reiterate it here again – if your child is going through life changes that might cause them a change in their routines, diet or bedtime hours, this may be an underlying cause of bedwetting. If there is nothing significant going on at home, you may want to check with their teacher at school, or you can ask your child directly. At 5+ years old, they should be able to communicate anything that might be bothering them. As always, listen with compassion and guide them through it. Sometimes, helping children resolve emotional issues will help resolve bedwetting, as well.
- Older children have more active, fuller days which may be a bit difficult to manage but bedtime can still be controlled. Sometimes, to beat bedwetting, you just need to make sure your kids aren’t overtired when they come home from school or from any other activity. Studies show that simpler lifestyles usually work well for children and help keep them relaxed and less-stressed. Having your child relax before bedtime with quiet, winding-down activities and then having them head to the toilet to fully empty their bladders before lights off may be a solution to a seemingly complicated problem.
- Reducing screen time and games/gadgets. Too much screen time and uncontrolled games may disrupt your child’s routines and may not have them hydrate throughout the day, have less active bodies and they may not go to the bathroom before bed. If this isn’t properly controlled, then they may possibly wet the bed. Curbing children’s screen time may just be the ticket to treating bedwetting.
- Medication. Medicine to help over-5 children have dryer nights and treat bedwetting is available should your doctor find it necessary to write down a prescription. However, there is no known medication that magically “cures” bedwetting. Over time and training, children will outgrow bedwetting and their bodies will be mature enough to wake up to pee while they sleep at night.
- Get enough sleep. Getting 8 to 12 hours of sleep at night helps children maintain good bodily functions and generally make them physically and emotionally healthy. Afternoon naps coupled with good night’s sleep every night is proven to help prevent bedwetting.
- Self-motivation. Most 6 or 7-year-old kids have active social lives. They have best friends at school, they may look forward to play dates with cousins or have sleep overs with good friends. At this age, children take a lot of stock in being a “big kid” and may feel that they’re no longer suited for playtime with their 3-year-old younger siblings. This “I’m a big kid” feeling will usually help them keep motivated to get up at night if they need to go to the toilet. They may already be more conscious of their self-esteem and would hate to have any accidents during daytime or nighttime that may cause them to look like “small babies”.
We’ll be moving along to the final section of this article. We hope that, so far, you’ve learned a bit more about bedwetting treatment and prevention. Just a quick reminder for anxious parents…
Bedwetting Coping Tips for Parents/Caregivers
Bedwetting is a challenge for many parents and millions of children across America. However, according to the National Association for Continence “15% of those dealing with bedwetting become dry without treatment” and they further provide this statistics chart to support this statement:
Based on all of the information above, we’ve gathered a few practical tips for parents and caregivers to help cope with bedwetting:
- Acceptance and Preparation. Knowing that your child may be prone to wet the bed helps you accept the situation. And once you’ve processed it, it will help you prepare. You can arm yourself with the tools necessary to help make wet nights easier – keep mattress protectors or mattress pads, odor protectors, waterproof under pads and protective comforters in stock as you may need it. You can also learn how to wash urine-stained mattresses correctly and effectively to eliminate the odor. If you anticipate that your child may have the occasional wet night as they’re still learning to completely control their bladder, then you can better prepare yourself for quicker nighttime clean ups that are fuss-free and less stressful for everyone.
- Patience and Empathy. We’ve mentioned this a couple of times in the above sections and as we’re going towards the end of this article, we’ll once again highlight that being understanding and compassionate towards your bedwetting child is one of the best keys to prevention and treatment of bedwetting. As this is a largely developmental issue, children oftentimes just need time, a healthy diet, hydration, regular sleep and consistent daily routines in order for them to be able to get up at night to pee. Making a huge fuss will not only lower their self-esteem but might also add to their emotional issues and prolong their bedwetting episodes.
- Reward but Don’t Punish. Simple reward systems such as star stickers are great ways to reinforce dry nights effectively. Punishment is uncalled for unless in situations where the child consciously urinates to annoy or offend someone. But nighttime bedwetting is very rarely a behavioral issue and children should not be punished for it, no matter how frustrated or tired we are.
- Look Out For Day Wetting Episodes. Day wetting is usually a red flag. Especially if it happens more than 3 or 4 times. For children older than 5 to 6 years old, this may be denigrating to their self-esteem and cause them to become bullied or traumatized. A trip to the doctor is needed as soon as you notice day wetting happening more than once.
- Seek Correct Treatment. There is no better place to seek help for bedwetting than your doctor’s office especially if your child is older than 7 years old. Your doctor should be able to do tests, perform evaluations and suggest treatments that are specific to your child’s needs.
Bedwetting can be a challenging phase in any child’s life. Parents need to be extra patient, too. But with perseverance, commitment and following correct medical advice, you and your child can both overcome bedwetting successfully.
Did you find this article helpful? If you have any bedwetting stories to share, let us know! We’re always happy to hear from you.
This article is for informational purposes only and should not be considered medical advice. Always consult with a doctor or licensed medical professional before making any medical decisions.