Helping your child with nighttime bed-wetting
While potty training and even after, your child may wet the bed while sleeping.
In nocturnal enuresis (uncontrolled release of urine from the bladder), this release happens at night while a child is sleeping. At age 5, about one in five children have nighttime accidents.
“Bed-wetting is a common problem,” says Reumah Ravoori, MMS, PA-C, a physician assistant in urology at Lurie Children’s. “You and your child are not alone.”
Often parents wonder if they failed to potty train their child correctly if nighttime accidents are occurring — but that’s not the case. Bed-wetting isn’t anyone’s fault, according to Lynn Freedman, MSN, MPH, APRN-NP, CPNP, an advanced practice provider in urology at Lurie Children’s.
Most children stop wetting the bed between the ages of 3 and 5. Many have occasional accidents before they’re able to stay dry all night. If your child is 5 or older and releases urine during sleep more than once a month, talk to their health care provider.
Bed-wetting occurs for different reasons. A child may experience primary enuresis. This is when kids haven’t achieved nighttime dryness yet and is the most common type of bed-wetting. One reason is that they may have immature bladder and brain connection.
Peeing the bed may happen when the connection between a child’s brain and bladder hasn’t fully matured. It can also happen in kids who are heavy sleepers.
“The bladder isn’t giving the brain a good signal to wake,” Freedman said. “Often, that’s more common in a kid who’s a deep sleeper. Eventually, the brain tells the bladder to hold urine through the night.” This connection takes extra time to mature in some children.
Constipation can also play a role in bed-wetting. The end of the colon — primarily the rectum — sits against the bladder. When stool (poop) collects in the colon, it reduces the bladder’s size temporarily. Less room to store urine creates a more urgent need to urinate or may cause the bladder to release urine.
“Your child may feel like they need to pass stool, but instead, their bladder releases urine. The relationship is so strong that when health care providers treat constipation, about half of kids stop wetting the bed,” Ravoori said.
Other health conditions such as anxiety, attention deficit hyperactive disorder (ADHD), diabetes, obstructive sleep apnea, neurogenic bladder or urinary tract infections can be the root cause of secondary enuresis. This occurs when your child has been dry at night for at least six months but is now wetting the bed.
Your child’s health care provider can help you learn why your child may be wetting the bed. They examine your child and talk with you about their medical history. Most children who wet the bed don’t have an underlying medical condition, but your provider may do certain tests to be sure.
Lifestyle changes and certain treatments help many children with primary enuresis and secondary enuresis. To help keep your child dry at night, health care providers may recommend a bed-wetting alarm that alerts children when moisture is detected. Additionally, kids often benefit from changes that help them learn to recognize bladder cues during the day. A health care provider can work with you and your child to establish a bladder and bowel regimen.
Many children stop bed-wetting in as little as three months. It often takes patience and encouragement. But some children may take as long as a couple of years, according to Ravoori.
If you’re concerned about bed-wetting in a child older than 5, don’t wait to get help, “Treating is important versus waiting for them to outgrow it,” Ravoori said. “There’s a big psychosocial impact on the child and their confidence.”
• Children’s health is a continuing series. This week’s column was provided by Lurie Children’s Hospital.