Urination - bed wetting Health Article

Definition

Bed wetting is nighttime urinary incontinence in children over age 5 or 6.

Alternative Names

Enuresis

Considerations

Bed wetting is divided into two categories. Primary nocturnal (nighttime) urinary incontinence is when a child has never achieved full bladder control (never been fully toilet trained). Secondary nocturnal urinary incontinence is when a child starts bed wetting again after having achieved bladder control.

Most children who haven't achieved bladder control have at least one parent or first degree relative who also had a problem with bed wetting. Knowing this often helps the child feel less stressed about the situation.

Roughly 20% of children still wet their beds at age 5, only 5% do so by age 10, and 2% by age 15. Only 1 out of 100 children who wet their bed continues to have a problem in adulthood.

Common Causes

Primary bed wetting is usually simply due to a delay in the maturation of the part of the nervous system that controls bladder function. Secondary be wetting may be due to either psychological problems or medical disorders, such as a urinary tract infection, urinary tract abnormalities, or diabetes.

Home Care

Do not worry about bed wetting in children before the age of 6, unless they were previously well toilet trained and the bed wetting is now a new problem.

Do not punish a child who wets. Bed wetting is NOT caused by laziness or rebelliousness. Shaming a child for wetting the bed can lead to poor self-esteem and feelings of low self-worth.

Reassure, encourage, and express confidence in the child. You can also have your child take an active part in cleaning up from the bed wetting (such as helping to strip the bed and put the sheets in the laundry).

Not giving drinks at bedtime may be helpful in some children because it decreases the volume of urine in the bladder, but this does not prevent the problem completely. Avoiding caffeine-containing drinks can also help decrease the amount of urine in the bladder (caffeine increases urine production).

See your health care provider to consider the use of alarm systems (such as Wet-stop or Enuretone), or drugs like DDAVP nasal spray or pills. The latter stops bed wetting in 60 - 75% of children while taking the drug, but is not a permanent cure (once the medication is stopped, the bed wetting tends to come back).