Bedwetting and School-aged Children

What is bedwetting?

When children pee (urinate) in their sleep at night, this is called bedwetting or nocturnal (nighttime) enuresis.

Bedwetting is common when children are learning how to use the toilet. Many children are fully toilet trained (no longer wetting the bed at night) between 2 and 4 years of age. However, bedwetting may continue for some children. Bedwetting affects 1 out of 4 children who are 5 years of age, 1 in 5 children who are 7 years of age, and about 1 in 20 children who are 10 years of age. Also, it is 2 to 3 times more common in boys than girls (male or female sex assigned at birth).

Bedwetting is rarely a serious medical condition, and parents and caregivers can help their children manage different bedwetting concerns.

Causes

Here are some possible reasons why bedwetting occurs.

• Family history of bedwetting. Most children who wet the bed have at least one parent who did it as a child.

• Your child hasn't developed the ability to hold their pee (urine). If the bladder signals the brain that it's filling up with pee and the brain doesn't send a message back to the bladder to relax and hold the pee until morning, bedwetting will happen.

• Your child is a deep sleeper and doesn't wake up when they have to pee.

• Your child's bladder is still too small to hold urine all night.

• Your child has trouble passing poop (stool). This can put pressure on the bladder.

Keep in mind that children have no conscious control of their bladders when they are sleeping. Also, children may temporarily wet the bed at night when they have a minor illness or are going through changes or stress at home.

Exam and Tests

If you are concerned about your child's bedwetting, or if your child is concerned, contact your child's doctor. You may be asked the following questions about your child's bedwetting:

• Is there a family history of bedwetting?

• How often and when does your child urinate during the day?

• How are your child's bowel movements?

• Have there been any changes in your child's home life, such as a new sibling, a move, or other family issues?

• Does your child drink a lot of water or other liquids before bed?

• Is there anything unusual about how your child urinates or the way the urine looks?

If needed, your child's doctor will perform tests or refer you to a doctor who is specially trained to treat children's kidney (pediatric nephrologist) or urinary conditions (pediatric urologist).

How to Manage Bedwetting

Bedwetting usually goes away as your child gets older. Here are ways to manage bedwetting.

• Support and offer reassurance to your child. Let them know that

  • Wetting the bed is not their fault.

  • It won't last forever.

  • Other children wet their beds, but no one talks about it at school.

• Set a no-teasing rule in your family. Let others know that it's not the child's fault.

• Don't make bedwetting a big issue so your child won't either.

• Protect the bed. Put a plastic cover under the sheets.

• Have your child use the toilet just before bedtime.

• Don't give your too many liquids before bed.

• Wake your child up to use the toilet 1 or 2 hours after going to sleep. This may help them stay dry through the night.

• Reward your child for dry nights. Try a star chart. Do not punish your child for wet nights.

• Let your child help change wet sheets and covers. But don't force your child to do this because your child may think they are being punished.

Treatment

There are many treatment programs and devices that claim they can "cure" bedwetting. However, many of these products may make false claims and promises and may be expensive. Your child's doctor is the best source for advice about bedwetting. Talk with your child's doctor before starting any treatment program.

In addition to the tips mentioned in the previous section on how to manage bedwetting, doctors may suggest trying a bedwetting alarm or medicine.

• A bedwetting alarm is a device that has a sensor that turns on an alarm when it gets wet. The alarm wakes the child so they can use the toilet. Over time, this helps a child stay dry at night. It can take weeks or months to work. Bedwetting alarms tend to work best for children who have some dry nights. Ask your child's doctor what kind of alarm would be best for your child.

• There are some medicines for treating bedwetting in older children. They almost never cure bedwetting. But they can help your child go to a sleepover or camp. Ask your child's doctor if medicine could be an option for your child.

Visit HealthyChildren.org for more information.

Disclaimer

The AAP is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of all infants, children, adolescents, and young adults.

In all aspects of its publishing program (writing, review, and production), the AAP is committed to promoting principles of equity, diversity, and inclusion.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.