Bedwetting - Akron Children's Hospital
Bedwetting - Akron Children's Hospital
Bedwetting - Akron Children's Hospital
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<strong>Bedwetting</strong> is an issue that millions of families face<br />
every night. It is very common in younger children, but can<br />
last into the teen years. If parents don’t handle it well,<br />
bedwetting can cause emotional problems. In some cases,<br />
parents become even more frustrated than the child.<br />
<strong>Bedwetting</strong> often is related to the child’s developmental<br />
immaturity. The good news is the vast majority of kids<br />
outgrow it.<br />
If your child wets the bed, be kind. Tell him it’s no<br />
disaster. It’s something you can fix together.<br />
CAUSE<br />
In most cases, the culprit behind bedwetting is easy to<br />
pinpoint: Your child’s bladder is unable to hold a whole<br />
night’s urine, and he misses the bladder’s “full” messages.<br />
Illness, stress or the start of school sometimes brings on<br />
bedwetting. There are physical causes of bedwetting —<br />
including urinary tract infections. If your child is wet or<br />
damp during the day, he has voiding dysfunction, not<br />
bedwetting. (See Tip #SI718, “Urinary Tract Infection,” and<br />
Tip #SI738, “Voiding Dysfunction in Children.”)<br />
Boys are 50 percent more likely than girls are to be<br />
bedwetters, and some 70 percent of all bedwetters have a<br />
parent, aunt or uncle who wet the bed in childhood.<br />
<strong>Bedwetting</strong> decreases as children get older. About 13<br />
percent of 6-year-olds wet the bed, and about 5 percent of<br />
10-year-olds wet the bed.<br />
Many kids wet the bed several times during the night.<br />
Most are sporadic, averaging a few times per week. Most<br />
bedwetters have never had a long period of dryness. One in<br />
10 has resumed wetting after two or three months of staying<br />
dry.<br />
TREATMENT FOR CHILDREN AGES 3 to 6<br />
• Make sure your child empties his bladder at bedtime.<br />
For some children, it helps to wake them for a<br />
midnight bathroom trip.<br />
• “Pull-ups” are often the best solution for children<br />
who are experiencing bedwetting.<br />
• Reward each dry night with lavish praise from<br />
everyone in the family. Gold stars on a calendar,<br />
coins and other treats are fine.<br />
• Respond gently to wet nights. Your child feels guilty<br />
enough. Allow no teasing or pressure from siblings.<br />
Never Never scold, scold, shame shame or or spank.<br />
spank.<br />
P1-11/09 TP304-09/09<br />
<strong>Bedwetting</strong><br />
TREATMENT FOR CHILDREN AGES 6 to 8<br />
Medical treatment for bedwetting isn’t advisable until<br />
your child reaches age 5 or 6. By then, he is likely to want to<br />
stay dry and be able to participate in treatment. After your<br />
child’s physician rules out a medical problem, take the above<br />
steps and add these:<br />
• Keep track of each time your child goes to the<br />
bathroom during the day and what times he goes to<br />
bed. Also keep a list of evening snacks and drinks.<br />
Compare this to bedwetting episodes to find<br />
patterns.<br />
• Have your child urinate into a measuring cup for<br />
three days and record urine volume. It should<br />
average one ounce per year of age. A 6-year-old who<br />
is producing only four ounces of urine each time has<br />
a small-capacity bladder and will need to urinate<br />
more often.<br />
• Help your child awaken at night once or twice to<br />
urinate. He should remember at bedtime. Don’t carry<br />
your child; let him walk.<br />
• Some parents think it’s important to have the child<br />
strip the bed and do the laundry, or at least help with<br />
it, to teach responsibility. Explain that this isn’t<br />
punishment, but part of the process of helping out.<br />
• Make sure the path to the bathroom is well-lighted.<br />
Late-night trips may be too scary for young children.<br />
• Don’t talk about the bedwetting with anybody<br />
outside the family except your child’s physician,<br />
especially in front of your child. Kids are sensitive.<br />
• Work with your child on strategies to spend the night<br />
at someone’s house and not worry. One solution: Take<br />
a sleeping bag with a pull-up in it to wear at night.<br />
TREATMENT FOR THE OLDER<br />
BEDWETTER<br />
After other methods are tried, some physicians will<br />
prescribe medication to help the bladder do its job. Make<br />
sure to ask about the medication’s side effects.<br />
<strong>Bedwetting</strong> alarms (urine sensors) have high success<br />
rates, however, this technique takes a lot of cooperation from<br />
both parents and the child. Remember, your child must be<br />
fully awake in order to learn how to stay dry. Unfortunately,<br />
the whole family may awaken when the alarm sounds.<br />
A book entitled Dry All Night by Alison Mack offers a<br />
different approach. Behavior modification and positive
einforcement, as well as parent education regarding<br />
bedwetting, are covered in this book. Your child must be able<br />
to read the second part of the book, which is directed<br />
specifically at helping the wetter help himself.<br />
WHEN TO SEE THE DOCTOR<br />
Your child’s doctor can help by ruling out illness and<br />
analyzing your child’s urination patterns. You may be given a<br />
“Texas hat” container, which fits into the toilet to collect and<br />
measure the volume of urine. Parents are asked to keep a<br />
diary of the child’s voiding patterns. Doctors can obtain<br />
important clues about bladder capacity from such details as<br />
how strong or weak the voided stream is.<br />
Consult your child’s physician if your child:<br />
• Has a burning sensation during urination;<br />
experiences frequency and urgency of urination; is<br />
leaking urine; has blood in the urine; or is<br />
experiencing fever, chills or back pain. These may<br />
signal a urinary tract infection.<br />
• Has daytime as well as nighttime wetting after age 3.<br />
• Wets every night after age 6.<br />
• Has a loss of control after previous dryness of more<br />
than one month.<br />
• Has a weak urinary stream<br />
• Has swelling of the feet or ankles<br />
One Perkins Square • <strong>Akron</strong>, Ohio 44308-1062<br />
www.akronchildrens.org<br />
TP304<br />
Your child’s physician is an excellent source of information about this<br />
and other child health topics. This information is of a general nature and is<br />
not intended to serve as a substitute for the advice of a physician.<br />
Tips to Grow By is a public service of <strong>Akron</strong> Children’s <strong>Hospital</strong>. To<br />
receive an order form, please call 330-543-8760.<br />
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P1-11/09 © 09/09