Bedwetting - Akron Children's Hospital

Bedwetting is an issue that millions of families face
every night. It is very common in younger children, but can
last into the teen years. If parents don’t handle it well,
bedwetting can cause emotional problems. In some cases,
parents become even more frustrated than the child.
Bedwetting often is related to the child’s developmental
immaturity. The good news is the vast majority of kids
outgrow it.
If your child wets the bed, be kind. Tell him it’s no
disaster. It’s something you can fix together.
CAUSE
In most cases, the culprit behind bedwetting is easy to
pinpoint: Your child’s bladder is unable to hold a whole
night’s urine, and he misses the bladder’s “full” messages.
Illness, stress or the start of school sometimes brings on
bedwetting. There are physical causes of bedwetting —
including urinary tract infections. If your child is wet or
damp during the day, he has voiding dysfunction, not
bedwetting. (See Tip #SI718, “Urinary Tract Infection,” and
Tip #SI738, “Voiding Dysfunction in Children.”)
Boys are 50 percent more likely than girls are to be
bedwetters, and some 70 percent of all bedwetters have a
parent, aunt or uncle who wet the bed in childhood.
Bedwetting decreases as children get older. About 13
percent of 6-year-olds wet the bed, and about 5 percent of
10-year-olds wet the bed.
Many kids wet the bed several times during the night.
Most are sporadic, averaging a few times per week. Most
bedwetters have never had a long period of dryness. One in
10 has resumed wetting after two or three months of staying
dry.
TREATMENT FOR CHILDREN AGES 3 to 6
• Make sure your child empties his bladder at bedtime.
For some children, it helps to wake them for a
midnight bathroom trip.
• “Pull-ups” are often the best solution for children
who are experiencing bedwetting.
• Reward each dry night with lavish praise from
everyone in the family. Gold stars on a calendar,
coins and other treats are fine.
• Respond gently to wet nights. Your child feels guilty
enough. Allow no teasing or pressure from siblings.
Never Never scold, scold, shame shame or or spank.
spank.
P1-11/09 TP304-09/09
Bedwetting
TREATMENT FOR CHILDREN AGES 6 to 8
Medical treatment for bedwetting isn’t advisable until
your child reaches age 5 or 6. By then, he is likely to want to
stay dry and be able to participate in treatment. After your
child’s physician rules out a medical problem, take the above
steps and add these:
• Keep track of each time your child goes to the
bathroom during the day and what times he goes to
bed. Also keep a list of evening snacks and drinks.
Compare this to bedwetting episodes to find
patterns.
• Have your child urinate into a measuring cup for
three days and record urine volume. It should
average one ounce per year of age. A 6-year-old who
is producing only four ounces of urine each time has
a small-capacity bladder and will need to urinate
more often.
• Help your child awaken at night once or twice to
urinate. He should remember at bedtime. Don’t carry
your child; let him walk.
• Some parents think it’s important to have the child
strip the bed and do the laundry, or at least help with
it, to teach responsibility. Explain that this isn’t
punishment, but part of the process of helping out.
• Make sure the path to the bathroom is well-lighted.
Late-night trips may be too scary for young children.
• Don’t talk about the bedwetting with anybody
outside the family except your child’s physician,
especially in front of your child. Kids are sensitive.
• Work with your child on strategies to spend the night
at someone’s house and not worry. One solution: Take
a sleeping bag with a pull-up in it to wear at night.
TREATMENT FOR THE OLDER
BEDWETTER
After other methods are tried, some physicians will
prescribe medication to help the bladder do its job. Make
sure to ask about the medication’s side effects.
Bedwetting alarms (urine sensors) have high success
rates, however, this technique takes a lot of cooperation from
both parents and the child. Remember, your child must be
fully awake in order to learn how to stay dry. Unfortunately,
the whole family may awaken when the alarm sounds.
A book entitled Dry All Night by Alison Mack offers a
different approach. Behavior modification and positive

einforcement, as well as parent education regarding
bedwetting, are covered in this book. Your child must be able
to read the second part of the book, which is directed
specifically at helping the wetter help himself.
WHEN TO SEE THE DOCTOR
Your child’s doctor can help by ruling out illness and
analyzing your child’s urination patterns. You may be given a
“Texas hat” container, which fits into the toilet to collect and
measure the volume of urine. Parents are asked to keep a
diary of the child’s voiding patterns. Doctors can obtain
important clues about bladder capacity from such details as
how strong or weak the voided stream is.
Consult your child’s physician if your child:
• Has a burning sensation during urination;
experiences frequency and urgency of urination; is
leaking urine; has blood in the urine; or is
experiencing fever, chills or back pain. These may
signal a urinary tract infection.
• Has daytime as well as nighttime wetting after age 3.
• Wets every night after age 6.
• Has a loss of control after previous dryness of more
than one month.
• Has a weak urinary stream
• Has swelling of the feet or ankles
One Perkins Square • Akron, Ohio 44308-1062
www.akronchildrens.org
TP304
Your child’s physician is an excellent source of information about this
and other child health topics. This information is of a general nature and is
not intended to serve as a substitute for the advice of a physician.
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