- Urine production does not slow down at night ‐ we all produce a substance called vasopressin to slow down production of urine overnight. If you wet the bed, it is possible you do not produce enough vasopressin to reduce urine production, causing the kidneys to produce more urine than your bladder can hold.
- Bladder capacity/instability ‐ the bladder is like a ‘stretchy bag’ which stores the urine produced by your kidneys. Some children who wet the bed have a small bladder with a low capacity that holds less than the average amount of urine so they may need to pass urine more often. In some people the bladder may contract as it is filling with urine once again resulting in wetting before it is full to capacity.
- Difficulty waking ‐ some children are not able to wake up when their bladder is full and so when it empties, they wet the bed. However, difficulty waking does not cause bedwetting alone and is normally present with one of the other problems.
- Bed/Personal enuresis alarms ‐ these alarms work by waking the child when they start to wet during the night so they can empty their bladder in the toilet, ultimately sensitising the child to respond quickly and appropriately to a full bladder during sleep. There are two main types of alarm; ‘bed alarms’ which use a sensor pad under the lower sheet to wake the child and ‘body‐worn alarms’ which use a sensor placed in the underpants.
- Bladder retraining ‐ this is a programme which your doctor or nurse will advise on if appropriate and helps a child improve control of their bladder.
- Bladder retraining and bladder relaxant medication ‐ treatment to improve bladder over activity requires bladder retraining in combination with a bladder relaxant medication. (Your doctor may prescribe this where appropriate). Bladder retraining can involve increased fluid intake and toilet trips. This helps relax the muscle around the bladder so it doesn’t contract and empty before it’s full.
- Antidiuretic Medication ‐ this is a medication which, when taken at bedtime, results in decreased urine production during the night and reduces the risk of bedwetting. (Your doctor may prescribe this where appropriate).
- 12 children in every hundred wets less than once a week
- 1 child in every hundred wets once per week
- 3 children in every hundred wets twice or more per week
- Firstly, always try to be patient and understanding as they cannot help it.
- Try to be positive and praise positive behaviors when they occur such as using the toilet before going to sleep.
- Don’t punish them.
- Keep your clinic appointments.
- Ensure they drink enough fluid during the day and in the evening.
- Take them to see a healthcare professional to seek advice.
- Maybe it runs in your family. For example, your mum or dad may have wet the bed when they were kids.
- You might be producing too much wee at night.
- Or maybe you need to go to the toilet a lot because your bladder (the stretchy bag that holds your wee) tells you it’s full when it’s not.
- It may be that you’ve had too much to drink before you go to bed.
- It might be as a result of something you’re worrying about.
- Lastly, it could be that your bladder doesn’t tell your brain to wake up when you need to do a wee and you don’t get up in time to go to the bathroom.
- Have a wash ‐ try and wash yourself properly after wetting the bed so that you’re nice and clean.
- Watch what you drink ‐ you shouldn’t have too much to drink before you go to bed, but it’s important to drink enough throughout the day – water is best. Try to keep an eye on what you drink to see if any type of drink makes you produce more pee at night. You can then try stopping drinking it to see if it helps.
- Needing the toilet at night ‐ always go to the toilet before you go to bed. And if you think you might need to go during the night, but don’t like the dark, ask mum or dad to put a night light in your room or give you a torch so you can see where you’re going. Or ask them to put a potty under the bed.
- Seek some help ‐ lots of kids grow out of wetting the bed, but if your problem continues long‐term your mum and dad might think it’s a good idea to go to a doctor or nurse.
- Your urine production might not slow down at night ‐ if you wet the bed, you may not produce enough vasopressin, the substance that reduces urine production. This causes the kidneys to produce more urine than your bladder can hold.
- You might suffer from a small or unstable bladder ‐ the bladder is like a stretchy bag which stores the urine produced by your kidneys. Some people have a smaller bladder than normal causing it to empty more often. For some people the bladder may not be functioning properly ‐ it may be overactive resulting in wetting before it is full. The bladder may contract and empty as it is filling with urine, which results in the bladder needing to empty before it reaches full capacity.
- You have difficulty waking at night ‐ some people are not able to wake‐up when the bladder is full and so when it empties, they wet the bed. However, difficulty in waking on its own does not cause bedwetting and is normally present with one of the other problems.
- Antidiuretic Medication ‐ this is a medicine that helps decrease your urine production at night. This helps to reduce the risk of bedwetting.
- Bladder relaxant medication ‐ helps your bladder hold more urine.
- Enuresis alarm ‐ this works by waking you if you start to wet the bed during the night so you can finish emptying your bladder in the toilet. It may help you respond more quickly to a full bladder during your sleep.
- Bladder retraining ‐ this involves increased fluid intake and more toilet trips.
- Try and drink regularly throughout the day ‐ try to keep an eye on what you drink to see if any type of drink makes you produce more urine at night. You can then try stopping drinking it to see if it helps.
- Don’t drink too much just before you go to bed.
- Be positive ‐ at least 1 in 6 children and teenagers stop wetting the bed every year and so you should grow out of the problem as you get older.
- Have a wash ‐ try and wash yourself properly after wetting the bed so that you are clean when you go back to sleep.
- Encourage your child to drink normally throughout the day. It is important that they recognize the feeling of a full bladder.
- Try to keep an eye on what your child drinks to see if any type of drink makes them produce more urine at night. They can then try stopping drinking it to see if it helps.
- Ensure that your child has plenty of fruit, vegetables, cereal and fluids. This will help to avoid constipation which can contribute to bedwetting.
- Ensure that your child goes to the toilet before going to bed.
- Leave the light on at night to ensure that your child has easy access to the toilet.
- Make sure that the mattress and bed are adequately protected.
- Allow your child to help with changing the bed and night clothes. It does help if they are actively involved in overcoming the problem.
- Make sure that your child has a bath or shower each morning. This removes the smell of stale urine and helps them feel more comfortable at school.
- Stay calm, be prepared and try not to worry.
- Remember, bedwetting is neither the child’s fault nor the parents. Patience, love and encouragement will go a long way to resolving the problem for everyone in the family.
- Encourage your child to come out of nappies, but do make sure that the mattress and bedding are protected.
- Do not get cross with your child, it’s not their fault.
- Do not use waking the child as a long‐term strategy to overcome bedwetting.
What causes bedwetting?
As a condition, bedwetting is only recognized as being a problem after the age of 5 and when a child regularly wets the bed three times a week or more. It is worth knowing that bedwetting can be hereditary and research has demonstrated that if one parent wet the bed as a child, the risk of his/her children also being affected by bedwetting is around 40%, this percentage may be higher if both parents were affected.
We now believe that bedwetting, also called nocturnal enuresis, may be caused by one or more of the following problems:
This problem is known as an overactive bladder.
Is there treatment available?
Yes. Quite a number of children become dry just by having the cause of the problem explained to them; however specific treatments for bedwetting are available. It is important to consult a health professional to ensure the correct diagnosis is made and so the appropriate treatment programme may be advised. Treatments include:
Why do none of my friends’ children wet the bed?
Primary Nocturnal Enuresis (PNE) is a far more common problem than many parents believe. Most children are able to remain dry at night by the time they reach 5 years old; however if left untreated it can persist so that even at 7.5 years 15 out of every hundred children sometimes wet the bed. This means that in a class of 30 pupils 4 or 5 of them could be affected. It is generally more common in boys than in girls.
The severity of the bedwetting varies for children 7.5 years of age:
Can I tell my child that one day they will stop wetting the bed?
One in six children stop wetting the bed every year, so the chances are they’ll stop wetting some time during childhood, even without any treatment or help.
What can I do to help my child become dry?
Is there anything I can do to help my child stop wetting the bed when they go to stay with friends or go on school holidays?
Some medication may help to produce dry nights almost immediately in many children. Your doctor will be able to advise if this is suitable. There are also a number of products that you can purchase to help your childto feel more secure whilst they are away, such as disposable bed protectors and discreet pants containingabsorbent pads. These can be bought online via websites such as www.eric.org.uk.
Should I reduce my child’s drinking during the day to help their bedwetting?
Reducing the amount they drink during the day or evenings do not help bedwetting. In fact, more fluids during the day and normal drinking in the evening, is advised. Try to keep an eye on what your child drinks to see if any type of drink makes them produce more urine at night. They can then try stopping drinking it to see if it helps.
It is particularly important not to drink too little during the day and then try to catch up with fluids after school or in the evenings because your child feels thirsty. This drinking behavior is quite common in children who have bedwetting problems. Equally important, they should not drink extremely large volumes of fluid during the day and evening as this will tend to make the bedwetting worse.
Am I the only one?
Bedwetting is more common than you might think. The medical name for this condition is Primary Nocturnal Enuresis (or sometimes just “PNE”). In the United Kingdom, over half a million kids between the ages of 5 and 16 wet the bed.
What causes it?
It’s important to remember that it’s not your fault if you wet the bed.
There are several reasons why it might happen:
What can you and your Mum and Dad do to help?
Am I the only one?
No, you are just one of many, but not surprisingly very few teenagers want to talk about it. In this country, bedwetting (nocturnal enuresis is the medical name) is thought to affect half a million children and adolescents. So you can see that you are not alone in seeking help.
Why do I wet the bed?
There are a number of possible factors which have been identified. These include stress, a family history of bedwetting, or too much urine produced overnight. Your doctor or specialist nurse will discuss these in more detail with you to determine the most suitable treatment programme. In the majority of cases the skill required to stay dry will eventually come. Getting some help may speed up the process and save a great deal of anguish.
Here’s a little more detail about why bedwetting can happen:
What can I do?
It’s a good idea to see your doctor or school nurse. Once satisfied that your bladder is not the cause of the problem, he or she might want to discuss the treatment options with you. These could include seeking advice from a bedwetting specialist at the enuresis clinic where alarm treatment is often used. The alternative, which is only available on prescription, is a medicine to help treat the problem.
What treatment is available?
Your Doctor will be able to determine the probable cause and therefore offer an appropriate treatment which could be:
Do you have any other advice?
There are some things you can do to help yourself, for example:
In a five-year old child, wetting the bed more than two nights per month is not normal. This shows that the child has a problem - Nocturnal Enuresis, which means accidentally and unconsciously wetting the bed during sleep.