Wondering if your child will grow out of bedwetting or if there’s more you can do to help them stay dry at night? Here’s what you need to know.
What is Bedwetting?
Bedwetting, or nocturnal enuresis, is involuntary urination while asleep. It occurs at least twice a month in children aged 7 or older.
Think of it as a communication error: the brain and bladder fail to coordinate effectively enough to wake the child when it’s time to go.
Staying dry through the night is often the final stage of toilet training and a biological milestone that can’t be hurried. Most children naturally achieve this by age 6 (girls) or 7 (boys). Encouragingly, 19 out of 20 children stop bedwetting by their 10th birthday.
What Bedwetting is Not
Occasional accidents—like a child drinking extra fluids before bed or dreaming they’re on the toilet—are not considered bedwetting. It’s only an issue if it happens at least twice a month.
Common Causes of Bedwetting
Bedwetting is almost always due to physical factors rather than parenting or psychological issues. Causes include:
- Bladder size: The bladder may not yet hold enough urine to last the night.
- Constipation: A full bowel reduces bladder capacity.
- Deep sleep: Children who are deep sleepers may not wake when their bladder signals fullness.
- Hormone production: The anti-diuretic hormone, which reduces urine production at night, develops with age.
- Over-reactive bladder: Sensitive bladders require frequent emptying.
- Urinary tract infections: Frequent urination, pain, or cloudy urine may indicate infection—consult a doctor if these symptoms occur.
Managing Bedwetting
While some causes, like infections or constipation, can be treated medically, other factors improve with age or training. Here’s how to manage bedwetting in the meantime:
- Increase fluid intake during the day: This helps stretch the bladder.
- Limit evening drinks: Reduce fluids an hour before bedtime, avoiding fizzy drinks or caffeine.
- Establish a bedtime routine: Encourage your child to use the toilet before bed.
- Praise small successes: Celebrate dry nights and waking to use the toilet, but avoid criticism for accidents.
Practical Tools for Parents
- Waterproof mattress protectors: Protect the bed with a washable, over-the-sheet protector for quick nighttime changes.
- Bedwetting alarms: These small devices wake the child when they begin to urinate, training their brain to respond to a full bladder. Alarms have a high success rate but require consistency and patience over several months.
- Pull-ups: While not a solution, pull-ups can prevent stress during the early stages of a bedwetting programme.
Emotional and Medical Support
- Stress-related bedwetting: Emotional upsets like bullying, divorce, or illness can cause bedwetting. Addressing the stress often resolves the issue.
- Medication: While some medications can reduce bedwetting temporarily, they don’t offer a long-term cure and may have side effects.
When to Seek Professional Help
Consult your GP if:
- Your child is at least 7 years old and still wets the bed regularly.
- They have daytime accidents.
- They begin bedwetting after being dry for 6+ months.
Understanding Bladder Control
- Babies urinate through a reflex.
- Between 18 months and 2.5 years, children become aware of a full bladder and begin daytime control.
- Nighttime dryness occurs when the brain unconsciously inhibits the bladder-emptying reflex.
Perspective Through Statistics
- At age 5, 2–3 children per class wet the bed.
- By age 7, 1 in 10 children still wets the bed.
- 97% of bedwetting children are dry by age 12.
Bedwetting is a phase most children outgrow. Praise your child for their efforts, and remember that accidents are not their fault. Stay patient, consistent, and supportive as you guide them through this stage of development.
Dr Yvonne Eve Walus is an Auckland-based education consultant and a mother of two.
