Paediatrician Dr Leila Masson explains the reasons behind bedwetting in young children—and what you can do to help.
When we talk about toileting accidents, we first need to differentiate between children who have never been dry and those who used to be dry but have started having accidents again.
The Natural Development of a Dry Night
Babies pass urine around the clock. As they grow, their bodies begin to produce more of the anti-diuretic hormone (ADH), which reduces night-time urine production. They also begin developing a regular urination schedule, both during the day and at night.
Eventually, with maturity, they’re able to go for longer stretches without passing urine—until they can make it through the night without wetting the bed.
This requires a mature sleep-wake cycle, where the child sleeps soundly but not so deeply that they fail to wake when their bladder is full.
It’s completely normal for young children to have accidents and wet themselves. About one in six 6-year-olds still wet the bed. The number decreases with age:
- 5% of 10-year-olds
- 1% of 15-year-olds
As their nervous systems mature, children naturally learn to control their bladders and wake up when needed.
What You Can Do to Help
Make Sure Your Child Is Not Constipated
A full bowel can reduce the space available for the bladder to expand, leading to overflow. Combat constipation with:
- High-fibre foods (vegetables, fruit, whole grains)
- Plenty of water
- Fermented foods like yoghurt
Hydrate During the Day
Encourage regular water intake. Avoid caffeine completely, and stop fluids after 6pm or about 2 hours before bedtime.
Remind Them to Go Before Bed
Have them empty their bladder right before sleep. You can also wake them at around 10pm or 11pm for a toilet visit.
Helping Deep Sleepers
Some kids sleep so deeply that their brain doesn’t register the signal from their full bladder. You can help them learn to wake up:
- Turn on the lights and call their name when waking them.
- At first, you may need to walk them to the toilet while half-asleep.
- Over time, reduce light and noise until they can wake up on their own.
Bedwetting alarms are another great option. These inexpensive tools detect the first sign of wetness and sound an alert. They’re effective for 75% of children within 12 weeks.
Check Their Breathing
Mouth breathing can lead to increased urine production. This happens because breathing through the mouth reduces CO₂ levels in the blood, prompting the kidneys to excrete more bicarbonate—and more urine.
Encourage nose breathing:
- Remind your child to keep their mouth closed when not speaking or eating
- Try activities like:
- Drinking through a straw
- Holding a spatula between their lips
- Blowing bubbles or playing “cotton soccer” with a cotton ball at the table
You can also consult a breathing coach to help reinforce nose breathing, which supports overall health—including facial development and jaw alignment.
Consider Allergies
Some children stop bedwetting when food or environmental allergens are removed.
Common food allergens:
- Dairy
- Wheat
- Eggs
- Soy
- Nuts
Common environmental allergens:
- Dust mites
- Grasses
- Mould
- Animal dander
Your doctor can help with skin-prick or blood tests to identify any sensitivities.
What If a Child Starts Wetting Again?
This is called secondary enuresis and it can indicate something more serious. Two main causes:
1. Emotional Stress
Bullying, changes at school, or stress at home (e.g. parental separation) can lead to regression.
Talk with your child and offer support. If needed, reach out to a counsellor or family doctor.
2. Medical Causes
Infections or health conditions such as:
- Urinary tract infections
- Diabetes (check with a urine test for sugar)
- Oxalate crystals in the urine (a precursor to kidney stones)
If your child experiences pain while urinating or has a family history of kidney issues, your doctor can check for these.
When Bedwetting Affects Social Life
If bedwetting keeps your child from joining sleepovers or camps, your GP may recommend short-term medication to help manage it.
The main thing to remember is: don’t stress too much if your child has never been dry. Most children grow out of bedwetting in their own time.
Edited extract from Children’s Health A to Z: Help Your Child Feel Better and Stay Well Naturally by Dr Leila Masson (Bateman Books, $39.99)
