What is bedwetting and how is it treated?

No child likes to wake up in a wet bed. Nevertheless, bedwetting is a normal scenario for a lot of families worldwide. As parents, we want to help our child get diaper-free as quickly as possible, but when it takes longer than expected, the result can be despair and frustration.

Enuresis nocturnal

The majority of children are able to control day-time urination by the age of three, but often it takes a little longer to gain nighttime bladder control. If your child is more than five years old and wets the bed at night, doctors call it enuresis nocturnal. Enuresis nocturnal means ”involuntary nocturnal urination” also known as bedwetting. Bedwetting is a very common condition that affects children worldwide.

Bedwetting can be divided into two categories; primary and secondary. Children in the primary category have never been dry at night, while children in the secondary category experience involuntary urination during the night. Often, the child has been dry for more than six months and then suddenly starts wetting the bed again.

Causes of bedwetting

The ability to control the bladder varies from child to child, but if your child is more than 5 years old and still wets the bed at night, it probably means that he/she has not yet developed the necessary skills to stay dry at night. Normally, the hormone ADH tells the kidneys that the urine production must be slowed at night. Some children do not produce enough of this hormone, which means their kidneys continue to produce urine at the same rate as during the day. This may be one of the reasons for bedwetting. When your child gets older, they will gradually produce more of this hormone, causing bedwetting to become less frequent, and eventually to stop entirely. Bedwetting can also be caused by psychosocial stress, or have physical causes such as a metabolic disorder like diabetes, external pressure on the bladder caused by constipation, or a urinary tract infection.

No matter the cause, there is no need to worry. Every child develops in their own way and pace. Be patient, support, and help your child stay dry and comfortable during the night.

How is bedwetting treated?

The majority of children will outgrow bedwetting without ever needing any kind of treatment. As parents it can be hard to determine whether your child’s bedwetting is something that will pass on its own, or if treatment is needed. The treatment method always depends on the underlying cause of the bedwetting. Therefore it is crucial to get your child examined by a doctor, who, together with you, will decide if and which treatment will be the best option for your child. In many cases treatment might not be necessary at all.

Treatment methods

The most common treatment methods of bedwetting are a bedwetting alarm, or medical treatment. The bedwetting alarm is a special kind of alarm that instantly wakes your child when he/she wets the bed. When your child’s sleep is interrupted their brain is forced to control the bladder and thereby prevent further accidents. This method is very effective, but only if your child is ready and motivated to try the alarm device.

The other treatment option is to have the doctor prescribe a drug called desmopressin acetate (DDAVP). DDAVP is made from the hormone "vasopressin” and works by decreasing the volume of urine at night. A pill with DDAVP is given an hour before bedtime for a shorter period of time.

When to take action?

Treatment is usually initiated before your child starts school. Around this age, your child is typically old and motivated enough for the treatment to be a success. You will quickly notice if the treatment is working, as the child’s self-esteem and wellbeing will increase significantly.

We always advise you to contact your family doctor if your child wets the bed at night. The doctor will diagnose your child and talk to you about the different causes and treatment possibilities.

Read more on how you can support your child the best way possible in this blog or see our Bambo Dreamy Night Pants  for comfortable and dry nights.

Source: Camilla Vogt Pedersen, international nurse, ABENA.

FAQ about bedwetting

Why does my child wet the bed at night?

There can be a lot of different reasons as to why your child wets the bed at night. The majority of children who experience bedwetting can easily stay dry during the day, but have trouble staying dry at night. This is often explained by a delay in your child’s development. When they sleep, their brain has a hard time registering that their bladder is full and that it is time to wake up and go to the bathroom. But no need to worry, your child will develop this skill with age.

Will bedwetting decrease as my child gets older?

Yes. With time, your child will most likely overcome bedwetting. Approximately 100% of all one-year-olds wet their bed. By the time they turn five, this number drops to around 15-25%, and that number decreases by 15 % each year hereafter. By puberty, only around 1% of children will still experience problems with bedwetting.

Why should we contact our family doctor with bedwetting?

The majority of children who wet their bed are healthy. But your child should be examined by your family doctor to determine whether or not your child’s bedwetting can be caused by a medical problem. Your doctor will ask you different questions about your child’s daytime and nighttime bathroom habits and fluid consumption habits. He/she will also do a physical examination as well as a urine test to check for infection or diabetes.

Does my child need further testing?

In most cases no. Your family doctor will decide what tests, if any, are needed, after speaking with you and after examining your child. Conditions that may need more testing include: combined daytime and nighttime wetting, urinary tract infections (UTI), constipation and/or bowel accidents, difficulties with the urinary stream and flow, recent neurological injury, or the like.

Are UTIs common in children?

Yes, urinary tract infections are common in children. By the age of seven, an estimated 8% of girls and 2% of boys will have experienced at least one episode of UTI. Within one year, 12-30 % of these children will contract their second UTI.

Will use of pants or other diaper-like products delay my child’s bladder control?

The use of night pants will not delay your child’s ability to control their bladder. Night pants can help take some of the stress around bedwetting away from both you and your child. Night pants can help reduce wet clothing and bedding at night and give your child a safe and comfortable night’s sleep. And when your child is ready, night diapers will no longer be necessary.

Sometimes my Bambo Dreamy Night Pants leak - what could be wrong?

In most cases, leakages occur when the diaper does not fit your child. It can either be put on wrong (see the text “BACK” on the diaper), or it can be too small or too big. Try using a smaller or bigger size also with regards to absorbency.

How do I prevent my child from getting an UTI? Good advice!

Your child’s bathroom visits need to be relaxed and it is important that your child is not rushed. If your child is in too much of a hurry, the bladder may not get emptied properly, which can be a breeding ground for bacteria. Some children have a tendency to delay their bathroom visits as "they do not have the time" to go to the toilet. As a rule of thumb, your child should go to the toilet every 2-3 hours during the day.

If your child suffers from diarrhea, the risk of contracting an UTI is higher, as it can be difficult to keep the rectal area clean. Bacteria can travel up through the urethra and then cause an infection. You especially need to be aware of how girls wipe themselves. Girls have a short urethra and they need to wipe themselves from the front and back after urination.

The diet is important too. It is advised that your child eat a fiber-rich diet to avoid constipation, as constipation can make it harder for children to completely empty their bladder. Also, make sure that your child drinks plenty of water during the day. This helps rinse their bladder.

If you go swimming, always change into dry clothes right away. Bacteria thrive in humid and warm environments.