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Understanding Bedwetting in Children

Bedwetting, or nocturnal enuresis, is a kind of right of passage in the early years when you’re still trying to work the kinks out of potty training. But how long is it normal for wetting the bed to continue? When should you be worried that something else is going on, besides just not being able to hold it anymore? Here’s a look at understanding bedwetting causes and treatments in children. 

Causes of Bedwetting in Children

Most children outgrow bedwetting around ages five to seven. There are several different reasons bedwetting can occur. The most common cause of primary bedwetting (ongoing nocturnal enuresis) is a nervous system that hasn’t matured sufficiently to notice the sensation of a full bladder enough to cause wakefulness. Another frequent issue might be that the child’s bladder isn’t quite big enough to hold a whole night’s worth of urine. Additionally, the body produces particular hormones at night to slow down the production of urine. Some children may not make enough of this anti-diuretic, and so their bodies make more urine than normal throughout the night. 

Psychological development can also impact nocturnal enuresis. If the child hasn’t quite gotten the hang of using the toilet well during the day, they may tend to have more difficulty at night. Secondary bedwetting (nocturnal enuresis that reappears after months or years without nighttime wetness) can also be highly impacted by stress. Being away from home, changes in the family or environment, or traumatic accidents can all cause high levels of stress that trigger bedwetting. Bedwetting can also be a symptom of abuse or ongoing conflicts at home. 

Anatomically, bedwetting can be the result of a structural abnormality, although this is fairly rare. Other anatomical influences include diabetes, of which extreme thirst and bedwetting are often indicators. Urinary tract infections can make it more difficult to hold urine, especially for an extended period of time. Chronic constipation can also weaken the involved muscles, contributing to nocturnal enuresis. Obstructive sleep apnea is also associated with bedwetting and behavior problems. 

Treatments for Bedwetting in Children

One of the most important things to remember as you try to help your child overcome nocturnal enuresis is that it is not voluntary. He isn’t going to bed at night with the express intention of peeing in his sleep -- in fact, it’s probably as frustrating for him as it is for you. 

While most children tend to outgrow bedwetting eventually, it is often more difficult if there is a family history of nocturnal enuresis. Additionally, boys tend to have more trouble with wetting the bed than girls. While you may choose to simply wait for the child to outgrow it, it can be extremely embarrassing at sleepovers -- and forcing the child to tough it out isn’t going to make it any better. In fact, it can increase stress and make the issue worse. 

New medications can help by reducing the amount of urine produced in the night or by helping reduce bladder activity. Other options include wetness alarms, reducing evening fluid intake, avoiding caffeine -- particularly at night (caffeine  isn’t especially good for children anyway), having the child go the bathroom twice before going to bed, encouraging good day time bathroom habits, treating any underlying disorders, and, of course, providing plenty of love and support as your child tries to get past this stage of childhood. 

Last Updated: October 06, 2016