Nocturnal enuresis, or bedwetting, is very common in young children. Around age five, they begin to develop a more efficient nervous system, allowing them to sense when they need to urinate enough to wake them up. However, it is not uncommon for children as old as seven to still have some trouble with bedwetting, but only a very small percentage continue after that. Here’s a look at a few things that can impact a child’s likelihood of wetting the bed.
Primary vs. Secondary Bedwetting
Enuresis is the involuntary release of urine. It is, essentially, a synonym for incontinence, although enuresis, in particular, is generally specific to children. Primary bedwetting refers to ongoing bedwetting, while secondary bedwetting refers to nocturnal enuresis that stopped for at least 6 months and began again. So, if a child has consistently wet the bed up to age seven, this is considered primary bedwetting. If the child wet the bed through age five and then started again at age seven, it is considered secondary bedwetting. Secondary bedwetting is generally the more concerning of the two.
Primary Bedwetting
It takes a few years for children to develop complete bladder control. Generally, they are able to manage the need to take bathroom breaks during the day before the night. This can be due, in part, to an undeveloped nervous system. As adults, our nervous systems are strong enough to wake us up when the sensation of needing to urinate (if it is strong enough) is detected. This isn’t necessarily true in the first few years of toddlerhood. So, basically, just being a little kid is in itself a risk factor for nocturnal enuresis, particularly when combined with smaller bladders. Additionally, female children have a tendency to gain control of their urinary tract more quickly than boys do. Therefore, young boys are at an increased chance of wetting the bed, potentially for longer.
Another risk factor for bedwetting concerns genetics. If nocturnal enuresis runs in the family, the child is more likely to wet the bed. Other causes of primary bedwetting, such as an imbalance of the anti-diuretic hormone that helps the body produce less urine in the evenings and structural abnormalities (which are rare), might also have a genetic link that influences this issue. Children with attention-deficit/hyperactivity disorder (ADHD) are also at an increased risk of wetting the bed.
Secondary Bedwetting
Secondary bedwetting often has a more designatable underlying cause. Children who develop urinary tract infections or chronic constipation are more likely to wet the bed. Additionally, children dealing with high levels of stress -- changes in the family, changes in the environment, and physical, mental, or sexual abuse -- all contribute to increasing the risk of wetting the bed, even after initial bedwetting issues have ceased. Being “punished” for wetting the bed may make bedwetting more likely to continue or start up again. For example, if isolated incidents lead to being severely scolded, it may cause the child to begin wetting the bed consistently again.
