Bedwetting affects children of all ages- Here’s how to help

By Dr. Miriam Harel, Pediatric Urologist, Children’s Hospital at Montefiore

If you think your child is the last one in class still wetting the bed, trust us, you are definitely not alone!

Approximately 10% of six-year-olds still wet the bed every night, and 5% of all 10-year-olds are still waiting to outgrow it. This means that over five million children in the U.S. have bedwetting. While bedwetting is not physically harmful, it can often lead to poor self-esteem and avoidance of social activities such as camp and sleepovers, if left untreated.

Bedwetting can also be very frustrating, expensive, and time-consuming for parents. In the department of pediatric urology at Montefiore, we have a whole team of doctors and nurses committed to helping you understand and treat your child’s bedwetting.

What is Bedwetting?

Bedwetting is due to a combination of factors, including family history of bedwetting (genetics), small bladder capacity, and possibly too much urine production at night. Additionally, most parents will agree that children who wet the bed are very deep sleepers, and they don’t wake up from the bladder’s signal to urinate. Constipation is also common among these children, and a full rectum can put pressure on the bladder and make it difficult for the bladder to hold urine, during the day or nighttime.

In some children, sleep disorders (sleepwalking or heavy snoring) may also contribute to bedwetting. It is important to remember that bedwetting is never the child’s fault and is not happening on purpose, or out of laziness.

How do we Evaluate Children with Bedwetting?

Perhaps the most important part of evaluating your child is taking a thorough history to learn about their urinary patterns and to determine if they have accidents during the daytime or any other urinary symptoms besides bedwetting alone. We will also ask questions about your child’s bowel movements as well as other conditions that might be related to bedwetting, such as sleep problems or behavioral concerns. The physical examination is not painful. A urine sample is often ob- tained, and sometimes an ultrasound of the kidneys and bladder can also be helpful to gain more information about your child’s bladder function.

What Treatments are Available?

It is important to remember that most cases of bedwetting will resolve on their own, therefore, if your child is young enough and is not bothered by the accidents, it may be an option to give him/her more time to outgrow it with- out active treatment. An important part of this approach is making sure that your child’s daytime habits are appropriate. This involves timed voiding, or having children urinate every two hours during the daytime, as well as making sure that they are drinking enough water and limiting their intake of soda or juices, which can irritate the bladder. Treatment of constipation is also extremely important.