Although bedwetting is rarely caused by a serious medical disorder and often resolves itself, for 5 million children in the United States over the age of 6, it’s a condition that can create anxiety, embarrassment, and shame. These feelings are heightened when the child is invited to a sleepover — that familiar childhood rite of passage.
According to Dr. Howard Bennett, a clinical professor of pediatrics at George Washington University Medical Center and author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting, the combination of several factors is the usual culprit that leads to bedwetting: an increased production of urine during the night, a small bladder capacity, poor arousal from sleep, and constipation.
Dr. Bennett advises parents to keep two issues in mind. “First, bedwetting is common, and children should not be punished for it. Second, parents should always remember that bedwetting is a medical problem — it happens because a child’s brain and bladder are not communicating with each other at night.”
In addition, Dr. Bennett warns of another type of disconnect. “Bedwetting is a topic people often shy away from. Parents may be embarrassed to broach the subject with their pediatricians, and doctors typically assume that if a child is wetting the bed, the parents will inquire about it. Parents need to be proactive and talk with their child’s pediatrician.”
What Parents Need to Know
Dr. Bennett offers the following answers to the most frequently asked questions about bedwetting.
Do you recommend restricting fluids in the evening to keep children dry?
Does bedwetting run in families?
Most children who wet the bed have at least one parent or close relative who had the same problem as a child. Approximately 45 percent of children wet the bed if one parent wet the bed as a child, and 75 percent wet the bed if both parents were bedwetters.
Is bedwetting more common in boys or girls?
Prior to age 13, boys wet the bed twice as often as girls. By the time adolescence rolls around, these numbers equal out. Interestingly, girls are more likely than boys to have other bladder symptoms, such as urgency, frequency, or daytime wetting.
Does bedwetting go away on its own?
Every year, 15 percent of children older than 5 who wet the bed become dry with no intervention. Although children usually follow the same pattern as their family members, this is not always the case. Because there is no way to predict when a child will overcome his wetting, I recommend that children start a bedwetting program if they’re motivated to become dry.
How can I tell if my child is motivated to work on becoming dry at night?
There are four signs you can look for to see if your child is ready to work on becoming dry:
Some people think restricting fluids after dinner helps children stay dry. Although this helps some children, it doesn’t work for most — if a child limits fluids, he may wet the bed with four ounces of urine instead of six, but he’s usually still wet. My approach to restricting fluids is practical. If a child tells me that limiting fluids helps him stay dry, I give it my “OK.” Otherwise, I generally don’t recommend this approach.
What is the best way to treat bedwetting?
The bedwetting alarm is the product that yields the best results. This device teaches the child’s brain to pay attention to his bladder while sleeping. Bedwetting alarms have two basic parts. (1) a wetness sensor that detects urine and (2) an alarm unit that produces a loud sound when a child wets the bed.
How does the bedwetting alarm work?
The alarm’s sensor has the ability to detect small amounts of moisture. When a child wets the bed, the urine in his underpants turns on the alarm. When the alarm goes off it awakens the child so he can go to the bathroom and finish urinating in the toilet. After weeks of hearing the alarm, the child’s brain learns to pay attention to the full bladder signals and he wakes up before wetting the bed.
Are drugs an effective way to treat bedwetting?
The medication that is prescribed most frequently is called desmopressin (brand name: DDAVP). Desmopressin is a manufactured form of the hormone the brain produces to decrease urine production at night. The effects of desmopressin only last for a short period of time, and children usually relapse when medication is stopped. For this reason, doctors generally recommend this for sleepovers, vacations, or special occasions.
Words of Encouragement for Children
Dr. Bennett recommends the following strategies to help ease your child’s anxiety.
- Do not punish or shame children for being wet at night.
- Remind children that bedwetting is no one’s fault.
- Let children know that lots of kids have the same problem.
- Let children know if anyone in the family wet the bed growing up.
- Maintain a low-key attitude after wetting episodes.
- Praise children for success in any of the following areas: waking up at night to urinate, having smaller wet spots or having a dry night.
- Encourage children to go on sleepovers.
Dr. Howard Bennett is a clinical professor of pediatrics at The George Washington University Medical Center and the author of Waking Up Dry: A Guide to Help Children Overcome Bedwetting. For more information on his book, visit the Bookstore.
This article was featured in Healthy Children Magazine. To view the full issue, click here.