Information From Your Health Care Provider

BED-WETTING

(Enuresis)

Basic information

description

Bed-wetting (enuresis) is the repeated urination during sleep by a child who is old enough (usually by age 5) to have urinary control. Some children have been wetting the bed all along. This is called primary nocturnal enuresis. Some children start bed-wetting after having been dry at night for at least 6 months. This is called secondary nocturnal enuresis. Most children who wet the bed are healthy. Bed-wetting is a common problem and occurs more in boys than in girls.

FREQUENT SIGNS & SYMPTOMS

Repeated bed-wetting at night (occasionally during the day). This is not usually a concern until a child is older than 5.

causes

Genetic factors (e,g, inherited) are involved. Delays in maturing, deep sleep, small bladder capacity, polyuria (excess urine), stress, or trauma may play a role. In a few children, a medical illness or other health problem may be the cause.

risk increases with

Family history of bed-wetting.
Illness such as diabetes or urinary-tract infection.
Stress or trauma in a child (e.g., parents divorce, new sibling, moving to new home, abuse, hospital care, and others).

PREVENTIVE MEASURES

No effective preventive methods are known.
Show your child love, support, and understanding for this problem.

expected outcomes

If there are no medical or emotional problems, children normally outgrow the bed-wetting problem. Treatment measures are successful in many cases.

possible complications

Child feels anxious, embarrassed, and shameful. May lead to social withdrawal, loss of self-esteem, or other problems. Parents become frustrated.
Urinary-tract infection.

diagnosis & treatment

general measures

Talk to your child's health care provider about the bed-wetting problem. A physical exam will be done and questions asked about the symptoms and your child's lifestyle. Medical tests are sometimes done to rule out diabetes or other medical problems as causes. These can include urine studies or imaging tests.
Follow any medical care advice from your child's health care provider.
Protect the mattress with a heavy plastic cover.
Stop using diapers or plastic pants by age 4. They may make it easy for the child to keep on wetting.
Have the child change the sheet on the bed and do the laundry, if he or she is old enough.
Have a nightlight so the child can find the bathroom.
Don't give any liquids to the child for 2 to 3 hours prior to bedtime.
Have the child urinate at bedtime. You can also wake the child at night to urinate, but this is hard on parents.
Reward the child for staying dry with praise and hugs. Use gold stars or happy faces to mark dry nights on a calendar.
Try alarms that are triggered by wetting. These may be used in undergarments, pajamas, or mattresses. They have a high success rate.
Counseling may be recommended for the child and the family if there are emotional or stress problems.
Respond gently to accidents. Don't blame, nag, restrict, or punish the child who has wet the bed. This can cause him to give up or lead to other problems. Your child's bed-wetting should resolve with time.

medications

The drug vasopressin may be prescribed if other methods fail and the family favors drug therapy.
Certain other drugs may be recommended for some.

activity

No limits.

diet

Avoid any beverages that contain caffeine (e.g., colas). Encourage your child to drink moderately during the day. Limit or discontinue any fluid intake during the 2 to 3 hours before bedtime.

notify our office if

You are concerned about your child's bed-wetting and your child is older than 5.
The child dribbles urine, has a weak urinary stream, feels pain when urinating, or must strain to urinate.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.