How to prevent a child from wetting the bed

How To Help Your Child Stop Wetting the Bed – Cleveland Clinic

You’re frustrated. You’re exhausted. Your child is already in school — but they’re still wetting the bed at night. You’ve tried limiting liquids after dinner. You’ve woken your child up in the middle of the night to use the bathroom. Still, no luck.

But you aren’t alone. Parents often worry about bedwetting in their children, a problem defined as “involuntary urination in children 5 years of age or older.” But in reality, about 15% of children in the U.S. are still wetting the bed at age 5.

To help parents deal with this challenge, we turned to pediatric nephrologist Charles Kwon, MD, and pediatric urologist Audrey Rhee, MD.

When your child is older than age 7 and still wetting the bed, you might want to talk with their primary care physician or a pediatric nephrologist or urologist.

Also, keep in mind that about 15% of children age 5 or older actually stop wetting the bed each year.

“When I meet a child who is wetting the bed, it’s twice as likely to be a boy. He usually presents with no other medical problems,” Dr. Kwon says.

What causes bedwetting?

“The underlying issue is usually a bladder that’s not yet matured,” says Dr. Kwon.

Other possible causes for bedwetting include hormone imbalance, constipation or more serious issues, shared below.

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Your child may be at a higher risk for wetting the bed if:

• They experience a lot of stress and anxiety.
• There is family history of childhood bed-wetting.
• They have ADHD (attention-deficit/hyperactivity disorder).

How to stop bedwetting

To combat bedwetting, doctors suggest:

• Shift times for drinking. Increase fluid intake earlier in the day and reduce it later in the day, stopping fluid intake after dinner.
• Schedule bathroom breaks. Get your child on a regular urination schedule (every two to three hours) and right before bedtime.
• Be encouraging and positive. Make your child feel good about progress by consistently rewarding successes.
• Eliminate bladder irritants. Start by eliminating caffeine (such as chocolate milk and cocoa). And if this doesn’t work, cut citrus juices, artificial flavorings, dyes (especially red) and sweeteners. Many parents don’t realize these can all irritate their child’s bladder.
• Avoid thirst overload. If schools allow, give your child a water bottle so they can drink steadily all day. This avoids excessive thirst after school.
• Constipation may be a factor. Because your rectum is right behind your bladder, difficulties with constipation can present themselves as a bladder problem, especially at night. This affects about one-third of children who wet the bed, though children are unlikely to identify or share information about constipation.
• Don’t wake children up to urinate. Randomly waking up your child at night and asking them to urinate on demand isn’t the answer. It’ll only lead to more sleeplessness and frustration for you and your child
• An earlier bedtime. Often, children are deep sleepers because they’re simply not getting enough sleep.
• Cut back on screen time, especially before bedtime. Improving sleep hygiene can help their minds slow down so they can sleep better.
• Never resort to punishment. Getting angry at your child doesn’t help end bedwetting. The process doesn’t need to involve conflict.

Are there medications for bedwetting?

“Although there are medications (including a synthetic form of a hormone) that can address bedwetting, I don’t prescribe them unless a child was already put on the medication by another provider,” says Dr. Rhee.

“There are side effects,” she says. “Plus, it’s a temporary fix, a quick remedy, when what we want is an overall solution.”

Is my child bedwetting on purpose?

Families often wonder if a child is bedwetting on purpose. Dr. Kwon often tells parents that it’s typically not their fault nor is it their child’s fault. “I tell them not to get too stressed because this issue often resolves on its own,” he says.

Dr. Rhee adds that it’s also important to talk to your child to see if there’s motivation to change. If they’re motivated to change, a bedwetting alarm can be the solution. 

You can clip the alarm to your child’s underwear or place it on the pad on the bed. Once the device detects any moisture, the alarm goes off.  But if your child isn’t independently motivated, the alarm may have no benefit and may just further frustrate the family.

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“If they’re still sneaking drinks late at night and eating what they shouldn’t, then it doesn’t make sense to invest in an expensive bedwetting alarm. So, I directly ask a child if bedwetting bothers them, to find out if it’s the parents’ frustration that brought the child to the appointment or their own,” Dr. Rhee says.

As your child gets older and has opportunities to go to slumber parties and weekend trips, bedwetting can affect their confidence and social life. This’ll most likely motivate your child to solve the problem and avoid feeling embarrassed.

Is bedwetting serious?

Occasionally, bedwetting is a sign of something more significant, including:

• Sleep apnea. If your child snores a lot or otherwise shows signs of sleep apnea, further investigation through your child’s pediatrician should be pursued. Otherwise, this isn’t a first course of evaluation of your child’s bedwetting issues.
• Urinary tract infections (UTIs). A urine sample can detect these infections, which is a typical test doctors will order when bedwetting is an issue.
• Diabetes mellitus. A urine sample can also detect diabetes in children.

Bedwetting may be a sign of a sleep disorder, as well, in which case, a sleep study can be conducted.

If you have additional concerns about your child’s bedwetting, make an appointment with your pediatrician.

How to Stop Bedwetting: Bedwetting Solutions

At age 7, Billy was getting invitations for sleepovers from friends. He wanted to go, but there was a problem: how to stop bedwetting.

Bedwetting had been an ongoing issue for Billy, says his mother, Jane, (not their real names) of Bethesda, Md. Her two older children hadn't had the problem, but Billy couldn't seem to stay dry. "He wanted to start being dry so he could go to sleepovers," she says.

Billy has lots of company -- 20% of 5-year-olds and 10% of 6-year-olds are bedwetters, says the American Academy of Pediatrics. Most grow out of it and usually there's nothing serious going on. But statistics and research weren't making the sleepovers easier for Billy.

So Jane broached the topic with Billy's pediatrician and heard some good news. Bedwetting solutions abound, from simple "reward" systems to using urinary bed alarms -- the strategy that ended up working for Billy.

Here, what parents hoping to help their child stop bedwetting need to know about solutions.

Addressing Bedwetting Misconceptions

Before pediatricians suggest a specific bedwetting solution or treatment, most seek to educate parents.

Bedwetting "often runs in families," says Howard J. Bennett, MD, a pediatrician in Washington, D.C., author of WakingUp Dry, and Billy's pediatrician. Usually, the child becomes dry at about the same age as the parent did. And no matter what you may think, bedwetting is not due to laziness or spite, two common misconceptions, pediatricians say.

Getting your pediatrician's input, instead of trying remedies on your own, may speed things along, according to a study published in the Journal of Urology. Researchers found that when children followed their pediatrician's advice about bedwetting solutions they were dry earlier than a group of children whose parents picked the treatment to stop bedwetting on their own.

Bedwetting: Ruling Out Medical Problems

Next, physicians are careful to take a medical history and rule out medical causes, such as constipation or infection. Most bedwetting is what doctors call primary enuresis, meaning the child has always wet the bed. Doctors think it’s usually caused by a delay in the maturation of the mechanisms controlling the bladder.

But if bedwetting occurs after the child has been dry for a year or so, it’s termed secondary enuresis, and doctors must look more closely at the cause. Secondary enuresis could occur with psychological stress or trauma, and the child may need counseling or other treatment.

If no medical or psychological causes for bedwetting can be found, the family can move on to ways to help the child stop bedwetting.

How to Stop Bedwetting: Urinary Bed Alarms

Urinary bed alarms are generally regarded as the most effective bedwetting treatment for the long term.

Alarms are available in several different styles, but all include a moisture sensor and an alarm. One model, for instance, involves a moisture sensor worn on the underwear or pajamas, attached to an alarm box worn on the shirt. The sensor detects moisture almost immediately and sounds the alarm, alerting the child to get up and go to the bathroom.

In a report summarizing the medical evidence on bedwetting treatments such as alarms, behavioral interventions such as giving rewards, and medications, alarms were found to be the most effective. The study was published in the Journal of Wound Ostomy Continence Nursing.

In another study, published in the Journal of Paediatric Child Health, researchers found that 79% of 505 children who wore bed alarms achieved dryness within about 10 weeks (half took longer, half took less time). Six months later, 73% of those children were still dry.

While many parents try the other strategies first even before discussing bedwetting with their pediatrician, some go straight to the bed alarm.

How to Stop Bedwetting: Rewards for Dry Nights

Eleanor and her husband, Ray, moved to another common strategy -- the reward system. This can involve giving the child a small toy after a dry night or rewarding him with a trip to the park or someplace else he wants to go. Eleanor and Ray bought little prizes, such as coloring books and rubber balls, and pasted them on the wall so Michael could look at them.

"When he had a successful night, he would pick a prize," Eleanor says. "That worked for a while."

Anything special to the child can be used as a reward, says Robert Mendelson, MD, a Portland, Ore., pediatrician who often counsels parents about bed-wetting issues. Load on the praise, too, he says. "Any time the child is dry in the morning, tell them how great they are," he says. "Congratulate them, tell them, 'You are getting to be a big boy or girl.'"

How to Stop Bedwetting: "Lifting"

Eleanor and Ray also tried a technique called "lifting." This strategy involves making sure your child goes to the bathroom right before his bedtime, and then waking him up after he has been asleep two or three hours and taking him to the toilet.

"We went to two times a night," Eleanor says. "One at 11 and the other at 2:30 a.m. My husband got the 2:30."

Patience won out. "It didn't work immediately," she says. "We did this for over six weeks." Suddenly, one day he didn't wet. And the next, and the next. She doesn't know if it was the lifting or just time. "I think he just grew out it," say Eleanor, who is relieved.

"Lifting can be a helpful temporary measure while you are waiting for kids to get dry on their own," agrees Bennett.

How to Stop Bedwetting: Bladder Training

Helping your child delay urination during the day is another strategy. Using an egg timer, you ask your child to tell you when they have to go, then ask them to hold it for another few minutes. You start with about five minutes and add a couple minutes each time, they say. The goal is to get to 45 minutes.

But this process takes time and you should do it every day, he says. If old enough, a motivated child can do it on their own.

How to Stop Bedwetting: Fluid Restriction

Limiting fluids at night is widely suggested but can be difficult to do. Eleanor, 40, of West Covina, Calif., tried taking away liquids every night at 7 p.m. when she was attempting to help her son Michael, now 4 1/2, stay dry all night.

Then she moved it up to 6 p.m. "He started begging me for a tiny drink, and I felt so bad," she says. Looking into his eyes as he begged for just a sip was too much for her, she says. "So I couldn't do that anymore."

"I don't recommend restricting fluids unless it is the kid's idea," says Bennett. "Otherwise the kids see it as a punishment."

Bedwetting Products: Waterproof Sheets

Plastic sheets and disposable underwear can save sanity and mattresses. You can also use the "double bubble" method of making a bed. Layer a plastic sheet, regular sheet and a blanket; then repeat the process.

Teach the child how to strip off the top layer and make a fresh bed. Keep some fresh pajamas or disposable underwear bedside, too, so they can easily change into dry ones.

Bedwetting Products: Super Training Pants

Super absorbent training pants designed for use at night can help, as well. Bennett tells parents they are fine to use when the child is 4, 5, or 6.

By age 7, they usually suggests trying something else.

Bedwetting Treatment: Medications

Medications usually work while the child is taking them, but once they’re stopped the bedwetting typically starts again. And the medicines can have side effects.

Among the bedwetting treatment options are desmopressin (DDAVP), a synthetic copy of a body chemical that controls urine production, given at bedtime. It's available in tablets and nasal spray forms, but the nasal spray is no longer indicated for primary bedwetting treatment, according to an alert issued by the FDA in late 2007. The agency cites risks of the nasal spray causing low blood sodium levels, in turn possibly leading to seizures and death.

Bennett sometimes prescribes DDAVP in tablet form temporarily, perhaps to help a child stay dry on a sleepover or at camp. "It works immediately if you have the right dose," he says. He will try out a dose before it's needed to be sure he has picked an effective one.

Another medication option is imipramine (Tofranil, Tofranil-PM), an antidepressant that may work by reducing urine production, affecting the amount of time a child can hold urine in the bladder, or other ways.

Bedwetting medications may help in a social situation such as sleepovers but are usually a last resort, according to the American Academy of Pediatrics. They are not recommended for children younger than 5 years old.

Bedwetting Solutions: Success Stories

Jane's family had tried most of the do-it-yourself strategies with Billy before turning to the bed alarm because nothing else had worked.

Using the bed alarm takes commitment from parents and children, according to Bennett, who says he has worked as an unpaid consultant helping bed alarm companies with product design. And it takes different amounts of time to work, he says.

"Early on, even the alarm didn't wake him," Jane recalls. "We would have to go wake him up." Things got better. "It wakes them up quicker and quicker. It took us a couple months of the alarm going off, and then it worked well."

"It took probably six months until he was totally dry. And then he had a recurrence about a year later. We put on the alarm again and in a week he was OK."

But Susan, her husband Mark, and their son Mike (not their real names), who was then 6, had a much more dramatic experience using the bed alarm. Within a week of using the alarm, he was dry. "He had a problem at least three or four times a week," Susan says. After the alarm worked, she says happily: "He went from a guy who wet the bed a few times a week to a guy who never had a problem."

Bedwetting Solutions: Getting to the Payoff

Encouragement is crucial as you work to help your child stay dry, Mendelson says. He encourages parents who wet the bed as children to tell their kids -- and to tell them at what age they became dry. It ''points out the hereditary nature of the problem" and helps children understand that eventually they will have control over the problem, he says.

Whatever method helps a child stay dry, most parents -- and kids -- are relieved when dry nights prevail. Eleanor, who used the reward system, considers dry nights a milestone that may even surpass other important ones such as learning to walk or starting preschool.

"This one wins," she says happily. "It is the biggest milestone we have hit so far."

Children's bedwetting: how to help your child

Nocturnal enuresis in children is common. And there can be many reasons for bedwetting in children. However, it often happens that parents underestimate the scale of the problem, unwittingly exacerbating the situation and the fragile child's psyche. In the article we will talk about the causes of incontinence in children, which are worth paying close attention to. We will tell you what to do and how to help your child cope with nocturnal enuresis.

Why does a child urinate at night

To begin with, it is necessary to understand in which case children's incontinence becomes a problem or a wake-up call. In pediatrics, the age norm when a child should not urinate in bed at night is considered to be the turn of 4-6 years. But for some reason, parents are so desperate to wean their child from a puddle in bed in almost a year or two. What is the risk?

The fact is that up to 1.5 years old, babies do not have a bladder and bowel control system. Therefore, attempts to teach the baby at this time to the potty may be in vain, or they will form the wrong reflex in the child. When the sounds of “ps-ps” and “scheduled planting” become a signal not to empty the bladder, but to fill the pot. And later, at 3, 4 or 5 years. There is a violation of this system, and the child again begins to write at night in bed. For parents, this causes surprise, and sometimes indignation.

Therefore, parents should not make this mistake - to compete in the development of their baby among peers, to rush physiological events that should proceed at a natural pace. In particular, to rush the “relationship” of the child with the pot.

Main causes of childhood incontinence

If a child of 4-6 years old regularly goes to the toilet during the day, but at night either wakes up in a puddle or sleeps without waking up wet, then you should pay attention and help your baby if necessary.

Wearing diapers

Often parents are too lazy to get up at night or they are tired of constant washing and changing bed linen for a wet child. Therefore, they are in no hurry to remove the diapers from the child, hoping that everything will come by itself. Will not come. Diapers prevent the baby from learning the physical reactions of his body, they do not allow him to establish a logical connection in time: I'm wet - I'm uncomfortable.

Such a connection begins to form in a baby after 1.5 years, and this can be seen by paying attention to the child's behavior. It becomes uncomfortable for him to walk in wet sliders or panties, and he demonstrates this in every possible way, gives a signal that he wants to go to the potty and distinguishes what it is to pee and poop. That's why it's important to wean your baby off diapers at this age.

Read about how to choose the right diaper HERE...

Diseases of the kidneys and bladder

Another reason why childhood enuresis occurs. Inflammatory processes are often accompanied by frequent urination. Infections and bacteria that affect the genitourinary system can also contribute to bedwetting. In girls, a disease such as cystitis occurs due to the structural features of the urinary canal (it is wider than in boys). Thus, girls experience discomfort and frequent urge to urinate, which they may not even control.

The kidneys are an organ for the distribution of “heat” in the body and in itself a “heat-loving organ”. Then, when hypothermia of the body occurs or due to an inflammatory, infectious process, their function is disturbed, enuresis develops in children.

Pathology of the nervous system

There are a lot of pathologies that can lead to problems with nighttime urination. This may be a delay in the development of urination centers in the brain, and the immaturity of the nervous system as a whole, and profundosomnia - a sleep disorder in which the child sleeps very soundly and cannot wake up on the “signal” of the nervous system to urinate.

In this case, you definitely need to consult a specialist or a doctor who will prescribe physiotherapy and select medication.

Chronic stress and psychological trauma

A common cause of childhood enuresis.

The availability of modern gadgets, the availability of social networks and not always correct and useful children's content, parental stress, the emotional situation in the family and kindergarten can provoke bedwetting.

Psychological stress, pressure and rigidity of upbringing lead to the fact that the child is tired in the same way as any adult. Children equally experience mood swings, as well as adults, experience anger, apathy, joy, longing. Accept your child as your equal.

Chronic diseases

Severe illnesses such as diabetes or epilepsy can lead to enuresis. In the first case, due to excessive drinking of water. This can be seen in the behavior of the child and undergo the necessary research. In the second case, urination may occur during nighttime cramps, which the child may not remember in the morning.

How to wean a child to write to bed

To begin with, to understand if there are serious reasons for concern and in any case, contact a specialist. It is important not to establish diagnoses and treatment “by eye”, but to identify the cause. The success of the treatment depends on this. This will require research, analysis and tests.

More often, enuresis has neuropsychological roots. The simplest thing parents can do in this case is to understand their child and pay attention to the situation within the family. Perhaps nighttime urination is an attempt by the child to draw attention to himself. This phenomenon occurs in hyperactive children or children with attention deficit disorder.

Support from parents is very important in terms of suggestions, open conversations and psychological assistance to your baby, no matter what age he is.

How to help a child

• Give the child sedatives, sedatives to reduce his daily activity and improve his psycho-emotional state, remove
• stress and tension. Suitable drugs such as motherwort tincture (necessarily diluted in drinking water according to the recommended dosage), children's tenoten, Magne B6, Edas-306 Passambra, Nervochel, Glycine.
• Enter the drinking regime. Limit the amount of liquid consumed during the day and stop taking liquid food and water after 18.00.
• Organize the correct daily routine. The baby should go to bed no later than 21.00
• Organize sleep hygiene. Mandatory reception of water procedures. Well, if it is a bathroom with herbal preparations. Mandatory absence of gadgets and TV an hour before bedtime. It is important to organize a quiet evening leisure immediately before bedtime, but an active evening - walks, outdoor games.
• Try the night awakening method. Have your child go to the toilet on an hourly basis. It is very important in this case not just to take the baby and put him on a potty or toilet to leave the bed dry. And it is important to wake up the child so that he does it consciously! Regular awakenings accompanied by a trip to the toilet will quickly teach the child to do it on his own.
• Try to give your child more time and be sure to monitor your emotional state. Children are sensitive to their parents like no other.
• Be sure to pay attention to the child and encourage him if he woke up dry. It is important here to do it without fanaticism and not to put the achievement on a pedestal.

What not to do for parents

• Do not lecture your child and do not shame him. Just understand that he does this not intentionally and not on purpose. The kid may not even understand that he peed in bed.

• Do not invest in him a sense of guilt and do not scold for the damaged sheet, for your nerves. Your nerves are your nerves and only you can spoil them. But without that, the existing feeling of guilt and shame can alienate the child from the parents, aggravating the internal complexes.

• Apply punishment. For example, you won't get it, or you won't watch cartoons, or you won't go out, or you won't get sweets because you did it in bed. This is how extremely negative attitudes and connections are formed in the child: in order to be good, I must do this or I am not good enough to be loved. This will be very harmful in the future. The child should feel unconditional love and support from adults.
• Let it go on its own. Despite the fact that the age of 5-6 years is considered the norm for enuresis, waving your hand in the hope that it will not go away on its own. By spending more time with your child, you will understand if he has complaints and physical discomfort, how often nighttime incidents occur and how the child behaves. You can’t panic, but you shouldn’t leave it “as is” either. If you have any concerns about nighttime urination, you should take action and seek the help of a specialist.
• To deprive a child of childhood and load the baby with classes, circles and sections, creating pressure of adult responsibility on the fragile child's psyche. Everything has its time. Constant tension, a strict daily regimen and the lack of time and opportunity to fully meet the needs of the child can provoke enuresis. So in pursuit of public opinion and standards, take care of your children who once chose you!

5 tips on how to wean a child from writing at night

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Once your little one is up to the task of getting used to the potty during the day, he will most likely be ready to sleep without a diaper at night in a very short time. It is quite normal for a child to urinate at night for a while, and it may take a little longer to get rid of this habit. With our 5 helpful tips, you will learn how to teach your child to get up at night on the potty, and say goodbye to changing diapers in the middle of the night for good - hooray!

As with many other aspects of child development, it will take you much less time to potty train your child at night if you wait for the right moment.

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