How to stop child from bed wetting

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 Help Kids Stop Bedwetting

Although wetting the bed or having accidents during the day isn’t uncommon for young children, it can still cause a lot of shame and frustration, particularly when kids don’t seem to be growing out of it, or are regressing back into the behavior. When the problem persists after their fifth birthday, it can be a sign of a disorder called enuresis.

Enuresis is characterized by voluntary or involuntary urination at inappropriate times and places. Children have to be at least five years old to be diagnosed with the disorder, and the wetting incidents must occur at least twice a week for three months or longer.

Dr. Laura Kirmayer, a clinical psychologist who has worked with many children who have enuresis, says that the disorder is very treatable, although she warns that it is important to rule out any possible medical condition before diagnosing a child with enuresis. Bedwetting could also be caused by diabetes, sleep apnea, urinary tract infection, hormone imbalance, chronic constipation or some other issue.

Kids with enuresis may wet the bed while they’re asleep (called night-time enuresis), or their clothes while they’re awake during the day (daytime enuresis), or both.

The psychology community also discriminates between what’s called primary and secondary enuresis. In the case of the former, the child never learned to control her bladder and has been wetting the bed since she was a baby. Children with secondary enuresis did learn to use the toilet correctly and stay dry over night, but develop the condition at least six months after learning to control their bladders.

Primary nocturnal enuresis is the most common form of the disorder.

When it comes to treatment, the most important distinction to make is whether the wetting is voluntary or involuntary. If it is voluntary, treatment should resemble that of any other oppositional behavior treatment plan: parents should focus on positive reinforcement for desired behaviors, and limit setting and appropriate consequences for undesired behaviors. For involuntary enuresis, treatment needs to begin with skill building because the child is still learning how to control her bladder. Using disciplinary methods — or shaming — for children with involuntary enuresis would be unfair and could potentially have negative consequences.

Be on the lookout for things that could be causing accidents, like anxiety that might make a child not want to go to the bathroom at school or feel like she can’t ask for permission. Other kids who struggle with distractibility or impulsivity might even forget that they need to use the bathroom because they’re doing something very fun or interesting. Kids going through significant stress at home or school might also begin having accidents again. Paying attention to potential underlining causes can let parents know if their child might require some targeted help besides regular enuresis interventions.

The most common treatment for nighttime enuresis is the bell and pad technique, also known as a bedwetting alarm. This method consists of a device kids wear at night that has a sensor, making a noise when it becomes wet and ideally waking up the child in time for him to stop the stream and go to the bathroom.

Dr. Kirmayer says that for a small percentage of children, the bell and pad method can have a kind of positive placebo effect. Just using the bell and pad means that they will start to be more aware of their bladder and have fewer accidents as a result. However the alarm doesn’t teach children how to prevent themselves from wetting the bed, since the alarm only goes off once the bed is already wet, often after the child has already emptied his bladder. It can also sometimes take several months before the bell and pad method starts having an effect.

If it has been determined that the child has involuntary enuresis, Dr. Kirmayer suggests a more proactive approach that families can try either by itself or combined with the bell and pad.

Dr. Kirmayer likes to begin treatment by explaining how the bladder works. In a session with parents and child, she frames the bladder as a muscle that can be controlled, and explains that the brain and muscle can work together. The session is informative, but she also tries to make it fun, using a balloon filled with water to demonstrate how the bladder can expand and contract.

Families coming for help with enuresis are often feeling frustrated, so it can be a relief to parents and children alike to shift the focus away from what the child is failing to do to more neutral, proactive grounds: learning about how the bladder works and how, with time and practice, the child can learn to control it.

After the child understands how the bladder works, it’s time to start practicing. Dr. Kirmayer recommends that the family first spend a week tracking the child’s pattern of urinating, diet and fluids, setting aside the weekend for the whole family to practice what she calls bladder training: “Filling the bladder, rating the level of urge, being mindful of what it feels like when the bladder is really, really full versus only a little bit full. ”

Making it an activity for the whole family takes some of the pressure off and creates a fun way for families to positively reinforce the child’s growing ability to pay attention to what he’s feeling. Dr. Kirmayer notes that this might be a good time for parents to also help kids start paying attention to other sensory experiences they are having, since children who struggle with bedwetting sometimes also are not aware of when they’re feeling full or tired.

Also, if parents notice that their child tends to have more accidents when he is deeply engaged in an activity, they can flag that tendency for him and give regular reminders to check in with how he’s feeling.

This daytime practice actually helps kids who struggle primarily with nighttime enuresis, too. “The skills training exposure and practice really has to happen in the daytime to see it generalize into the nighttime,” says Dr. Kirmayer. “If they’re deep sleepers then they need to have already started increasing their attention and awareness when they’re conscious and not fatigued in the daytime for it to able to map onto the time when they’re most at risk. ”

Besides helping the child learn to start being more mindful of the sensations he is having in his body, another goal should be for the child to start feeling like he has some control over his body’s functions, and for him to take some pride and excitement in the skill he is developing. Parents can help by periodically reminding kids to check in with how their bladder is feeling and offering lots of positive reinforcement to keep kids motivated and engaged.

There is a pill for enuresis, and parents often employ it for events like sleep-away camp or a sleepover. But it won’t solve the problem in the long-run. Dr. Kirmayer likens it to taking a Xanax before a plane ride — “It’s not going to cure your fear of flying if you don’t eventually fly without the Xanax,” she says. Still, she thinks taking the medication does make sense for certain situations, like a sleepover the child is desperate to go on.

It can take time for kids to learn to control their bladder, so it is important for families to stay positive. Dr. Kirmayer says that kids should be encouraged to keep practicing body awareness and stay engaged. “Even if they end up wetting the bed, maybe they could still get up in the morning and change the sheets or put them in the laundry basket — whatever the routine is that has been agreed upon — without them having to be prompted,” Dr. Kirmayer suggests. That way the child is staying invested in the process and playing an active role. It also gives parents something positive to reinforce.

“I think the biggest challenge is that unfortunately with nighttime wetting either parents are getting woken up and they’re tired and they’re frustrated or they wake up in the morning it’s not what they want to be dealing with first thing,” says Dr. Kirmayer. It’s hard for parents to contain what they might be feeling internally, but it’s important to stay neutral and focus on the positive. Inadvertently shaming and blaming the child won’t help and may even cause her to start having “accidents” on purpose out of defiance.

Modeling distress tolerance in the face of disappointment will help everyone in the family stay feeling positive. After an accident the lesson should be: It’s no big deal. We’re still working on it, you’re going to get it, but we’re just not there yet.

Frequently Asked Questions

You can help your child stop bedwetting by using the bell and pad technique, in which a child wears a device with a sensor that makes a noise when it becomes wet. The alarm wakes the child in time for them to stop urinating and go to the bathroom. You can also help your child learn to track when they go to the bathroom and what it feels like to need to go. That way they can gain more control of their bodily functions.

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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