Practical Tips for Dealing With Bedwetting

The last day your child needs diapers is often cause for celebration in families. While your child may be able to stay dry during the day, for some, bedwetting, also known as nocturnal enuresis, can be a challenging issue for both children and parents.

Fellow parent and Stanford Medicine Children’s Health pediatrician Nivedita More, MD, of Bayside Medical Group – Fremont, shares practical tips for parents dealing with this common concern. She also discusses this topic in a HealthTalks podcast.

According to Dr. More, bedwetting affects millions of children. “More than five million children in the United States continue to wet the bed past the age of 6. Bedwetting occurs in approximately 20% of children at 5 years of age,” she shared. “So, it’s essential for parents to understand that it’s a common concern, but it can often be outgrown with time and appropriate guidance from their pediatrician.”

Understanding why kids wet the bed

For many young children, bedwetting is simply a normal part of development that they will outgrow as they get older and more mature. It tends to run in families, so for older kids, if a parent wet the bed, there is a greater chance the child will too.

“Most children who wet their beds have really small bladders, and their bladders cannot hold all the urine that is made during the night. So, when they sleep really deep, they cannot feel when the bladder is full and wake up to urinate,” Dr. More said. “There is a real strong genetic predisposition to bedwetting. Most of the older children who wet their bed have had one or both parents who also wet their bed as teens.”

Creating a supportive environment

Dr. More encourages parents to set their child up for success by creating an environment where the child feels comfortable discussing their bedwetting without fear of shame or embarrassment.

“A combination of a motivated child and a cooperative family is the best predictor for a positive outcome with bedwetting,” she said. “Parents should not be blaming or shaming their child for bedwetting. It is never the child’s fault, so they should not be punished for bedwetting.”

Establishing a nighttime routine

Here are some suggestions from Dr. More for parents and caregivers around bedtime to reduce the likelihood of bedwetting:

• Monitor your child’s fluid intake before bedtime; encourage them to drink more earlier in the day and limit fluids closer to bedtime.
• Decrease intake of food or liquids in the daytime that cause increased urine production or urinary volume (diuretics), such as chocolate, caffeine, carbonated drinks (including carbonated water), and coconut water.
• Remind your child to urinate before going to bed.
• Make it easy for your child to use the bathroom at night: add a night light, or use a portable potty if the bathroom is too far away.

While Dr. More recommends waking a child during the night to urinate, she cautions parents to limit it to once a night. “A child may also be awakened and taken to the bathroom to urinate before parents go to bed, because typically children go to bed before the parents,” she said. “But I wouldn’t recommend waking them up numerous times in the night, because a good night’s sleep is really important for everyone.”

Additional support for older children

For kids who are a little older, Dr. More recommends adding more support, such as a moisture or bedwetting alarm. These are small alarms that children or teens can wear at night when they go to bed.

“This is just another way of reminding them to wake themselves when they are wet so they can use the bathroom in time. If bedwetting alarms are used appropriately, they do work, and they do start working within a few weeks,” Dr. More said. “And most of the time, a lot of the anxiety around this issue can be alleviated. If all else fails, of course, your child’s doctor can prescribe medications to help as well.”

Sleeping away from home

For children who struggle with bedwetting, the thought of attending a sleepover or camp can be intimidating. Dr. More suggests that parents first discuss it with their child and then reach out to the host family or camp counselor in advance of the event.

“Let the child know that you’re doing that and take them into confidence. Tell them they’re only there to help them and not to shame them. Most adults and camp counselors understand bedwetting and want to help,” she said. “Obviously, parents need to remind their children to follow the same strategies that they would use at home—for example, absorbable and disposable underpants for overnight stays—and packing extra clothes and underwear in case an accident occurs also helps.”

When to see your pediatrician

Ignoring bedwetting is not recommended, and it is best to bring it to the attention of the child’s pediatrician if bedwetting is becoming an issue—if it’s persistent and causing a lot of stress for the family or for the child.

“If they’re really struggling because of this, I would definitely bring it to their pediatrician’s attention,” she said. “Your pediatrician can help mitigate these tough times. The bottom line is, it is going to get better with age. I always tell my families, I have yet to know of somebody who is going to college and still bedwetting.”

For more advice from Dr. More, check out “Helping Your Child Cope With Anxiety and Depression,” “What Parents Need to Know About Teen Acne,” or read “Healthy Skin Habits for Your Family.”