Children And Bed-Wetting
What is "bed-wetting"?
Bed-wetting is when children wet their beds. This is very common at night in all children. Indeed bed-wetting is extremely common, even up to six years of age twenty percent of children still wet their beds. This is called nocturnal enuresis. Enuresis is bed-wetting and nocturnal points to the fact that it happens at night.
Is it normal for children who are potty-trained to continue wetting their bed?
Even kids that are potty trained still wet their bed at night. A lot of children establish daytime dryness, but still wet their bed occasionally at night. This is very normal. If your child has been dry both during the day and at night for an extended period of time, over several months, and then they starts wetting during the day or at night, that would be a time where you would want to talk to your pediatrician to see if there are any other causes. However, in general, most kids sporadically are wet and dry throughout several years and this is normal. They may have a week here and there where they show some dryness, but they've never been fully dry for more than a specific three month period at a time.
How can I train my child to not wet his bed?
In the first six years, really, there's not much intervention that you need to do. You don't want to make a big deal of it. It's very normal, and you don't want to place any blame on your child. So, really it's a laundry problem but not a medical problem. After the age of six we do start some intervention. Now, the simplest intervention is limiting fluids at nighttime, so, after dinner trying to limit fluids, and having your child try to pee before they go to sleep. Even if they don't feel like it, try, at least, to do it, and try to empty the bladder. The other thing you can try: a lot of children need help learning to hold the urine in their bladder, and so one of the things we do to train the bladder to do this is something called "nighttime wakening", and this is when you have your child pee before bedtime, and you've eliminated fluids, and then maybe a couple of hours later, about midnight, before you go to sleep, you wake them up and you have them go and try to pee again. And when they stay dry for several nights in a row, when you've woken them up at midnight, then you start waking them up at 11:45, and what you're doing is you're training the bladder to hold the urine longer and longer for the latter portion of the night until you get back, basically, to their bedtime, and it helps teach them to potty train. Now, in severe cases of potty training -- if kids are older; it's becoming a social stigma; they can't go to sleepover parties -- there are certain medications that can help. There are even some training tools like pads that go on the bed that ring a bell when the child starts to pee that wakes them up and signals for them to go to pee, but none of these treatments work great. Nor do they work close to 100% of the time. So a lot of it is a waiting game. And nocturnal enuresis and bed-wetting runs in families, so if you are a bed-wetter, your dad was a bed-wetter, it's very likely that your child will be too, and then if you were dry by the age of twelve, probably it's just going to take some time, and when your son or daughter is a little older they're going to stop as well.
When should I get help for my child's bed-wetting?
We usually get concerned with bed-wetting if it's something called secondary enuresis, and what that is: primary enuresis means that you're wetting but that you've always been wetting, and these are the kids that for the first six years are dry occasionally but sporadically wet their bed. But when you've been dry for a good three months, day and night, and you haven't had any accidents and then out of the blue, all of a sudden you start wetting your bed again or wetting your pants during the day. This should be investigated because there are other cause of bed-wetting that we should look at: things with infection, diabetes, different types of diabetes (insipidus and mellitus), that with certain urine tests we can check to see if there is anything going on. And if there is nothing, it could still be nothing, and we just do some behavioral modification. But those are the times when it's new, out of the blue, or they're complaining about it, it's effecting your child and that when it should be brought to your doctor's attention.
