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Toilet training a child takes a lot of patience, time, and understanding. Most children do not become fully toilet trained until they are between 2 and 4 years of age. Some will be able to stay dry during the day.  Others may not be able to stay dry during the night until they are older.

When should you be concerned about bed wetting
Your child is at least 6 or 7 years old and has never been able to stay dry overnight.

Your child is troubled by wetting the bed--even if the child is younger than 6 years.

Your child was once able to stay dry but has begun bed-wetting again.

You are troubled and frustrated by the bed-wetting.

You punish or are concerned that you might punish your child for wetting the bed.

Your child wets or has bowel movements in his or her pants during the daytime.

Causes of bed-wetting

Nighttime bed-wetting, called enuresis, is normal and very common among preschoolers.  Most of the evidence points to a genetic link (i.e. it runs in families). One of the most recent studies we found reported that if both parents were bedwetters, there is a 77% chance that a child of theirs will be. And if one parent was, there is a 44% chance. It affects about 40% of three year olds, About 15% of 6-year-olds wet the bed, And about 5% of 10-year-olds wet the bed, and 1% are over 18 and above.

Medical illness (Get your child medical checked out before assuming it's another cause)

Small bladder
Changing schools
Parents fighting or getting a devorce
Birth of a new child in the home
Being in or just getting out of the hospital
Being abused
Being picked on at school

ADHD (Attention Deficit Hyperactivity Disorder):

       There is still so much research into how ADHD effects the brain/body. And we still know so little about it today. But what we believe so far about how it effects children in reguard to bed wetting and/or day wetting is this disorder itself doesn't cause the bedwetting/day time accidents. It's the lack of paying attention and deep sleeping that is thought to be the cause. During the night the child sleeps so deeply that their brain does not get the signal to wake up due to the disorder. And during the day the lack of attention the child fails to relize they need to use the bathroom and find it's too late when they do want to finally pull themselves away from the activity.

All of the causes of bed-wetting are not fully understood, but the following are the main reasons a child wets the bed:

His bladder is not yet developed enough to hold urine for a full night, or

He is not yet able to recognize when his bladder is full, wake up, and use the toilet. 

Often, a child who has been dry at night will suddenly start bed-wetting again.  When this happens, it is usually due to stress in the child's life. Such stress could be due to a big change, such as a new baby in the home, moving, or a divorce.  Children who are being physically or sexually abused may also develop bed-wetting. If your child wets the bed after having been dry at night in the past, your doctor should do an evaluation. The bed-wetting may be a sign that stress or a disease is causing the problem.

         The most important thing to remember to do is to be calm. Do not be angry with your child or punish him/her for the wetting. It will only make the problem worse. After all, it's only pee, it will come out in the wash. The blankets are not ruined. The next night just be sure to place a plastic/rubber sheet on the matress to protect the bed which can't be washed.

Signs of a problem

Some parents fear that their child's bed-wetting is due to a disease or other physical problem.  Actually, only about 1% of bed-wetting cases are related to diseases or defects such as bladder or kidney infections, diabetes, or defects in the child's urinary system.

With any of these cases, there will often be changes in how much and how often your child urinates during the day. Your child may also have discomfort while urinating. Tell your doctor if you see any of the following signs at any age:

Unusual straining during urination, a very small or narrow stream of urine, or dribbling that is constant or happens just after urination

Cloudy or pink urine, or bloodstains on underpants or nightclothes

Daytime as well as nighttime wetting

Burning during urination

The visit to the doctor
In trying to find the cause of your child's bed-wetting, the doctor may ask you the following questions:

Is there a family history of bed-wetting?

How often does your child urinate, and at what times of the day? (It would help to keep a diary a week or two prior to seeing the doctor if you can of his/or her times of when she uses the toilet and what he/she did. As well as you best guess as to what time of night the child wets the bed at night even though it does count as going in the toilet.)

When does your child wet the bed? Is your child very active, upset, or under unusual stress when it happens?

Does your child tend to wet the bed after drinking carbonated beverages, caffeine, citrus juices, or a lot of water?

Is there anything unusual about how your child urinates or the way his urine looks?

If the doctor suspects a problem, he may take a urine sample from your child to check for signs of an infection or other problem. The doctor may also order tests such as an x-ray of the kidneys or bladder, if there are signs that wetting is due to more than just delayed development of bladder control.

If the tests point to a problem that may require surgery, your doctor may recommend that you see a pediatric urologist who is specially trained to treat children's urinary problems that require surgery (although it's rare. 90% of the time it's just a case of the child having to grow out of it, and that happens most times around age 13-15 typically).

Most school-age children who wet their beds have primary enuresis. This means they have never developed nighttime bladder control. Instead, they have had this condition since birth and often have a family history of the problem. Children who are older when they develop nighttime bladder control often have at least one parent who had the same problem. In most cases, these children become dry at about the same age that their parent did.

Tips to manage bed-wetting
Reassure your child that the symptoms of enuresis will pass as he or she gets older. Until that happens naturally, however, the following steps might help the situation. Take steps before bedtime. Have your child use the toilet right before getting into bed and avoid drinking large amounts of fluid just before bed time.

     Setting up a daily routine helps as well to reduce stress. It helps the child to know what is expected daily. Avoid as much as possible any change of the routine. Seems to help some kids.

Use a bed-wetting alarm device if possible.  If your child reaches the age of 7 or 8 and is still not able to stay dry during the night, an alarm device might help.  When the device senses urine, it sets off an alarm so that the child can wake up to use the toilet.  Use this device exactly as directed so that it will detect the wetness right away and sound the alarm.  Be sure your child resets the alarm before going back to sleep.  These alarms are available at most pharmacies and cost about $50.  Although they provide a 60% to 90% cure rate, children often relapse once they stop using them.  Alarms tend to be most helpful when children are starting to have some dry nights and already have some bladder control on their own.

Protect and change the bed.  Until your child can stay dry during the night, put a rubber or plastic cover between the sheet and mattress. This protects the bed from getting wet and smelling like urine. One suggestion a parent had was to make up the bed complete with sheets and blankets and then apply the plastic sheet and then make up the bed again on top of it all with sheet and all. This way when the child wets he/she can strip the bed and have a complete bedding waiting below that is already warm and made for him/her. All they have to do is climb in after changing their night clothing. It also keeps the child from having to wake someone up to help make the bed and feeling guilty about it.

Let your child help. Encourage your child to change the wet sheets and covers. This teaches responsibility. At the same time it can relieve your child of any embarrassment from having family members know every time he or she wets the bed.  If others in the family do not have similar chores, though, your child may see this as punishment. In that case it is not recommended.

Other treatments. 
Behavioral treatment is often more effective and certainly is safer than medical treatment. While behavioral treatment may take somewhat longer to show results, the improvement usually continues indefinitely. There are several methods that may be helpful:

Evaluation for allergies: In rare cases, food or other allergies may be related to enuresis.

Retention Control Training: Some doctors recommend bladder-stretching exercises. The child is asked to control urinating during the day by postponing it, first by a few minutes and then by gradually increased amounts of time. This exercise can extend the capacity of the bladder and strengthen the muscle that holds back urination.  Parents should always check with a doctor before asking their child to practice retention control. With these, your child will gradually increases the time between daytime urinations so that the bladder can slowly stretch to hold more urine.  Should you and your child decide together to try bladder-stretching exercises, follow instructions from your doctor. Because bed-wetting is such a common problem, many mail-order treatment programs and devices advertise that they are the cure. Use caution; many of these products make false claims and promises and may be overly expensive. Your doctor is the best source for advice, and you should ask for it before your child starts any treatment program.

Night-lifting:  This procedure involves waking your child periodically throughout the night, walking your child to the bathroom to urinate, and then returning your child to bed. By teaching your child to awaken and to empty his or her bladder many times during the night, it is hoped that he or she will eventually stay dry.

Moisture alarm:  Moisture alarms are considered a useful and successful way to treat bed-wetting. Medical research has shown that moisture alarms have helped many children stay dry. This treatment requires a supportive and helpful family and may take many weeks or even several months to work. Moisture alarms have good long-term success and fewer relapses than medications.

An alarm consists of a clip-on sensor probe that attaches to the outside of bed-clothing.  An alarm is set off when the child begins to wet the bed.  The alarm wakes the child, who will then go to the bathroom to finish and then go back to sleep.  This slowly conditions the brain to respond appropriately during sleep to messages from the bladder.

Psychotherapy: This is used when the child is showing severe anxiety in relation to his bedwetting and this anxiety is interfering with teaching him to become dry. It is also useful if the enuresis is associates with external stress or trauma.

Hypnosis:  Hypnosis has been found to be a very effective form of treatment for bedwetting. By repeated listening to a hypnosis tape, the brain is re-programmed so that the child will be able to respond to a full bladder while asleep the same way he or she does while awake.

Do medications help? 
When no other form of treatment works, your doctor may prescribe medication. The use of medications to treat bed-wetting is in dispute. Since primary enuresis stops as a child matures, some doctors worry that using medication may have more risks than benefits. Not only can medications cause side effects, but they may not work. Your doctor can talk with you about the different medications that are available, their possible side effects, and their success rates. Two of the medications that are used are:

Imipramine (Tofranil)  This drug is a tricyclic antidepressant.  It is thought to either improve the child's sleeping pattern to improve the functioning of the smooth muscles found in the bladder.  This medication brings some improvement to about 30% of the children who have tried it.  Often, the symptoms return when the medication is discontinued.  The drug can cause serious side effects and needs to be closely monitored by the prescribing physician.

Desmpressin acetate  (Also called DDAVP)This drug is a synthetic form of the antidiuretic hormone and is administered as a nasal spray.  It helps the child's body make less urine, and thus lessens the risk that the child's bladder will overfill during sleep.  The medication often works quickly.  However, the condition may return after discontinuation of it's use.  While this medication is much safer than Imipramine, it still can cause some side effects. This medication without insurance is said to cost around $10.00 per dose.

       Most parents who do use the drugs opt to only use it when the child goes on a sleepover or to camp. Then they use either goodnites or some other method at home as the drugs can be expensive used on a regular basis. Not to mention the drug looses it's effect if it's taken daily all the time and the dosage has to be raised higher and higher and the risks and side effects climb with the higher doses. Which is why again, most parents opt to only use it for camp or sleepovers where goodnites and other methods would be embarrassing around friends.

If none of the treatments work
A small number of children who wet the bed do not respond to any treatment.  Fortunately, as each year passes, bed-wetting will decrease as the child's body matures. By the teen years almost all children will have outgrown the problem. Only 1 in 100 adults is troubled by persistent bed-wetting. Until your older child outgrows bed-wetting, he or she will need a lot of emotional support from the family. Support from a doctor or a mental health professional can also help.

It is important that parents give support and encouragement to children who wet the bed. They should be sensitive to the child's feelings about bed-wetting. For instance, children may not want to spend the night at a friend's house or go to summer camp. They may be embarrassed or scared that their friends will find out about their problem. 

Make sure your child understands that bed-wetting is not his fault and that it will get better in time. Reward him for "dry" nights, but do not punish him for "wet" ones. Remember, your child does not have control over the problem and would like to stop, too!

     Some parents want to try protection such as goodnites and it can be a good idea if done right. Do not force it on the child. Let it be their choice. Explain to them that the option is there for them to use them. Explain that they are not diapers and wearing them does not make them a baby. Let it be their choice. A wet goodnite is alot better than a cold wet bed, and I speak from experience.

Do not pressure your child to develop nighttime bladder control before his body is ready to do so. As hard as your child might try, the bed-wetting is beyond his control, and he may only get frustrated or depressed because he cannot stop it.

Set a no-teasing rule in your family. Do not let family members, especially siblings, tease a child who wets the bed.  Explain to them that their brother or sister does not wet the bed on purpose. Do not make an issue of the bed-wetting every time it occurs.

If your child has enuresis, discussing it with your doctor can help you to understand it better. Your doctor can also reassure you that your child is normal and that he or she will eventually outgrow bed-wetting.

          If you have anything you would like correct or to see something added to this article please e-mail me at Thank you.
This page was last updated on: August 18, 2013