As unpleasant as bed-wetting is for your child (and you), it's a natural part of childhood development. Twenty percent of 5-year-olds and 10 percent of 6-year-olds wet the bed, according to the American Academy of Pediatrics. And it's twice as common in boys as it is in girls. Here's what causes some kids to wet their beds, and how you can help your child stay dry through the night.
Why do kids wet their beds?
Bed-wetting, called "enuresis," is rarely an emotional or psychological problem. It doesn't mean your child is too lazy to get up and go to the bathroom or that she's stubborn or immature. Researchers have found that genes play a role. If both parents wet their beds after the age of 6, their child has about a 75 percent chance of doing the same; if only one parent wet the bed, the child has a 44 percent chance. The actual causes of bed-wetting are physical, which means your child has no control over them:
- She has a developmental lag. There are late walkers, late talkers -- and late dry-nighters. And all eventually catch up.
- She may sometimes sleep so deeply that she fails to wake up when she needs to use the bathroom.
- She may have a small bladder that's more easily overfilled.
Nap time vs. nighttime
"Nighttime control can lag behind daytime control by a few months to a few years," says David Joseph, M.D., chief of pediatric urology at Children's Hospital in Birmingham, Alabama. A preschooler's bladder may still be too small to contain a night's worth of urine. Plus, it takes time to learn to recognize that almost-full feeling -- and either wake up or instinctively hold it -- especially if your child's a heavy sleeper. Nighttime dryness will happen naturally as your child learns to key in to his body's signals, and there are ways to (gently) help him along.
When to let the doctor know
Although you may be tempted to see if your child will ditch his bed-wetting habit on his own, it's a good idea to talk to her pediatrician after the third or fourth time it happens. Many parents are embarrassed to discuss the problem with the pediatrician, but together you can figure out how best to help your child stay dry. Your child's doctor will:
- Do a urinalysis to be sure there's not a kidney problem, which, though not common, can lead to bed-wetting.
- Consider your child's nighttime breathing pattern, since studies have shown a link between bed-wetting and sleep apnea. This partial airway obstruction, sometimes due to large tonsils, interferes with the sleep cycle and can trigger bed-wetting.
If these potential triggers are ruled out, it's safe to assume that the bed-wetting is a normal immaturity of the bladder-brain communication system. Explain to your child that she's not to blame, and then take steps to help ease her out of this harmless phase.
How to help
- Limit drinks after dinner, and keep caffeinated beverages to a minimum all day (they irritate the bladder and make the kidneys produce more liquid).
- Start the habit of using the bathroom right before bed.
- Explain that it's okay to get up during the night to go to the bathroom. (And leave a nightlight on in there.)
- Consider stationing a portable potty (and a nightlight) in your child's bedroom.
- Don't wake your child to use the potty before you turn in -- it won't teach him to get up on his own.
- Never push him, shame him, or make him sleep in a soggy bed. It could have the opposite effect, causing daytime accidents and lowering self-esteem.
- Offer simple reinforcement -- a sticker, say, and words of praise -- when there's a dry night.
- Expect accidents. Retire the diapers once your child's able to stay dry five nights in a row (it's fine to bring them back out if his streak doesn't last), but don't take the plastic cover off the mattress for another year or so.
If the problem persists and your child has not outgrown his bed-wetting by the time he turns 6 or so, you might ask the doctor about a moisture-sensitive pad that fits in underwear and sounds an alarm at the first trickle of pee. He may also prescribe DDAVP, a tablet or nasal spray that slows the production of urine at night.
Most kids outgrow bed-wetting without treatment. The best thing you can do is support your child by being patient. Don't let siblings tease him. Reassure him that lots of other kids have the same problem even though they don't talk about it, and that things will get better as he grows. And in the meantime, offer plenty of encouragement and a pat on the back for dry nights.