Bedwetting

Bedwetting occurs when a child urinates (pees) during his sleep without knowing it, at an age when this would not usually happen. Most, but not all children, stop bedwetting between the ages of 5 and 6 years.

What causes bedwetting?
If your child stopped wetting the bed for at least 6 months and then started again, talk with your doctor. If your child has always wet the bed and has never had 6 months or more of dry nights, there is nothing "wrong" with your child. This type of bedwetting is NOT caused by medical, emotional or behavioural problems.

Bedwetting is most often related to deep sleep. Your child doesn’t wake up when his bladder is full because he is such a deep sleeper. Some children have smaller bladders, or produce more urine during the night. Other children who suffer from constipation may also experience bedwetting because of the bowel pressing on the bladder.

Does bedwetting run in families?
Yes. In fact, scientists have discovered a gene for bedwetting. If one parent wet the bed as a child, their child has a 25% risk of bedwetting. If both parents wet the bed as children, their child’s risk increases to about 65%.

Bedwetting is more common in boys.

Do children outgrow bedwetting?
Yes. At 5 years of age, 15% of all children wet the bed. By 8 years, 6 to 8% wet the bed. Even without treatment, this number goes down to 2% by 15 years of age.

Does bedwetting need to be treated?
Usually not. The most important question is whether the bedwetting is a problem for your child. If bedwetting isn’t upsetting her, then treatment probably isn’t necessary. Children will outgrow it. By 8 to 10 years of age, however, bedwetting may affect your child’s self-esteem and can affect with social activities like sleepovers.

If you and your child’s doctor decide that the bedwetting should be treated, there are a couple of options:

One treatment is an alarm that the child wears at night which goes off when he starts to pee. The goal is to teach him to wake up when he has a full bladder. Studies show that alarms work in only about 50% of children who use them, so it’s best to talk to your doctor before you decide to buy one. Also, alarms usually wake up others in the house, so they aren’t practical for sleepovers or camp.
Desmopressin acetate (or DDAVP) is a drug that has been used to treat bedwetting since the 1970s. It comes as an oral melt (a tablet that melts under the tongue), a pill or as a nasal spray. Studies show that it works in most children on nights the medication is given. It wont' stop bedwetting completely, but it may be useful for special situations, such as sleepovers or camp. Children should not drink water 1 hour before and 8 hours after taking DDAVP. DDAVP can have mild side effects, such as headache or stomach pain or it can have severe side effects if not used properly or if your child has certain medical conditions. Like all medications, DDAVP should be used only as prescribed by your doctor. Health Canada advises that the oral form of the medication is safer for your child than is the nasal spray.

Whether you and your doctor decide to treat the bedwetting or simply wait for your child to outgrow it, be sure that your child knows bedwetting is not a bad behaviour. It is not his fault. Comfort and support are very important.

What else can I do to manage the amount and effects of bedwetting?

Make sure your child doesn’t drink too much fluid before bedtime.
Avoid drinks with caffeine (such as colas).
Encourage your child to go to the bathroom before bedtime.
Use training pants instead of diapers.
Make sure your child can easily reach the bathroom at night. For example, use a night light in the hall or in the bathroom.
Use a hospital-strength plastic mattress cover to avoid damage to the mattress.
Place a large towel underneath the sheet for extra absorption.
Don’t bother to change a sleeping child who is wet. It’s more important for everyone to get a good night’s sleep. Leave a towel and change of clothes in case your child does wake up.
When your child does wet the bed, help him wash well in the morning so that there is no smell.

Talk to your doctor if your child:

Wants to be dry at night and is concerned by the bedwetting.
Is having daytime accidents.
Is dry for many months and then suddenly starts bedwetting.
Has other symptoms such as a frequent need to pee or a burning sensation when he pees.
Is still wetting at 5 to 6 years of age (or older).

For more information: Enuresis, a statement of the Canadian Paediatric Society

Reviewed by the CPS Community Paediatrics Committee and Public Education Subcommittee

Updated: September 2007

This information should not be used as a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

Canadian Paediatric Society
2305 St. Laurent Blvd.,
Ottawa, Ont. K1G 4J8
Phone: 613-526-9397, fax: 613-526-3332