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Five things you should know about bedwetting among children

Pediatric Nurse Practitioner Jessica Stafford Draper shares a few tips to help parents understand the causes of and solutions for bedwetting.
Often, changing daytime habits or avoiding certain drinks may resolve bedwetting. Sometimes, however, bedwetting can be a sign of a more serious health problem. University of Minnesota Health expert Jessica Stafford lends answers several common questions about bedwetting.

Here’s a counterintuitive thought: If your child wets the bed, it might because he or she isn’t getting enough water or other fluids.

Kids can easily get distracted and forget to hydrate themselves during the day, according to Pediatric Nurse Practitioner Jessica Stafford Draper, NP, who is a University of Minnesota Health pediatric urology specialist. This may also occur if they are in school and do not have access to adequate fluids during the school day. If they go prolonged periods during the day without drinking, they may get thirsty in the evening and drink more water, which sets the stage for bedwetting. Dehydration also causes irritation to the bladder, which can then lead to increased frequency of urination.

There are many possible causes for bedwetting beyond daytime dehydration, which is why parents who are at their wit’s end seek out Draper’s expertise when their child struggles with bedwetting. Here are five things Draper believes parents should know about the topic, known medically as nighttime enuresis.

Learn more about our pediatric urology services.

In most cases, children simply outgrow the problem.
Roughly one in six children age 5 or younger have a problem with bedwetting. Most children outgrow bedwetting. By age 10, more than nine out of 10 children no longer struggle with bedwetting. This occurs, in large part, because of a maturation issue. As a child physically matures, his or her brain is better able to interpret and respond to messages from the bladder.

When treating children who experience bedwetting, the goal is create a normal adult voiding pattern with time, and without the use of the fluid restrictions, medication or a bedwetting alarm. These interventions should be viewed as temporary, if they are needed.

The problem most likely isn’t serious.
Bedwetting rarely indicates an underlying medical condition. Typically, the problem simply occurs because the child’s brain and bladder are still learning to communicate. Some children sleep so deeply that the bladder’s “emergency” signals can’t break through to wake them.

In fact, parents who use a “bedwetting alarm,” which detects moisture, often report that children sleep right through the noise. Treatment using the bedwetting alarm can take time, but in the absence of any other medical issues, it is the most successful cure for bedwetting. In such cases, it is important for the parent to wake the child, but not shut off the alarm. In other cases, Draper may prescribe anti-diuretic medication, which reduces the amount of urine produced by the body overnight.

When the problem is medical, it’s usually not serious. For instance, the child may simply be constipated, and their full bowel may put significant pressure on the adjacent bladder. In such cases, a simple bowel regimen may solve or decrease the problem.

Bedwetting can sometimes be resolved by changing habits.
To stop bedwetting, Draper recommends limiting beverages with caffeine or carbonation, like soda, because these can stimulate the bladder. Parents can also limit fluid consumption in the evening—as long as the child doesn’t become dehydrated. Stress can also cause bedwetting in children, so removing stressors from the child’s daily life may also relieve the issue.

It may still be a good idea to see a health care provider.
On occasion, bedwetting can be a sign of something more serious, such as sleep apnea, snoring, daytime wetting, urinary frequency, urinary urgency, bedwetting after a prolonged period of dryness or an infection in the urinary tract. Bedwetting is considered normal in children ages 5 and younger. But if the child continues to have a problem after the age of 6 or 7, and especially if there are other symptoms such as painful urination or oddly colored urine, a trip to the clinic is warranted. Our M Health staff take a comprehensive team approach to health—and our patients have access to a wide range of multi-disciplinary care options.

Bedwetting isn't anyone's fault.
Wetting the bed doesn’t mean the parents did a bad job with toilet training. Nor does it mean that your child is lazy. The problem may be partly genetic, and even when a lifestyle change is mandated, the factors aren’t always in a parent’s or child’s control. Draper often works with schools to make sure children are getting enough hydration, and are taking regular bathroom breaks to build habits and develop an improved bladder-brain connection.