No. 18; Updated December 2014
Many parents are concerned when their child continues to wet their bed at night past the age of three years old. Since most children begin to stay dry through the night around three years of age their concerns are valid. However, child and adolescent psychiatrists stress that bedwetting is fairly common and not a disease. Occasional accidents may occur, often when the child is ill. Parents need to be understanding particularly if the child has been able to have a majority of dry nights. Some facts parents should know about bedwetting:
- About 15 percent of children wet the bed after the age of three
- Many more boys than girls wet their beds
- Bedwetting runs in families
- Usually bedwetting stops by puberty
- Most children who wet the bed do not have emotional problems
Continued bedwetting beyond the age of three or four rarely signals a kidney or bladder problem. The child’s pediatrician or family doctor can help rule out medical causes such as infection. Bedwetting may sometimes be related to a sleep disorder. In most cases, the child's bladder control might be slower to develop. Bedwetting may also be the result of the child's tensions and emotions that require attention.
- There are many emotional reasons for bedwetting. For example, when a young child begins bedwetting after several months or years of dryness during the night, this may reflect new fears or insecurities. Often, this may follow changes or events which make the child feel insecure, such as: moving to a new home, parents divorce, losing a family member or loved one, or the arrival of a new baby or child in the home.
Parents should remember that children rarely wet on purpose, and usually feel ashamed about the incident. Rather than make the child feel ashamed, parents need to encourage the child and express confidence that he or she will soon be able to stay dry at night. Parents may help children who wet the bed by:
- Limiting liquid drinks before bedtime
- Encouraging the child to go to the bathroom before bedtime
- Praising the child on dry mornings
- Avoiding punishments
- Waking the child during the night to empty their bladder
Treatment for bedwetting in children usually includes behavioral conditioning devices (pad/buzzer) and/or medications if behavioral tools like the ones listed above are unsuccessful. In rare cases, the problem of bedwetting cannot be resolved by the parents, the family physician or the pediatrician. Sometimes the child may also show symptoms of emotional problems--such as persistent sadness or irritability, or a change in eating or sleeping habits. In these cases, parents may want to talk with a child and adolescent psychiatrist or mental health provider, who will evaluate physical and emotional problems that may be causing the bedwetting, and will work with the child and parents to resolve these problems. Early supportive intervention will help minimize the potential emotional impact of persistent bedwetting on the child.