Your Health

Understanding bedwetting

What to do when your child doesn't wake up in time

What to do when your child doesn't wake up in time

BY AUDRA KOLESAR
Winnipeg Health Region
Wave, January / February 2016

What is bedwetting?

Bedwetting is when your child urinates while asleep. It is fairly common until age six. Some children develop bladder control faster than others, and most children who wet the bed overcome the problem between the ages of six and 10.

What is the cause? 

Bedwetting is often due to a small bladder, and as children grow, their bladders enlarge. This may explain why the problem often goes away by itself with age.

Problems with bedwetting also tend to run in families. Very rarely is bedwetting caused by a physical problem such as a urinary tract infection, diabetes, or a nerve or muscle problem.

Most often, bedwetting is related to children sleeping so soundly they do not feel their bladder getting full or cannot wake themselves up. It may take longer for the nervous system to mature in some children. The brain and the bladder may not fully communicate with each other until the child is older.

If your child has always wet the bed and has never had six months or more of dry nights, there is nothing wrong with your child. This type of bedwetting is not caused by medical, emotional or behaviour problems.

How can I help my child?

Some things you can do to help your child with bedwetting:

  • Remind your child to go to the bathroom before going to bed.
  • Put a nightlight in the bathroom and encourage your child to get up to urinate during the night as needed. Consider a portable toilet if the bathroom is far away.
  • Encourage your child to drink plenty of liquids during the day. This may help produce more urine and help enlarge the bladder. However, limit fluids two hours before bedtime.
  • Avoid drinks that contain caffeine.
  • Don't wake up your child when you go to bed. It doesn't help with bedwetting and will just disrupt your child's sleep.
  • Have your child try to wait an extra 15 minutes before using the bathroom during the day. Slowly make the times longer and longer. This can help stretch an unusually small bladder to hold more urine.
  • Avoid diapers or pull-ups. They do not help your child learn to get up at night to urinate. If you are going to use something, try training pants instead.
  • Protect the mattress from urine with a waterproof pad or cover.
  • Praise your child for dry nights and be understanding on wet nights. Do not punish your child for wetting the bed.
  • Don't bother to wake a sleeping child who has wet the bed; it is 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.
  • Establish a morning routine to deal with wet pajamas and bedding. Have your child help with the cleanup, but do not make the child feel ashamed for a wet bed.

There are some medicines that can be used to treat bedwetting for older children such as Desmopressin acetate (DDAVP). However, wetting often returns when the medicine is stopped. 

It may not stop bedwetting completely, but may be useful for special occasions like sleepovers and camp. Like all medications, it should be taken as prescribed. DDAVP can have mild side-effects, such as headache or stomach pain. It can also have more severe side-effects if not used properly or if your child has certain medical conditions such as cystic fibrosis or problems with fluid balance.

Bedwetting alarms are often helpful and are available without a prescription. The alarm goes off when your child starts to pee and teaches them to wake up when their bladder is full. Your health-care provider can give you good information about how to use the alarm properly.

What effects can bedwetting have on my child?

Bedwetting can place enormous emotional burdens on a child. A child's self-esteem can be devastated by parents who punish or embarrass their child for bedwetting, or when siblings or friends make fun of them. Getting angry does not help and may worsen the situation. Restricting fluids, shaming, and rejection do not help the child gain bladder control. These techniques only make your child more anxious. It is important to be patient and supportive and to remember that it is not the child's fault. 

When should I call my child's health-care provider?

Call your health-care provider if:

  • There are any other problems with urinating such as pain or burning, a weak or dribbly urine stream, strong odor, or blood in the urine.
  • Bedwetting is a new problem after months of being dry at night.
  • Your child also wets during the day.
  • Your child is constantly thirsty.
  • Your child has abdominal pain.
  • Your child is still wetting past five to six years of age.

Audra Kolesar is a registered nurse and manager with Health Links - Info Santé, the Winnipeg Health Region's telephone health information service.

The information for this column is provided by Health Links - Info Santé. It is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a health-care professional. You can access health information from a registered nurse 24 hours a day, seven days a week by calling Health Links - Info Santé.

Call 204-788-8200 or toll-free 1-888-315-9257.

Wave: November / December 2015

About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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