Why my child is bedwetting?

Bedwetting is divided in two groups.

1. Primary bedwetting refers to children who have never been consistently dry at night.
2. Secondary bedwetting refers to children who were dry for at least six months before they started wetting again. Because nighttime wetting is common in young children, doctors don’t diagnosis a child as being a bedwetter until he reaches six years of age.

Does bedwetting run in families:

Most children who wet the bed have at least one parent or another close relative who had the same problem as a child.

Why do children wet the bed?

Bedwetting is due to a maturational delay in the way the brain and bladder communicate with each other at night. There are three main factors that contribute to the problem.

• Bladder size: Children who wet the bed usually have bladders that are smaller than their peers. This causes them to urinate more frequently during the day and their bladder has less room to “hold” urine at night.
• Night time urine production: The brain produces a hormone at night that reduces the amount of urine the kidneys make. Some children who wet the bed produce less of this hormone and thereby produce more urine while they sleep.
• “Deep” sleep: Some children have difficulty waking up at night in response to internal or external stimuli. As a result, the brain may not respond when the bladder signals that the child needs to urinate.

Do medical disorders cause bedwetting?

If a child has primary bedwetting, a medical problem is unlikely to be the cause of the wetting. However, if a child has secondary bedwetting, a medical problem may be the culprit. Disorders that can cause bedwetting include urinary tract infections, diabetes, snoring that interferes with a child’s breathing, and certain neurological disorders. These conditions can be readily be identified for by your doctor.

Another factor is constipation. Because the rectum is located behind the bladder, constipation can interfere with bladder emptying or the way the bladder signals the brain that a child needs to go. This can lead to both daytime and nighttime wetting episodes.

Do psychological problems cause bedwetting?

Although children may start wetting the bed after an episode of emotional stress, psychological problems are not responsible for primary bedwetting. Examples of stressful situations that can trigger secondary bedwetting include moving to a new home, changing schools or the death of a loved one. The wetting usually resolves when the stress passes.

Does bedwetting go away on its own?

After the age of six, 15% of children who wet the bed become dry every year with no intervention. Although children usually follow the same pattern as family members, this is not always the case. Because there is no way to predict when a child will overcome his wetting, it is important to address the problem once he is motivated to become dry.

How can I tell if my child is motivated to become dry?

There is no cutoff age but mostly we are concerned by the time they are seven. There are five signs you can look for to see if your child is ready to do the work necessary to become dry.

• He starts to notice that he’s wet in the morning and doesn’t like it.
• He tells you he doesn’t want to wear Pull-Ups anymore.
• He tells you he wants to be dry at night.
• He asks if you wet the bed when you were a child.
• He doesn’t want to go on sleepovers because he is wet at night.

Can I help my child avoid the negative feelings associated with bedwetting?

There a number of steps you can take to help children feel better about themselves.

• Do not punish or shame your child for being wet at night.
• Remind your child that bedwetting is no one’s fault.
• Let your child know that lots of kids have the same problem.
• Let your child know if you or anyone in the family wet the bed growing up.
• Make sure your child’s siblings do not tease her about wetting the bed.
• Reinforce any efforts your child makes to help with her wetting, e.g. stripping the bed or helping you carry wet bedding to the laundry room.
• Praise your child for success in any of the following areas: waking up at night to urinate, having smaller wet spots, and having a dry night.

Does fluid restriction help children stay dry?

Some doctors believe that restricting fluids after dinner helps children stay dry. Although this helps some kids, it doesn’t work for most—if a child limits fluids, he may wet the bed with four ounces of urine instead of six, but he’s usually still wet. My approach to this issue is practical. If a child tells me that limiting fluids helps him stay dry, I give it my “okay.” Otherwise, I don’t recommend this approach because some children will see it as a punishment.

Does it help if parents take children to the bathroom before they themselves go to sleep at night?

Waking your child to go to the bathroom is called “lifting” because they are often carried or guided zombie-like to the toilet. Although this will help some children stay dry at night, it is a temporizing solution and does not actually teach them to be dry at night. That said, it is a simple method that can help until a child outgrows the problem or is ready to work on other methods to become dry.

What is the best way to treat bedwetting?

The most effective treatment for bedwetting is a product called the bedwetting alarm. Most bedwetting alarms are small, battery-operated devices that children wear to bed at night. The device teaches the child’s brain to pay attention to her bladder while  sleeping. Bedwetting alarms have two basic parts:

(1) a wetness sensor that detects urine and (2) an alarm unit that produces a loud sound when a child wets the bed.

How does the bedwetting alarm work? 

The alarm’s sensor has the ability to detect small amounts of moisture. When a child wets the bed, the urine in his the child so he can go to the bathroom and finish urinating in the toilet. (In the beginning, most parents have to wake their child when the alarm goes off.) After weeks of hearing the alarm, the child’s brain learns to pay attention to the full bladder signals and he starts to wake up before wetting the bed. Interestingly, most children stop waking up at night to urinate over time. This happens because the bladder learns to hold all of its urine until morning.

Are there other methods to help children become dry?

Although the bedwetting alarm is the most effective device to help children become dry, there are other behavioral techniques that can be used alone or in combination with the alarm.

• Motivational counseling: Research shows that children will be more invested in becoming dry if they are actively involved with the program. This means letting them help with all aspects of the treatment plan.
• Dryness calendar: Children use this to record wet and dry nights and to monitor their progress. Younger children like to put stickers or stars on their calendar whenever they have a dry night.
• ladder exercises: bladder exercises consist of drinking more water during the day and teaching children to respond promptly when their bladder signals that they need to urinate.
• Waking up practice: This is an exercise that helps children learn to wake up at night if they can’t hold all of their urine until morning.

Are drugs an effective way to treat bedwetting?

There are a few medications available to treat bedwetting. The one that’s prescribed most often is called desmopressin (brand name: DDAVP). Desmopressin is a manufactured form of the hormone the brain produces to decrease urine production at night. It helps 50% of children who take it, though it appears to be less effective in children who have small bladders.