Bed-Wetting / Enuresis

Parents often become 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, enuresis (bed-wetting) is a fairly common symptom and not a disease.  Keep in mind that occasional accidents may occur, often when the child is ill.  It is important that parents be understanding, particularly if the child has been able to have a majority of dry nights. These are some facts parents should know about bedwetting:

  • Bedwetting runs in families
  • Usually bedwetting stops by puberty
  • Boys wet their beds more often than girls
  • Most bedwetters do not have emotional problems
  • Approximately 15 percent of children wet the bed after the age of three

In most cases, bedwetting it is due to the development of the child’s bladder control being slower than normal.  Bedwetting may be related to a sleep disorder.  In addition, it can also be the result of the child’s tensions and emotions that require attention.  There are a variety of emotional reasons for bedwetting.  For example, when a young child begins bedwetting after several months or years of dryness during the night (secondary enuresis), this may reflect new fears or insecurities the child is having.  Often, this may follow changes or events which make the child feel insecure.  Such things as:  moving to a new home, parental divorce, losing a family member or loved one, or the arrival of a new baby or child in the home, all can trigger new onset bedwetting.

It is important for parents to 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:

  • Avoiding punishments
  • Limiting liquids before bedtime
  • Praising the child on dry mornings
  • Waking the child during the night to empty their bladder
  • Encouraging the child to go to the bathroom before bedtime

Treatment for bedwetting in children usually includes behavioral conditioning devices (bell & pad/buzzer) and even medications, if behavioral interventions are unsuccessful.   Sometimes the child may also show symptoms of emotional problems.  When persistent sadness, irritability, or a change in eating or sleeping habits becomes evident, parents may want to talk with a child and adolescent psychiatrist.  He/she will evaluate physical and emotional problems that may be causing the bedwetting, and will work with the child and parents to resolve these problems. Bare in mind that early supportive intervention will help minimize the potential emotional impact of persistent bedwetting on the child.