Bedwetting: what can you do about it?
(2021 • 07 • 29)
Last week, we talked all about potty training, and how to help little ones take charge of their bladders and bowels throughout the day. However, as some of you may already know, the nighttime can be an entirely different kettle of fish. While some children may stay dry through the night from fairly early on, for others, this may be more difficult.
Bedwetting - or nocturnal enuresis - can be an embarrassing problem that both parents and children can struggle to talk about. In fact, one study in Australia found that only a third of parents of children struggling with nocturnal enuresis sought any kind of help. So, in this blog, we’re going to take a look at what causes bedwetting, and how you can help your little one stay dry.
First up, what’s normal?
While most children will be potty trained and out of nappies during the day by the age of 3, bedwetting can continue much later than this. In fact, according to Bladder and Bowel UK, regular nighttime wetting is not considered to be a possible medical problem until after the age of five. And, even then, 20% of five year olds, 10% of 7 year olds, and even 1-2% of adults wet the bed.
So, if your 4 year old still has accidents, don’t worry, this is very normal!
What causes bedwetting?
For many years, it was thought that nocturnal enuresis was caused by stress. However, according to Patrina Caldwell (an academic paediatrician and associate professor in Child and Adolescent Health at the University of Sydney), this has been largely disproven. “The psychological cause of bedwetting is minimal… 1 to 2 per cent, if that,” states Caldwell.
In fact, the reason some children wet the bed is (usually) very straightforward. There are three factors involved: the size of the bladder, the amount of urine, and the ability to wake up. So, if someone has a bladder big enough to hold all the urine produced at night, they can sleep right on through and stay dry. If their bladder isn’t big enough, they’ll need to be able to wake in response to it being full, get up, and go to the loo. However, if the bladder is too small for the amount of urine, but they are not woken by fullness signals, they’ll wet the bed.
As Caldwell puts it: “Children don’t deliberately wet the bed. They wet the bed because when their bladder is full, they don’t know how to wake up and go to the toilet.”
So, bedwetting is nobody’s fault! While bedwetting can run in families, it isn’t something that either children or their parents can control. It’s easy for parents to feel like they’re doing something wrong if their little one can’t stay dry through the night, but we assure you this is not the case.
However, if your little one has been dry at night for a while and suddenly starts wetting the bed again, this could be sign of a deeper issue, such as constipation, type 1 diabetes or emotional stress. If your child has a sudden onset of bedwetting, or is continuing to wet the bed into late childhood or early adolescence, contact your GP so they can help you identify the cause.
So, if my little one can’t control their bedwetting, is there anything I can do to help them stop?
Yes! Here are some top tips for helping your little one learn to stay dry at night:
- Stay hydrated.
Some children who are struggling with bedwetting may avoid drinking enough water in an attempt to combat the problem. However, as we mentioned in our previous blog, drinking plenty of water stretches the bladder, making it easier to hold on to the urine produced overnight.
Primary school aged children should be drinking around 1.5l of water every day, or more if the weather is hot or they’re being particularly active. Try not to give them fizzy, caffeinated or very sugary drinks, however, and if possible, avoid all food and drink for an hour before bedtime.
- Make sure they’re using the loo.
According to the NHS, children should be going to the toilet around 4 to 7 times a day. Keep an eye on your little one’s toileting habits to ensure everything is working correctly - constipation can cause children to avoid the toilet altogether.
It’s also a good idea to encourage them to use the toilet before going to bed. You could even try implementing a sticker chart to encourage them!
- Talk about it.
A lot of people hate talking about bowel and bladder movements. But, when it comes to our little ones, it’s important to be open and honest. Most children want to be dry by around the age of 5, so it’s important they know they can talk to you about any issues, and have a clear understanding of what is expected of them.
- Think about accessibility.
Does your little one know where they can go during the night? How easy is it for them to get there? Can they get their pyjamas off? Make sure clothes are easily removable, and maybe consider having a potty in the bedroom.
- Make sure they’re getting plenty of sleep.
As we mentioned above, an element of our ability to stay dry is being able to wake up. A number of studies have found that children who suffer from nocturnal enuresis are more likely to have sleep disorders, and that improved sleep quality may help them to wake in response to bladder signals.
With this in mind, Bladder and Bowel UK recommends implementing a good bedtime routine by going to bed at the same time every day, avoiding screens for a while beforehand, and turning off the lights in the bedroom.
It’s also not a good idea to wake your little one regularly throughout the night to get them to go to the toilet. While regular toilet stops may help with potty training, this will not necessarily help them to wake in response to a full bladder, and will stop them from getting the sleep they need.
- Be kind.
Bedwetting can cause a lot of anxiety for children but, as we mentioned before, is something they cannot control. Punishments for wetting the bed will only add to this distress, which, in turn, could affect sleep, drinking and toileting habits, making the problem worse. According to Patrina Caldwell, the main reason treatments for bedwetting fail is that the child or young person becomes too embarrassed and gives up.
- Try an alarm.
If nocturnal enuresis is a persistent issue for your little one, you could try a bedwetting alarm, which works by waking your child when they start to wet. However, it’s important to understand that alarms require persistence and patience, and will usually take around 2 to 3 months to be effective. At first, your child may not wake to the alarm, wetting the bed and waking everyone else in the house! Over time, however, your little one will learn to wake in response to signals of fullness from the bladder, waking first when the alarm goes off, and eventually not needing it at all.
- Don’t be embarrassed.
If bedwetting is a consistent issue for your little one past the age of 5, go to your GP! You won’t be judged, or seen as doing something wrong: they’ll be able to help.
So, I hope this helps, and wish many a dry night upon you and your family!
Content Creator at MEplace