Bedwetting factsheet

Introduction

Bedwetting during the night, also known as nocturnal enuresis, is a common issue in young children. It is normal for children who can use the toilet well during the day to struggle with staying dry overnight until they are around five years old.

Bedwetting that is ongoing after the age of 6-7 can be stressful for both children and their families, especially for older children and teenagers.

Generally, bedwetting happens because your child’s body is making more urine overnight than their bladder can hold, and they cannot fully wake up in time to empty it.

Other factors can include:

hormones – during the night, the body produces a hormone that helps the bladder to hold more urine by making it more concentrated. Some children may not produce enough of this hormone
family history – children who have a family history of bedwetting are more likely to experience bedwetting themselves.
bladder and bowel problems – issues like constipation, being unable to hold on when you have the urge to wee, or not being able to empty your bladder fully
physical issues –physical issues or disability that affect the bladder and muscles
psychological issues – experiences of stress, trauma, and fear.

Remember that bedwetting usually happens when your child is in a very deep sleep. It is not something your child can control, and it is not something children do on purpose.

Diagnosis

See your local doctor if bedwetting is happening for longer than developmentally normal.

Generally, there are two types of bedwetting:

primary nocturnal enuresis – bedwetting for longer than developmentally normal with no periods of being dry for more than a few months at a time
secondary nocturnal enuresis – bedwetting that happens after your child has been completely dry overnight for over six months.

Your child’s doctor will do a physical exam and take a medical history.

They might ask about:

the amount of fluid your child is drinking
what your child is eating
your child’s sleep habits
your child’s daytime toilet habits
any trauma, events or changes that have happened recently.

Your child may also be referred to a continence nurse advisor for further checks.

Treatment

The way bedwetting is treated depends on what is causing it. If your child has a physical disability or ongoing illness that is causing bedwetting, talk to your child's treatment team about management.

For other treatment strategies, you speak to your child's doctor or local continence nurse advisor.

Medication

Some children may need medication to manage bedwetting. Medications can help reduce the amount of urine that is made overnight. Medications do not cure bedwetting but can help manage it in some cases. Speak to your local doctor for more information.

Bedwetting alarms

Bedwetting alarms help children wake up when they start to do a wee while asleep. A sensor in the underwear or bed sheet triggers a loud alarm when it touches liquid.

Over time, this can help lower the amount of bedwetting accidents. Bedwetting alarms must be used consistently to work. Parents and carers must be able to respond to the alarm quickly and help their child get to the toilet. Speak to your local doctor for more information.

Management

Constipation

Constipation is when your child has hard poo that is difficult to pass. Constipation puts extra pressure on the bladder and can cause issues with bladder control during the day and at night.

To prevent constipation, make sure your child drinks enough fluids and eats a healthy, fibre-rich diet. Talk to their doctor, nurse, or dietician for help with diet and constipation.

Bladder irritation

Dehydration can irritate your child's bladder, making it difficult to know when to do a wee.

Encourage your child to drink enough water during the day to keep their bladder healthy and their body hydrated.

Avoid drinks that irritate the bladder, including drinks that are:

fizzy
sugary
caffeinated.

Emotional support for bedwetting

If your child is wetting the bed due to stress or trauma, your doctor may refer you to a psychologist for support and treatment. Emotional and psychological support is important as bedwetting can be challenging and emotionally taxing for both your child and your family.

Managing emotions can be difficult when sleep is disrupted. Your child may also feel embarrassed and upset about bedwetting, affecting their self-esteem and confidence.

Emotional support for bedwetting can include:

being patient and avoiding showing anger or frustration in front of your child
talking to your child about bedwetting, explaining what is normal and how you are working on treatment
letting your child know they are doing the right thing when they come to you for help at night.

Managing bedwetting at home

To manage bedwetting at home:

encourage your child to drink a good amount of fluids during the day – for example, use a water bottle marked with different times to help them stay on track.
keep a laundry basket and spare set of pyjamas close to your child's bed to make it easier for them to change after an accident
buy a nightlight to help your child find their way to the toilet in the dark
set a good sleep routine and limit screen time before bedtime
use a mattress protector and waterproof or absorbent sheets and pads on your child's bed to make cleaning up easier at night.

It's important to note that urine can have a strong smell that can be difficult to remove. This can impact your child's health and self-esteem.

Make sure you:

help your child to have a bath or shower after an accident
change their clothes and underwear
wash any sheets, toys, or clothing that have come into contact with urine as soon as possible.

When to see your doctor

See your local doctor if your child:

wets the bed regularly beyond the age of 6-7
starts wetting the bed suddenly after a year of being dry
is distressed about regular bedwetting.
has trouble staying dry during the day after being toilet trained.

Bedwetting